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To Your Good Health: Underlying problem needs to be identified | Columnists

1 week ago Angie K. Claar

Pricey DR. ROACH: I am a 65-year-aged girl and have experienced suffering in my ideal hip for a lot more than a year. I have a ordinary overall body mass index. My common practitioner diagnosed trochanteric bursitis and recommended stretches as well as Voltaren cream to minimize the agony. The stretching assisted command the ache, but Voltaren cream did almost nothing for me.

At my previous appointment, I asked my GP if a cortisone injection would minimize the pain, but she was not ready to try out it, stating the use of cortisone would weaken the hip joint.

I bike 10 miles or wander 5 miles each day to get body weight-bearing exercise for osteoporosis. Do you have any tips? — NH

Respond to: Greater trochanteric discomfort syndrome (the agony is absolutely near the bursa, but it turns out the bursitis isn’t typically the most important challenge) is a frequent condition — most frequent in girls in their 60s — that is generally prompted by extra worry to the tendon of the gluteus medius muscle mass. Ache and tenderness where by the tendon inserts on the bone in the aspect of the hip is the essential actual physical exam getting to make the diagnosis.

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Prior to discussing therapy, it is important to take into account why folks get it. It is typically from irregular motion of the hip, which in convert can be brought about by many issues, such as problems with the foot or knee. Bone issues, like scoliosis or a leg-duration discrepancy, predispose to this affliction. Treating the lateral hip soreness without contemplating the underlying dilemma may possibly assist at first, only to guide to recurrences of the ache.

The gluteus muscle tissue operate with forceful extension of the hip, this kind of as stair or hill climbing or highly effective biking, this kind of as sprinting or hill climbing. All of these can worsen your problem. Momentary reduction in exercise till the suffering gets underneath management is prudent.

My particular tactic to this situation is a mixture of injection of a cortisone-like drug and physical treatment. For all those who elect not to get the injection, oral anti-inflammatories can be substituted. Topical anti-inflammatories like diclofenac (Voltaren) gel are most successful for folks with a regular or below-normal BMI, but even then do not perform on most people. A single injection, or even if repeated when, is not very likely to worsen osteoporosis or the hip joint.

Your indicators have been heading on way too prolonged, and I would refer a man or woman like you who hasn’t responded to exceptional cure to an skilled in orthopedic surgery, who may possibly attain state-of-the-art imaging (this kind of as MRI) to ensure the prognosis. I have had an occasional client with a tear of the gluteus medius tendon necessitating maintenance.

Expensive DR. ROACH: I am 76, and constipation has by no means been a concern, until eventually now! I have extensive endured from benign prostatic hyperplasia, and numerous nightly urinations are the norm. I was just lately recommended tamsulosin. Could this be the trigger for my bowel variations? — MR

Respond to: When a symptom starts just after a new medicine, it is often sensible to take into account no matter if it truly is a side impact of the medicine. It undoubtedly could be for you, but constipation is not a popular side outcome (6% of gentlemen get diarrhea, and there are only occasional studies of constipation).

Constipation is additional frequent as we get older. Sixteen p.c of 65-yr-aged guys have constipation, increasing to 26% of adult men in their 80s (the charge for females is about 10% greater). I would also acquire a look at your diet plan for any adjustments, as very well as earning certain you have satisfactory but not extreme h2o intake.

Finally, minimal thyroid ranges are widespread in more mature individuals, and it is worth a brief blood check if the dilemma persists.

Dr. Roach regrets that he is unable to respond to person letters, but will incorporate them in the column when feasible. Viewers may perhaps e-mail inquiries to [email protected] or send mail to 628 Virginia Dr., Orlando, FL 32803.

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