HIP SPECIALIST NYC

1. What Tests Do Health-Care Professionals Use to Diagnose Hip Pain? History Making the diagnosis of the cause of hip pain begins with the health-care professional talking with the patient, their family, or caregivers and taking a careful history of the what, where, and when of the pain as well as reviewing any other underlying complaints. By factoring in the past medical history of the patient, the health-care professional can make a differential diagnosis or list of what potential causes might be considered. The physical examination helps refine that list, and tests may be done to confirm a specific diagnosis. Sometimes the diagnosis is evident. The patient fell, hurt their hip, can't bear weight, and X-rays show a fractured hip. Sometimes the diagnosis requires more searching and may take time and repeat visits to find the source of the hip pain. The history may involve many questions regarding everything from the onset of the hip pain to what makes it better or worse. The goal is for the health-care professional to understand the frequency, duration, and context of the pain in relationship to the daily activities of the patient. Aside from the history of the pain, other information looking for a systemic illness may be helpful in finding the cause of pain. Has there been an injury? Has there been a history of fever or chills? Weight loss? Abdominal pain? Diarrhea? Do other joints hurt or swell? While the questions may seem unrelated to the hip, it is necessary for the health-care professional to consider all possibilities. A review of past medical history, including medications, may give direction to assessing the situation. Physical Examination The physical examination for hip pain most often will focus on the hip, leg, and back, however, the rest of the body will not be ignored; a health-care professional will look for associated findings that may help explain the patient's complaints. Observation of the hip at rest and while standing or walking, palpation (or feeling) of the hip and surrounding structures, testing for range of motion and strength, and checking for sensation and pulses all may be appropriate. Imaging Many times plain X-rays of the hip and pelvis are done to look at the bones and the joint spaces. In a fall, this may diagnose an acute fracture, but occasionally, the break cannot be seen on routine films. If the suspicion for fracture is high,

2. computerized tomography (CT) or magnetic resonance (MRI) imaging may be considered to confirm or disprove that a fracture is present, even in the presences of normal plain X-rays. The bone fracture may be occult (hidden). Narrowed joint spaces and arthritis can be seen on plain X-rays and help confirm the diagnosis of osteoarthritis and degenerative joint disease. When looking for cartilage or labrum tears in the hip, an arthrogram may be done, in which a radiologist injects contrast dye into the hip joint using a long thin needle. Usually, MRI images are taken to look at the joint surfaces outlined by the dye. With the test, a local anesthetic is injected prior to the dye. It is helpful to know if the anesthetic resolves the pain, because if so, it may confirm that the source of the pain is from within the joint. A bone scan may be performed to look for inflammation. Radioactive dye is injected intravenously, and the whole body is scanned. The radiologist looks for abnormal accumulations of the dye that may help establish a diagnosis. This might be helpful in determining whether it is a single hip joint that is involved or whether multiple parts of the body are also inflamed. Blood Tests If the health-care professional is concerned that a systemic (body-wide) illness is the cause of the hip pain, blood tests may be ordered. Some markers for inflammation include elevation of the white blood cell count, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). These are nonspecific tests but can help direct further testing based upon the clinical situation. A white blood cell count may also be helpful as a screening test for infection and inflammation. When to see a doctor You may not need to see a doctor if your hip pain is minor. Try these self-care tips: ● Rest​​. Avoid repeated bending at the hip and direct pressure on the hip. Try not to sleep on the affected side and avoid prolonged sitting. ● Pain relievers​​. Over-the-counter pain relievers such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) may help ease your hip pain. ● Ice or heat​​. Use ice cubes or a bag of frozen vegetables wrapped in a towel to apply cold treatments to your hip. Conversely, a warm bath or shower may help prepare your muscles for stretching exercises that can reduce pain.

3. If self-care treatments don't help, make an appointment with your doctor. Seek immediate medical attention Ask someone to drive you to urgent care or the emergency room if your hip pain is caused by an injury and is accompanied by: ● A joint that appears deformed ● Inability to move your leg or hip ● Inability to bear weight on the affected leg ● Intense pain ● Sudden swelling ● Any signs of infection (fever, chills, redness) Help for Your Hip Pain Your hip hurts, and you don’t know what to do. Is it serious enough to see a doctor? Or should you tough it out a little longer? It depends on what the problem is. "The hip is a complicated region with the bony joint itself, 24 muscles that cross it, and a lot of nerves," says Peter Moley, MD, of the Hospital for Special Surgery in New York. The first step is to get clear on what you feel and whether it’s a new problem or an old one that’s flaring up. Or maybe it’s not even your hip at all. "Most people don’t know where their hip is," says Andrew Freiberg, MD, chief of the Center for Hip & Knee Replacement at Massachusetts General Hospital in Boston. When you "put your hands on your hips," you might actually put them on part of your pelvis. Your hip joint is much deeper, closer to the groin, and harder to feel with your fingers.

4. "If you’re sitting in a chair and you put your right hand across your body to your left hip and you bend your knee up towards the ceiling a little bit, you can feel where it rotates and bends," Freiberg says. "That’s where the hip joint is." Keep Moving Did your hip pain begin after you started a new workout plan or activity? "Stop the program, but don’t stop all activity," Moley says. "Frequent moderate activity is probably the healthiest thing you can do for a joint, whether it’s the joint or the muscle that’s causing you pain," Moley says. "Completely shutting down isn’t good for you." Try These Exercises While you take a few days rest from the activities that might cause your pain, try these other exercises that Moley recommends. "Work on stretching, balance, and range of motion," he says. Figure-four stretch:​​ Hold onto something if you need to while doing this exercise. ● Stand on one leg. ● Bend the knee of the other leg, and place the ankle of that leg on your standing knee. Your legs should make the shape of the number four. ● Bend your standing knee as if you were sitting down in a chair with one leg crossed over the other. You should feel a deep stretch in the hip muscles on the standing leg side. ● Do this on both sides. Try These Exercises continued... Hip flexor stretch:​​ Hip flexors are the muscles at the hip that allow you to raise your leg, for example, when you walk, run, or kick.

5. ● Kneel on one knee so that the leg you're kneeling on forms a 90-degree angle. ● Extend the other leg behind you so that the knee is on the floor. You might want to put a towel under the knee to cushion it. ● Shift your pelvis forward until you feel a stretch in the muscles across the top of the hip and thigh in the extended leg. ● Do this on both sides. Balance exercise:​​ Practice standing on one leg. Alternate sides for several repetitions. Range of motion:​​ Stand on one leg and raise the knee of the other leg towards your chest. Keep the knee bent and open the leg out to the side. Do several repetitions on each side. Should You Ice It? If the pain is truly in your hip joint, ice probably won’t reach it. The hip joint isn’t close to the surface of the skin like the knee, Freiberg says. If it’s muscle pain and swelling at the front or side of the hip, ice might help. "Ice can be good for bursitis because it’s pretty near the skin," Freiberg says. Bursitis is a painful swelling of the bursae. These are fluid-filled sacs that cushion ligaments, muscles, and tendons so they can glide smoothly over bone. When these sacs swell, that movement becomes painful. What Can You Take? Over-the-counter anti-inflammatory pain medications, such as ibuprofen or naproxen, can help.

6. Moley tells his patients to take painkillers for about 48 hours, but not for weeks or months on end. Taking an anti-inflammatory for too long can have side effects. "Normal healing requires a certain amount of inflammation, so just take a short dose," he says. You can ask your doctor or pharmacist to make sure it’s OK for you to take a medicine. And of course, you should follow the directions on the label. When to See a Doctor A little rest, ice, and over-the-counter painkillers might be all you need. "If your pain is lasting for 4 to 6 weeks and not improving, you should probably have someone look at it," Moley says. If your pain returns as soon as you get back to your regular exercise routine, it could be a stress fracture, Freiberg says. If you lose range of motion, limp, or feel pain when you walk, these are signs you should see a doctor. "You don’t just suddenly lose range of motion in your hip. That happens over years. Not weeks or months," Freiberg says. People with hip arthritis might find it hard to put on their shoes. They might feel especially stiff after long periods without movement, such as sitting or sleeping or after a hard workout. Groin pain, which may be worse at night, could also be a sign of hip arthritis.

7. If you notice any of these things, get it checked out. For hip pain, you can see your regular doctor, an orthopaedic surgeon, or a nurse practitioner or physician assistant who works with an orthopaedic surgeon. https://nydnrehab.com/blog/hip-injury-doctor-hip-pain-specialist-in-nyc-new-york/