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To ifgo you have to sit down and breathe in. For those people who don't know how to sit or breathe I will tell you. To sit you have to bend you legs so yuo can place your bottom on a chair. To breathe you have to suck up air into to your nose or mouth.Ifgo is a word I made up to understand stuff. In my secret language If means to breath and go means to sit. While you Ifgo you have to eat fried chicken.
What else can I help you with?
Sprains?
DefinitionA sprain is an injury to the ligaments around a joint. Ligaments are strong, flexible fibers that hold bones together. When a ligament is stretched too far or tears, the joint will become painful and swell.Alternative NamesJoint sprainCausesSprains are caused when a joint is forced to move into an unnatural position. For example, "twisting" one's ankle causes a sprain to the ligaments around the ankle.SymptomsJoint pain or muscle painSwellingJoint stiffnessDiscoloration of the skin, especially bruisingFirst AidApply ice immediately to help reduce swelling. Wrap the ice in cloth -- DO NOT place ice directly on the skin.Try NOT to move the affected area. To help you do this, bandage the affected area firmly, but not tightly. ACE bandages work well. Use a splint if necessary.Keep the swollen joint elevated above the level of the heart, even while sleeping.Rest the affected joint for several days.Aspirin, ibuprofen, or other pain relievers can help. DO NOT give aspirin to children.Keep pressure off the injured area until the pain subsides (usually 7-10 days for mild sprains and 3-5 weeks for severe sprains). You may require crutches when walking. Rehabilitation to regain the motion and strength of the joint should begin within one week.Call immediately for emergency medical assistance ifGo to the hospital right away or call 911 if:You suspect a broken boneThe joint appears to be deformedYou have a serious injury or the pain is severeThere is an audible popping sound and immediate difficulty using the jointCall your doctor if:Swelling does not go down within 2 daysYou have symptoms of infection -- the area becomes redder, more painful, or warm, or you have a fever over 100FThe pain does not go away after several weeksPreventionWear protective footwear for activities that place stress on your ankle and other joints.Make sure that shoes fit your feet properly.Avoid high-heeled shoes.Always warm-up and stretch prior to exercise and sports.Avoid sports and activities for which you are not conditioned.ReferencesMercier LR. Sports medicine. In: Mercier LR, ed. Practical Orthopedics. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2008:chap 15.Krabak BJ, Baima J. Ankle sprain. In: Frontera, WR, Silver JK, eds. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 75.Geiderman JM. General principles of orthopedic injuries. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. St Philadelphia, Pa: Mosby Elsevier; 2006:chap 46.
Opisthotonos?
DefinitionOpisthotonos is a condition in which the body is held in an abnormal posture. It usually involves rigidity and severe arching of the back, with the head thrown backward. If a person with opisthotonos lays on his or her back, only the back of the head and the heels would touch the supporting surface.See: Abnormal posturingConsiderationsOpisthotonos is much more common in infants and children than in adults. It is also more exaggerated in infants and children because of their less mature nervous systems.Common CausesOpisthotonos may occur in infants with meningitis, where it is a sign of irritation of the membranes surrounding the brain and spinal cord (meninges).It may also occur as a sign of depressed brain function or injury to the nervous system.Other causes may include:Brain tumorGrowth hormone deficiency (occasionally)Glutaric aciduria and organic acidemias (forms of chemical poisoning)Krabbe Disease (disorder of metabolism)MeningitisSeizuresSevere head injuryStiff-person syndrome (a condition that involves worsening rigidity and spasms)Subarachnoid hemorrhage (bleeding in the brain)TetanusArnold-Chiari syndrome (a brain structure problem)Gaucher disease (disorder of metabolism)Drugs, particularly phenothiazines and other antipsychotic medications, can cause a side effect known as acute dystonic reaction. Opisthotonos may be part of this reaction.In rare cases, infants born to women who drink large amounts of alcohol during pregnancy may have opisthotonus due to alcohol withdrawal.Home CareHospital care is required for a person who develops opisthotonos.Call your health care provider ifGo to the emergency room or call your local emergency number (such as 911) if this symptom occurs. Typically opisthotonos is a symptom that follows late in the course of other conditions, which are serious enough that medical attention will likely have already been sought.What to expect at your health care provider's officeThis condition will be evaluated in a hospital setting. Emergency measures will be taken as appropriate.The medical history will be obtained, and a physical examination will be performed.Medical history questions documenting opisthotonos in detail may include:When did this behavior start?Is it always the same type of posturing?What other symptoms preceded or accompanied the abnormal posturing (particularly fever, stiff neck, headache, but also any others)?Is there any significant medical history (such as a recent illness)?The physical examination will include a complete assessment of the nervous system.The cause of the opisthotonos will be suggested by the history and physical examination. Diagnostic tests may include:Lumbar punctureand analysis of the cerebrospinal fluid (CSF culture, CSF cell counts, and similar studies), electrolyte analysisCT scan of the headMRI of the headBlood and urine testsReferencesChiriboga CA. HIV, fetal alcohol and drug effects, and the battered child. In: Rowland LP, ed. Merritt's Neurology. 11th ed. Baltimore, Md: Lippincott Williams & Wilkins; 2005:chap 168.
Eye redness?
DefinitionRed eyes are caused by enlarged, dilated blood vessels, leading to the appearance of redness on the surface of the eye. Alternative NamesBloodshot eyes; Red eyes; Scleral injection; Conjunctival injectionConsiderationsThere are many possible causes of a red eye or eyes. Some are cause for concern; some are medical emergencies. Others are of no consequence or concern at all. The degree of redness or appearance of blood usually does not correlate to how serious the situation is. It is generally more important whether you also have eye pain or impaired vision.Common CausesBloodshot eyes appear red because the vessels in the surface of the white portion of the eye (sclera) become enlarged and irritated. This may result from extremely dry air, sun exposure, dust, foreign body, an allergic reaction, infection, trauma, or other conditions.One common cause of a red eye is straining or coughing. This can lead to a bright red, uniformly dense bloody area on the sclera. This is called a subconjunctival hemorrhage. Although this bloody area may appear alarming, it is a fairly common occurrence and of little significance. If you notice a bloody blotch in one eye that doesn't hurt, but just looks bad, don't worry. It generally clears up on its own within a week or two.Eye infections or inflammation can occur in different locations. They cause redness as well as possible itching, discharge, pain, or vision problems:Blepharitis -- inflammation of the eyelash follicles along the eyelid. It is caused by skin bacteria. Itching is common, and your eyelids may appear greasy or crusty.Conjunctivitis-- inflammation or infection of the membrane that lines the eyelids and coats the surface of the eye (the conjunctiva). This condition is often referred to as "pink eye." It may be caused by a virus, bacteria, allergy, or irritation. If caused by an organism, this is highly contagious.Corneal ulcers-- often caused by a bacterial or viral infection. (The cornea is the outer covering of the eye.)Uveitis -- inflammation of the uvea, which includes the iris, ciliary body, and choroid. This is often related to an autoimmune disorder, infection, or exposure to toxins. Often, only the iris is inflamed, which is called iritis.Other potential causes include:Cold or allergies.Foreign objects in the eye that cut or damage the eye. (See eye emergencies.)Acute glaucoma-- a sudden increase in eye pressure that is extremely painful and causes serious visual disturbances. This is a medical emergency. Most times, glaucoma is chronic and gradual.Corneal scratches caused by sand, dust, or overuse of contacts.Bleeding problems (for example, from excess use of blood thinning drugs).Home CareFor fatigue or eyestrain, try to rest your eyes. No treatment is necessary.If you have conjunctivitis:Avoid touching the infected eye and then rubbing the other eye -- the infection can spread from one eye to the other.Apply cool or warm compresses throughout the day.Over-the-counter homeopathic eye drops may provide relief.Do not use eye makeup or wear contact lenses until the infection has cleared. Throw away items like these that you used in your infected eye.Wash your hands frequently.If you have blepharitis:Apply warm compresses to your eyes for 5 minutes. Do this at least two times per day.Using a cotton swab, gently rub a solution of warm water and no-tears baby shampoo along your eyelid, where the lash meets the lid. Do this in the morning and before you go to bed.Call your health care provider ifGo to the hospital or call 911 if:Your eye is red after a penetrating injury.You have a headache along with blurred vision or confusion.You are seeing halos around lights.You have nausea and vomiting.Call your doctor if:Your eyes are red longer than 1-2 days.You have eye pain or vision changes.You take blood thinning medication, like warfarin.You may have an object in your eye.You are very sensitive to light.You have a yellow or greenish discharge from one or both eyes.What to expect at your health care provider's officeYour doctor will take your medical history and perform a physical examination, which will include a detailed eye exam.To help diagnose the cause of the problem, your doctor will ask medical history questions, such as:Are both of your eyes affected? If only one eye, which one?What part of the eye is affected -- the white part, or elsewhere?Did the redness come on suddenly?Have you ever had eye redness before?Do you have eye pain? Does it get worse after movement of the eyes?Do you have other symptoms like eye discharge, burning, or itching? Nausea or vomiting? A headache?The eyes may need irrigation with normal saline solution, and any foreign bodies will need to be removed. Eye drops may be prescribed.PreventionTo prevent conjunctivitis:Do NOT share anything that has touched the eye of someone with this contagious condition -- like pillowcases, sheets, towels, or eyeliner.Wash your hands right away if you have come in contact with someone with conjunctivitis.Wash out any chemicals or objects from your eye immediately.ReferencesGreenberg MF. The red eye in childhood. Pediatr Clin North Am. 2003;50(1):105-124.Wirbelauer C. Management of the red eye for the primary care. Am J Med. 2006;119:302-306.Mueller JB, McStay CM. Ocular infection and inflammation. Emerg Med Clin North Am. 2008;26:57-72.Rodriguez JO. Prevention and treatment of common eye injuries in sports. Am Fam Physician. 2003;67(7):1481-1488.Rubenstein JB, Jick SL. Disorders of the conjunctiva and limbus. In: Yanoff M, Duker JS, Augsburger JJ, et al, eds. Ophthalmology. 2nd ed. Philadelphia, Pa: Mosby Elsevier; 2004:chap 55.
Breathing difficulty?
DefinitionBreathing difficulty involves a sensation of difficult or uncomfortable breathing or a feeling of not getting enough air.See also: Difficulty breathing - first aidAlternative NamesShortness of breath; Breathlessness; Difficulty breathing; DyspneaConsiderationsNo standard definition exists for difficulty breathing. Some people may feel breathless with only mild exercise (for example, climbing stairs), even though they do not have a specific disorder. Others may have advanced lung disease but never feel short of breath.Wheezing is one form of breathing difficulty.See also:ApneaLung diseasesRapid breathingCommon CausesShortness of breath has many different causes.A blockage of the air passages in your nose, mouth, or throat may lead to difficulty breathing.Heart disease can cause breathlessness if your heart is unable to pump enough blood to supply oxygen to your body. If your brain, muscles, or other body organs do not receive enough oxygen, a sense of breathlessness may occur.Sometimes emotional distress, such as anxiety, can lead to difficulty breathing.The following problems may cause breathing difficulty:Problems with the lungsPneumonia(severe)BronchiolitisChronic obstructive pulmonary disease (COPD), asthma, and other chronic lung problemsBlood clot in the arteries of the lungs (pulmonary embolism)Pulmonary hypertensionProblems with the airways leading to the lungsChoking on something stuck in the airwaysCroupEpiglottitisProblems with the heartHeart attack or anginaHeart failureHeart rhythm disturbances (arrhythmias)Children born with heart defects (congenital heart disease)Other problemsRapid ascent to high altitudes, where there is less oxygen in the airA large amount of dust in the environmentAllergies (such as to mold, dander, or pollen)Lack of exerciseObesityCompression of the chest wallPanic attacksHiatial herniaHome CareIn some circumstances, a small degree of breathing difficulty may be normal. Severe nasal congestion is one example. Strenuous exercise, especially when you do not exercise regularly, is another example.If difficulty breathing is new or is getting worse, this may indicate a serious problem. Though many causes are harmless and easily corrected, any breathing difficulty requires that you contact your health care provider.If your doctor has been treating you for a long-term problem with your lungs or heart, follow your health care provider's directions to help with that problem. (See: asthma, COPD, heart failure)Call your health care provider ifGo to the emergency room or call the local emergency number (such as 911) if:Breathing difficulty comes on suddenly or seriously interferes with your breathingSomeone completely stops breathingSee your health care provider if breathing difficulty starts suddenly or is severe, or if any of the following occur with breathing difficulties:Chest discomfort, pain, or pressureShortness of breath after only slight exertion or while at restShortness of breath that wakes you up at night or requires you to sleep propped up to aid breathingWheezingHaving inhaled or choked on an object (foreign object aspiration or ingestion)Tightness in the throat or a barking, croupy coughDevelopment of a fever or significant coughWhat to expect at your health care provider's officeYour health care provider will take a detailed medical history and perform a physical examination.You may be asked the following medical history questions:Do you notice shortness of breath?Do you make grunting sounds while breathing?Do you have to work hard to breathe?How long have you had breathing difficulty?Did it slowly progress over weeks to months?Did it begin recently?Did it begin suddenly?Did it come on slowly (gradual onset)?Is there a sequence of separate occurrences (episodes)? How long does each last, and does each episode have a similar pattern?Has the breathing difficulty worsened recently?Does breathing difficulty cause you to wake up at night (paroxysmal nocturnal dyspnea)?Does the amount of breathing difficulty change (variable over hours)?Does breathing difficulty occur at rest?How long does each episode last?Is it worse when you lie flat (orthopnea)?Is it worse when you change body position?Did it develop within 4 to 6 hours after exposure to something that you are or may be allergic to (antigen)?Is it worse after exercise?Does shortness of breath occur only when you are wheezing?Is your breathing pattern irregular?Do you draw back the chest muscles with breathing (intercostal retractions)?What other symptoms do you have?The physical examination will include a thorough check of your lungs, heart, and upper airway passages.Tests that may be performed include the following:Blood tests (may include arterial blood gases)Measurement of blood oxygen saturation (pulse oximetry)ECGX-ray of the chestPulmonary function testsExercise testingCT scan of the chestEchocardiogramIn severe cases of difficulty breathing, hospitalization may be required. Many different medications aimed at treating the cause of breathing difficulty may be used.If your blood oxygen level is very low, you may need to receive oxygen. High doses of supplemental oxygen may be hazardous for some patients, however. Oxygen is not necessary in all cases of shortness of breath.ReferencesBraithwaite S, Perina D. Dyspnea. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. Philadelphia, Pa: Mosby Elsevier;2006:chap 18.Kraft M. Approach to the patient with respiratory diseases. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 83.
Ankle pain?
DefinitionAnkle pain involves any discomfort in one or both ankles.Alternative NamesPain - ankleConsiderationsAnkle pain is often due to an ankle sprain. A sprain is an injury to the ligaments, which connect bones to one another. In most cases of ankle sprain, the ankle is twisted inward, causing small tears in the ligaments. This makes the ankle unstable. The tearing leads to swelling and bruising, making it difficult to bear weight on the joint.Once an ankle is sprained, the injury may take a few weeks to many months to fully heal. Often, the injured ankle remains a little weaker and less stable than the uninjured one. A proper recovery program can prevent this problem.Other structures in the ankle that can be damaged and cause pain are tendons (which join muscles to bone), cartilage (which cushions joints), and blood vessels. Adjacent areas can cause pain to be felt in (referred to) the ankle -- these include the foot, lower leg, knee, and even hip.Common CausesIn addition to ankle sprains and other injuries, ankle pain can be caused by arthritis, gout, pseudogout, and infection.Gout occurs when you produce too much uric acid (a waste product in the body). The extra uric acid gets deposited and forms crystals in joints, rather than being excreted in the urine.Pseudogout is similar to gout. In this condition, calcium deposits in one or more of your joints, causing pain, redness, and swelling.The types of arthritis that can cause ankle pain include:Chronic gouty arthritisOsteoarthritisPsoriatic arthritisRheumatoid arthritisSeptic arthritisHome CareIf you feel pain in your ankle, rest it for several days. Try NOT to move the affected area.If your ankle is unstable, support it, especially during standing or walking. ACE bandages work well. If this does not provide enough support, you may need to be fit for a brace. Crutches or a cane can help take the weight off a sore or unsteady ankle.For swelling, keep your foot elevated above the level of the heart, even while sleeping. Ice the area right away. Apply ice for 10-15 minutes every hour for the first day. Then, every 3-4 hours for 2 more days.Try acetaminophen or ibuprofen for pain and swelling.Even after the pain subsides, you will need to keep pressure off of it for up to 10 days for a mild sprain and up to 5 weeks for a more severe sprain.Once you have healed adequately, you can start exercises to strengthen your ankle and avoid injury in the future. Do not begin these exercises until a health care professional tells you it is safe to start. One exercise, for example, involves balancing on your healing foot and hopping.For arthritis of the ankle, take medication exactly as prescribed. When the pain and swelling start to decrease, gently begin to exercise the joint again. Swimming is good, followed by stretching. Walking can be added later. Exercises can be done several times a day; but DO NOT overdo it. Pain is a message from your body to stop.Call your health care provider ifGo to the hospital or call 911 if:You have severe pain when NOT bearing weight.You suspect a broken bone (the joint appears deformed and you cannot put any weight on the leg).There is an audible popping sound and immediate difficulty using the joint.Call your doctor if:Swelling does not go down within 2-3 days.You have symptoms of infection -- the area becomes red, more painful, or warm, or you have a fever over 100F.The pain does not go away after several weeks.What to expect at your health care provider's officeYour doctor will perform a physical examination, including a detailed examination of the ankles, and ask questions such as:Does the pain shift from joint to joint?Is the pain the same in both ankles?Did the pain begin suddenly and severely?Did the pain begin slowly and mildly and then get worse?Did the pain resolve spontaneously in less than 6 weeks?Does the ankle feel warm to the touch?Does the ankle hurt when you are not bearing weight on it?Diagnostic tests that may be performed include the following:X-ray of the ankle and possibly the footAspiration of synovial fluid (fluid from the joint space) and synovial fluid analysisNonsteroidal anti-inflammatory medications (NSAIDs), special foot gear, or braces may be prescribed. Surgery is occasionally necessary.PreventionLose weight if you are overweight. Extra pounds put strain on your ankles.Warm-up before exercising. Stretch the muscles and tendons that anchor the ankle.Avoid sports and activities for which you are not properly conditioned.Make sure that shoes fit you properly. Avoid high-heeled shoes.If you are prone to ankle pain or twisting your ankle during certain activities, use ankle support braces. These include air-casts, ACE bandages, or lace-up ankle supports.ReferencesChorley JN. Ankle sprain discharge instructions from the emergency department. Pediatr Emerg Care. 2005; 21(8): 498-501.Van Rijn RM, van Os AG, Bernsen R, Luijsterburg PA, Koes BW, Bierma_Zeinstra SM. What is the clinical course of acute ankle sprains? A systematic literature review. Am J Med. 2008;121:324-331.e6.Osborne MD. Chronic ankle instability. In: Frontera WR, Silver JK, eds. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, Pa: Saunders Elsevier;2008:chap 77.Ivins D. Acute ankle sprain: an update. Am Fam Physician. 2006;74:1714-1720.
Numbness and tingling?
DefinitionNumbness and tingling are abnormal sensations that can occur anywhere in your body, but are often felt in your fingers, hands, feet, arms, or legs.Alternative NamesSensory loss; Paresthesias; Tingling and numbness; Loss of sensationCommon CausesThere are many possible causes:Remaining in the same seated or standing position for a long timeInjury to a nerve -- for example, a neck injury may cause you to feel numbness anywhere along your arm or hand, while a low back injury can cause numbness or tingling down the back of your legPressure on the spinal nerves, such as from a herniated diskPressure on peripheral nerves from enlarged blood vessels, tumors, scar tissue, or infectionShingles or herpes zoster infectionLack of blood supply to an area -- for example, cholesterol (plaque) build up from atherosclerosis in the legs can cause pain, numbness, and tingling while walking (this is called vascular claudication); frostbite can also reduce blood supply and lead to numbnessOther medical conditions, including: Carpal tunnel syndrome (pressure on a nerve at the wrist)DiabetesMigrainesMultiple sclerosisSeizuresStrokeTransient ischemic attack (TIA), sometimes called a "mini-stroke"Underactive thyroidRaynaud's phenomenonAbnormal levels of calcium, potassium, or sodium in your bodyA lack of vitamin B12 or other vitaminUse of certain medicationsToxic nerve damage due to lead, alcohol, or tobaccoRadiation therapyHome CareYour doctor should identify and treat the underlying cause of your numbness or tingling. Treatment of the underlying condition may reverse the symptoms or prevent them from becoming worse. For example, if you have carpal tunnel syndrome or low back pain, your doctor may recommend certain exercises.If you have diabetes, your doctor will discuss ways to control your blood sugars.Low levels of vitamins will be treated with vitamin supplements.Medications that cause numbness or tingling may need to be switched or adjusted. You should not change or stop taking any of your medicines or take large doses of any vitamins or supplements until you have talked with you doctor.Because numbness can cause a decrease in feeling, you may be more likely to accidentally injure a numb hand or foot. Take care to protect the area from cuts, bumps, bruises, burns, or other injury.Call your health care provider ifGo to a hospital or call your local emergency number (such as 911) if:Weakness or paralysis occurs with numbness or tinglingNumbness or tingling occur just after a head, neck, or back injuryYou cannot control the movement of an arm or a leg or you have lost bladder or bowel controlYou are confused or have lost consciousness, even brieflyYou have slurred speech, change in vision, difficulty walking, or weaknessCall your doctor if:Numbness or tingling has no obvious cause (like a hand or foot "falling asleep")You have pain in your neck, forearm, or fingersYou are urinating more oftenNumbness or tingling is in your legs and worsens when you walkYou have a rashYou have dizziness, muscle spasm, or other unusual symptomsWhat to expect at your health care provider's officeYour health care provider will take a medical history and perform a physical examination, with careful evaluation of your nervous system.Medical history questions may include the following:What part or parts of your body have numbness or tingling? The trunk? Your legs or feet? Your arms, hands, or fingers?Which side of your body is involved?Which aspect of the specific body part? For example, is your inner thigh, calf, or foot affected? Your palm, fingers, thumb, wrist, or forearm?Does the numbness or tingling affect your face? Around your eyes? Your cheeks? Around your mouth? Is one or both sides of your face involved?Does the part of your body with numbness or tingling change colors? Does it feel cold or warm?Do you have other abnormal sensations?Do you ignore everything on the affected side?How long have you had the numbness or tingling?When did it start?Does anything make it worse like exercise or standing for long periods of time?Do you have any other symptoms?Your doctor may also ask you questions to determine your risk for stroke, thyroid disease, or diabetes, as well as questions about your work habits and medications.Blood tests may include:Complete blood count ( CBC)Electrolyte level (measurement of body chemicals and minerals)Thyroid function testsMeasurement of vitamin levelsHeavy metal or toxicology screeningImaging tests may include:CT scan of the headCT scan of the spineMRI of the headMRI of the spineAngiogram (A test that uses x-rays and a special dye to see inside the blood vessels)CT angiogramX-ray of the affected areaUltrasound of neck vessels to determine your risk for TIA or strokeVascular ultrasoundOther tests that may be done include:Electromyography and nerve conduction studies to measure how your muscles respond to nerve stimulationLumbar puncture(spinal tap) to rule out central nervous system disordersCold stimulation test may be done to check for Raynaud's phenomenonReferencesAmerican Diabetes Association (ADA). Standards of medical care in diabetes. VI. Prevention and management of diabetes complications. Diabetes Care. 2007 Jan;30(Suppl 1):S15-24.Creager MA, Libby P. Peripheral arterial disease. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Saunders; 2007:chap 57.D'Cruz DP, Khamashta MA, Hughes GR. Systemic lupus erythematosus. Lancet. 2007 Feb 17;369(9561):587-96.Piazzini DB, Aprile I, Ferrara PE, et al. A systematic review of conservative treatment of carpal tunnel syndrome. Clin Rehabil. 2007;21(4):299-314.Rowland LP. Diagnosis of pain and paresthesias. In: Rowland LP, ed. Merritt's Neurology. 11th ed. Baltimore, Md: Lippincott Williams & Wilkins; 2005:chap 5.
Leg pain?
DefinitionHip pain involves any pain in or around the hip joint. Alternative NamesPain - hipConsiderationsHip-related pain is not always felt directly over the hip. Instead, you may feel it in the middle of your thigh or in your groin. Similarly, pain you feel in the hip may actually reflect a problem in your back, rather than your hip itself.See: Low back painCommon CausesHip fractures are a significant and serious cause of sudden hip pain. Hip fractures become more common as people age because falls are more likely and bones become less dense. People with osteoporosis can get a fracture from simple, everyday activities, not just a dramatic fall or injury.A hip fracture can change the quality of your life significantly. Fewer than 50% of those with a hip fracture return to their former level of activity. In addition, while recovering from a hip fracture, several possible complications can be life-threatening. These include pneumonia and a blood clot in the leg, which can dislodge and travel to cause a clot in the lungs. Both are due to immobility following a hip fracture and hip surgery.Other possible causes of hip pain include:Arthritis -- often felt in the front part of your thigh or in your groinOsteonecrosisof the hipTrochanteric bursitis -- hurts when you get up from a chair, walk, climb stairs, and driveTendinitis from repetitive or strenuous activityStrain or sprainLow-back pain such as sciaticaInfectionHome CareTry to avoid activities that aggravate the pain.Take over-the-counter pain medication, like ibuprofen or acetaminophen.Sleep on your non-painful side with a pillow between your legs.A hip fracture is considered a medical emergency. Therefore, if suspected, you should get medical help right away.As the pain improves, gradually begin to exercise. It is best to work with a physical therapist to learn proper exercises and how to advance your activity. Swimming may be a good option because it stretches the muscles and builds good muscle tone without straining your hip joint. However, swimming does not build bone mass. When you are ready (a physical therapist can help determine that), slowly and carefully resume walking or another activity against the resistance of gravity.Call your health care provider ifGo to a hospital or call 911 if:Your hip pain is caused by a fall or other injuryYour hip is misshapen, badly bruised, or bleedingYou are unable to move your hip or bear any weightCall your doctor if:Your hip is still painful after 1 week of home treatmentYou also have a fever or rashYou have sudden hip pain, plus sickle cell anemia or long-term steroid useYou have pain in both hips or other jointsWhat to expect at your health care provider's officeYour health care provider will perform a physical examination, with careful attention to your hips, thighs, back, and gait.To help diagnose the cause of the problem, your doctor will ask medical history questions, such as:Do you have pain in one or both hips?Do you have pain elsewhere like your lower back or thigh?Do you have pain in other joints?Did your pain begin suddenly, or slowly and mildly?Did the pain begin after an injury, fall, or accident?Does any particular activity make the pain worse?Have you done anything to try to relieve the pain? If so, what helps?Are you able to walk and bear weight?What other medical problems do you have? Osteoporosis or other signs of bone loss? Sickle cell anemia?Do you take any medications? If so, which ones? If on steroids, for how long have you been on them?X-rays of the hip may be necessary.Your doctor may tell you to take a higher dose of over-the-counter medication, or give you a prescription anti-inflammatory medication.Surgical repair or hip replacement may be recommended for osteonecrosis. Hip replacement is necessary for hip fracture and severe arthritis. With current technology, an artificial hip should last at least 10 to 15 years. Expect recovery from surgery to take at least 6 weeks. Plates and screws may be used to fix fractures around the hip.Complications can occur from surgery. A blood clot in the leg is the most common complication, which can lead to a blood clot in the lungs.PreventionAvoid activities that raise one of your hips above the other for extended periods of time, like running on an uneven surface. Running on a treadmill can keep your hips level.Warm up before exercising and cool down afterward. Stretch your hips, low back, and thighs.Avoid falls.Wear hip pads for contact sports like football and hockey. For those at high risk for a hip fracture, pads with a streamline design can be worn in undergarments.Learn how to prevent osteoporosis.ReferencesDaboy G. Miscellaneous nontraumatic disorders. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier;2007:chap 25.LeVelle DG. Fractures and dislocations of the hip. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier;2007:chap 52.Cornell CN, Sculco TP. Orthopedic disorders. In: Duthie EH, Katz PR, Malone ML, eds. Practice of Geriatrics. 4th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 37.Wong TK, Lee RY. Effects of low back pain on the relationship between the movements of the lumbar spine and hip. Hum Mov Sci. 2004; 23(1): 21-34.Dohnke B, Knauper B, Muller-Fahrnow W. Perceived self-efficacy gained from, and health effects of, a rehabilitation program after hip joint replacement. Arthritis Rheum. 2005; 53(4): 585-592.Tak E, Staats P, Van Hespen A, Hopman-Rock M. The effects of an exercise program for older adults with osteoarthritis of the hip. J Rheumatol. 2005; 32(6): 1106-1113.
