Having an achy hip is just miserable. You can’t walk comfortably, sitting is painful (forget about crossing your legs!) and even laying on the painful hip while trying to sleep can be nightmare. And your hip has started hurting a month before your big road trip across the United States was planned. It’s something you and your spouse have dreamt of doing forever, but now you’re dreading sitting in a car for a minute, much less hours at a time. Before you cancel that trip, let’s talk about your options and how I can help you travel, after all.
The first thing you should do is call and get an appointment with me for x-rays, a complete physical examination, diagnosis and treatment plan. The most common hip issues (not counting traumatic injuries) are arthritis, bursitis, hip impingement, avascular necrosis, tendonitis, and ilio-tibial band syndrome.
I’ll also note here that a number of patients who come in for hip pain actually turn out to be patients with a spine issue, which will show up when we do x-rays. Their hips will look great, but they may have a very arthritic spine, spinal stenosis or a spondylolisthesis (one vertebrae slips forward on the one below it) . The pain that originates in their spine is getting referred to their hip from a compressed or irritated nerve emerging from the spinal column. It’s a common occurrence and one I can easily treat conservatively. If you need further, more aggressive treatment, I’ll refer you to one of my partners who specialize in treating spinal issues, Drs. Carlson or McFarland.
Of course, each specific hip diagnosis has its own treatment plan, some requiring surgical intervention, but for our purposes here, I’ll keep our discussion on what would happen conservatively.
Prescription anti-inflammatory medications are the first business order for most diagnoses. We can try oral medications or a steroid injection for more severe inflammation, swelling and stiffness. These typically provide relief in less than a week.
At that point, I would also try to get you in for at least a few sessions of Physical Therapy to work on strengthening the muscles around your hip to provide stabilization for the walking/activities you need to do on your upcoming trip. The Physical Therapist can also use specific modalities – such as laser, H-Wave, cold packs to reduce inflammation and swelling in the hip and to speed healing. The more PT you can complete before your trip, the better.
I can also prescribe a hip brace for you to wear. There aren’t as many braces for hips as there are for knees, but there are a few. Unloader braces help redistribute the weight of the hip to take pressure off a particularly arthritic area. We can find a brace that you like and will wear on your trip that will make activities more enjoyable.
I can prescribe an assistive device, like a cane or a walker if necessary. Collapsible canes are all the rage, and the new walker/rollators are foldable, portable and have so many bells and whistles, they are becoming a status symbol!
When you leave on your trip, whether you are flying or driving, sitting in the same position for a long time can make your hip stiffer and more painful. When driving, it is important to stop the car, take breaks, get out and stretch, walk, flex and bend your leg and hip. Stretch and do your at-home PT routine while traveling.
While flying, get up and walk around the plane whenever you can, taking a moment to stretch and bend. If you can wear compression stockings on long flights, do so. There are also specific exercises you can do on long flights for circulation and hip muscle activation. Ask me about them! Take an ice pack and get the flight attendant to bring you ice for any pain you may have. Ice is a very effective pain reliever!
When walking and taking in all the glories our beautiful country has to offer, remember to take a break and simply watch the sunset to give your hip a rest. If you have a particularly hard day walking and your hip hurts, plan a more leisurely activity the next day. Remember to use common sense.
I hope you have a wonderful trip. Bon Voyage!