A hip joint is a ball and socket joint. It has a ball at the top of the thigh bone that fits into a socket in the pelvis.

The ends of bones in a typical joint are covered by cartilage (a smooth slippery surface). This smooth but tough cartilage surrounding the bones’ end help in the smooth movement of the bones against each other preventing friction. The cartilage within the joints acts like a shock absorber.

Joints wear and tear during one’s lifetime due to normal aging, overuse, injury, or for any other reason.  The cartilage in the hip joint becomes thin and the bone surfaces of the joint become rough. This may lead to pain, swelling, and joint stiffness. The condition is known as osteoarthritis of the hip joint.

Though there are many types of arthritis, osteoarthritis of the hip and knee joints is the most common one. Osteoarthritis is also known as degenerative arthritis or age-related arthritis. It is common in people who are older – especially in women compared to men.

What happens if you have osteoarthritis of the hip?

If you have this condition, you will feel pain in different locations – such as the thigh, buttocks, groin, or knee. You will also experience sharp or stabbing pain or sometimes, a dull ache. Your hip is often stiff.

What are the symptoms of osteoarthritis of the hip joint?

 If you have osteoarthritis, you will experience:

• Pain, tenderness, or swelling in the hip joint
• Joint stiffness when you sit for long
• Stiffness while getting out of bed
• Crunching sound in the joint
• Difficulty in moving the hip joint to perform routine activities

Arthritis Causes

• A family history (genes) inherited from parents
• Excess body weight (obesity or overweight)
• Heavy lifting
• Professions involving long periods of standing
• Deformity in the hip joint
• Injuries
• Age 45 years or above
• Overuse of the joints
• Repetitive stress and mechanical overload
• Hip fracture or hip trauma
• Hip dislocation

Diagnosis of Hip Osteoarthritis

Your doctor performs a physical examination, takes your medical history, and checks the mobility of your hip joint. Your doctor may order an X-ray. The X-ray of the hip joint shows spurring of joint margins and narrowing of the joints (thinning of cartilage in the joints) and joint space narrowing if you have osteoarthritis of the hip joint.

Management of osteoarthritis

Your orthopedic doctor, physiotherapist, occupational therapist, and dietician form a multidisciplinary team to effectively manage your condition. The management approach varies according to the stage and severity of the condition. Customized exercise programs, weight reduction methods, activity restrictions, balance training, and medications are included in a typical management program.

If these approaches do not offer any relief, as seen in most severe cases, total hip replacement surgery is recommended.

Learn more about Robotic Hip Replacement

Bottom Line

Osteoarthritis of the hip may progress to the point where you may need joint replacement. Early diagnosis and prompt management of the condition can help in preventing progressive degeneration of the cartilage and delaying surgery.

Avascular necrosis causes | Dr. Praharsha Mulpur Explains

Lack of blood supply to a bone results in the death of bone tissue. This condition is known as avascular necrosis or osteonecrosis. The condition can lead to minute breaks in the bone – which gradually cause the bone to collapse over a period of time. The process of bone damage may take several months to years. When a bone breaks or a joint dislocates, it can lead to blockage of blood flow to a section of the bone. Excessive and long-term use of certain medications, high-dose steroids, and alcohol can also cause avascular necrosis. Avascular necrosis can affect anyone, but it is most common in people between 30 to 50 years of age.

Avascular necrosis Causes

When the blood supply to a bone or joint is reduced, interrupted, or blocked – avascular necrosis occurs. The cause of a reduced blood supply can be:

Injury or trauma: bone fracture, bone injury or trauma, or a dislocated joint can damage nearby blood vessels. Radiation therapy can also weaken bones and damage blood vessels.

Medical conditions such as Gaucher’s disease and sickle cell anemia can reduce blood flow to bones.

Fatty deposits in blood vessels:  lipids and fats accumulate and lead to the formation of plaque that blocks small blood vessels and reduces blood flow to bones.

Medical conditions associated with avascular necrosis include:

Sickle cell anemia, Systemic lupus erythematosus, HIV/AIDS, Gaucher’s disease, Pancreatitis, Certain types of cancer, such as leukemia and divers’ disease (Decompression sickness)

Symptoms

Avascular necrosis can affect the hip, thighs, buttocks, groin, shoulder, knee, hand, and also foot. The condition develops gradually and is associated with mild to severe pain.

In the case of avascular necrosis of the hip, the pain is centered around the buttock, groin, and thigh. Avascular necrosis of the hip and knee is common. It can affect one or both hips or knees.

Complications

Avascular necrosis can progressively become severe and worsens over a period of time. Bones can become weak and eventually collapse. It can also lead to severe arthritis if unaddressed in time.

Diagnosis

Your orthopedic doctor performs a physical examination by pressing your joints and checking for tenderness. The doctor also moves your joints through different positions to check whether you have restricted motion in your joints.

X-rays: Help in detecting changes in the later stages of avascular necrosis. In the early stages, X-rays usually don’t reveal bone changes or any issues in the bones.

CT and MRI Scans: These scans show early changes in the bones that are indicative of avascular necrosis. MRI and Ct scans produce detailed images.

A bone scan after injecting radioactive material into a vein helps in spotting the damaged or injured parts of the bones. On an imaging plate, these spots appear as bright spots.

Treatment

Early detection of the condition helps in giving effective treatment in the initial stages of bone damage.  Doctors prescribe over-the-counter pain-relieving medicines and drugs to slow down the progress of avascular necrosis. If the cause of blockage is excess cholesterol and fat deposits then cholesterol-lowering drugs and blood thinners are prescribed. Taking rest as advised by the doctor and exercising under the supervision of a physiotherapist help maintain or improve movement in the joint.

Surgical treatment: Core decompression, bone reshaping (osteotomy), bone transplant (graft), and joint replacement are the surgical treatment options.

Bottom Line

You should consult an orthopedic doctor for any ongoing joint pain – especially when the pain is persistent. You must immediately seek emergency medical care for a possible dislocated joint or broken bone.

Pseudogout causes & Symptoms | Dr. Praharsha Mulpur

Pseudogout or calcium pyrophosphate deposition disease (CPPD) is a condition in which you have sudden and painful swelling in one or more joints. It can last for around a few days to weeks. The condition is commonly known as pseudogout because it looks similar to gout. The other common feature of both these conditions is the deposition of crystals within a joint though the type of crystals differs for each condition.

What are the symptoms of pseudogout?

The signs and symptoms associated with pseudogout include warm, swollen, and severely painful joints. The episodes may last for a few days to weeks. Pseudogout mostly affects the knees. It may also affect other joints, but ankles and wrists are affected less often.

What are the causes of pseudogout?

Pseudogout causes: The most prominent reason for this condition is due to deposition of calcium pyrophosphate dihydrate crystals in the affected joint of the body (most commonly in the knee joint). The condition is mostly associated with advancing age as older adults and people above age 65 to 70 years develop pseudogout. However, a majority of elderly people who have crystals in their joints never develop this condition. In addition, some people may have symptoms and others don’t have any symptoms at all.

What are the risk factors for pseudogout?

Age is a major risk factor. And also, the condition runs in families (genetic predisposition). This means people have a strong hereditary tendency to develop this condition. In addition, any serious accidental injuries, joint trauma, or post-surgical injury may also increase the risk of developing pseudogout.

Pseudogout causes: Certain medical conditions – such as underactive thyroid or an overactive parathyroid gland and mineral imbalances (excess iron or calcium in the blood or magnesium deficiency) can also increase the risk.

Bottom Line

The deposition of calcium crystals in the joints can damage the joints and cause stiffness, restricted mobility, and severe pain. The symptoms associated with pseudogout mimic the signs and symptoms of osteoarthritis or rheumatoid arthritis.

You should meet Dr. Praharsha Mulpur if you have sudden and severe pain, warmth, and swelling in your joints – especially in your knee joints. The symptoms may also be due to other joint conditions. Therefore, to rule out other joint conditions, a comprehensive physical and clinical examination and evaluation of the condition based on the symptoms is important.

Fibromyalgia treatment in Hyderabad | Dr. Praharsha Mulpur

Fibromyalgia is a condition characterized by widespread musculoskeletal pain associated with fatigue, sleep, memory, and mood problems. Researchers believe that fibromyalgia increases painful sensations by affecting how the brain and spinal cord process painful and non-painful signals. Symptoms often begin after events such as Physical trauma, surgery, infection, or significant psychological stress. In other cases, symptoms gradually accumulate over time without a single triggering event occurring.  Many people with fibromyalgia also experience tension headaches, temporomandibular joint disorders (TMJ), irritable bowel syndrome, anxiety, and depression. There is no cure for fibromyalgia, but various drugs can control symptoms. Exercise, relaxation, and measures to reduce stress can also help.

Fibromyalgia Symptoms

The main symptoms of fibromyalgia include:

Widespread pain

Pain associated with fibromyalgia is often described as constant, dull pain lasting at least three months. The pain must be on both sides of the body and above and below the hips to be considered widespread. Malaise.

People with fibromyalgia report sleeping late but often wake up tired. Sleep is often disturbed by pain, and many people with fibromyalgia suffer from other sleep disorders, such as restless leg syndrome and sleep apnea.

Cognitive difficulty. Commonly referred to as “fiber fog,” the condition affects concentration, attention, and ability to focus on mental tasks.

Fibromyalgia is often associated with other conditions such as irritable bowel syndrome chronic fatigue, migraines and other types of headaches, interstitial cystitis, or painful bladder syndrome.

Fibromyalgia causes

Many researchers believe that repeated nerve stimulation in fibromyalgia patients causes changes in the brain and spinal cord. This change involves an abnormal increase in certain chemicals in the brain that signal pain. In addition, pain receptors in the brain appear to somehow develop and become sensitive to pain memory. These changes can be attributed to many factors, including genetics. Because fibromyalgia runs in families, certain genetic mutations may predispose people to develop the condition. Some disorders appear to induce or exacerbate fibromyalgia.

A physical or emotional event: Fibromyalgia can be triggered by physical events such as car accidents. Persistent psychological stress can also trigger fibromyalgia.

Risk factors for fibromyalgia

your gender

Fibromyalgia is diagnosed more often in women than in men.

Family history- If you have a parent or sibling who also has fibromyalgia, you are more likely to develop fibromyalgia.

If you have osteoarthritis, rheumatoid arthritis, or lupus, you are more likely to develop fibromyalgia. 

Complications

The pain, fatigue, and poor-quality sleep associated with fibromyalgia can affect your ability to function at home and at work. It can also lead to pain-related anxiety.

Diagnosis

In the past, doctors would check 18 specific points on a person’s body to see how much those points hurt when pressed hard. New guidelines from the American College of Rheumatology do not require a tender point test. Instead, the main factor required for a diagnosis of fibromyalgia is pain that has spread throughout the body for at least 3 months. To meet the criteria, there must be pain in at least 4 of these 5 areas: upper left region including shoulders, arms, or chin upper right region including shoulder, arm, or chin lower left region including hips, buttocks, or legs lower right region including hips, buttocks or legs. Axial regions including neck, back, chest, or abdomen test. Doctors may want to rule out other conditions with similar symptoms.

Blood tests include complete blood count, erythrocyte sedimentation rate, cyclic citrullinated peptide assay, and rheumatoid factor. Other tests include thyroid function tests, antinuclear antibody serology, and vitamin D test.

Fibromyalgia Treatment in Hyderabad

In general, fibromyalgia treatment includes both medication and self-care therapy. The focus is on minimizing symptoms and improving overall health. There is no cure for every symptom, but trying different treatment strategies can have cumulative effects. Medications can help relieve fibromyalgia pain and improve sleep.  The common choices include over-the-counter pain relievers, muscle relaxants, and other prescription medicines. In addition, physical therapy, exercise, and other lifestyle and dietary modification can also help improve the condition.

Hand Pain Causes

Human hands are complex structures with different types of bones. The joints and muscles in the hand help in allowing dexterous movements, gripping, and grasping ability. However, hand joints are susceptible to injuries. There are many causes of hand pain as different conditions can contribute to hand pain. Therefore, treatment depends on the cause and it may range from making lifestyle changes, to exercise and medications.

Hand pain causes

Hand pain reasons: Hand pain can begin in different parts of the complex structure such as nerves, tendons, connective tissues, joints, and bones. Among the several known causes of hand pain, these are the common ones: fractures and strains, repetitive hand movement-related injuries, nerve damage, inflammation, and many other chronic conditions such as rheumatoid arthritis, lupus, and others.

Some of the common hand pain causes include:

Peripheral neuropathy: It is associated with pain, weakness, and numbness in the hands. The causes include infections, metabolic problems, diabetes, and traumatic injuries.

Common symptoms include burning, freezing, throbbing, and sharp pain in the hands and feet; tingling sensation in hands and feet, extreme sensitivity in hands, and weakness.

Carpal Tunnel Syndrome

The median nerve runs through a tunnel-like passage of bone and ligament located at the base of the hand. Tendons responsible for moving your fingers also pass through this passageway. Squeezing of this median nerve due to a narrowing carpel tunnel can cause this condition. It happens when there is inflammation or irritation of tendons that causes swelling in the area.

The symptoms include frequent numbness, tingling, itching, and burning sensation in the palm of the hand and fingers. You will feel pain in the index and middle finger and around the thumb.

The other symptoms of carpal tunnel syndrome include reduced grip strength; stiffness and pain in the hand or wrist in the morning; pain during the night; difficulty feeling hot and cold sensations; difficulty in performing certain tasks and trouble grasping small objects.

Some of the common treatments for this condition include using ice and cold packs; avoiding certain activities; using splints; taking OTCs, stretching, and exercises; taking oral steroids or injections; and, in severe cases, surgery remains the best treatment option.

Arthritis

Arthritis is an inflammatory condition of the joints. There are different types of arthritis, but osteoarthritis and rheumatoid arthritis are the most common.

Osteoarthritis is a progressively deteriorating bone and joint condition that mostly affects older adults. The cartilage that covers the ends of bones is damaged due to wear and tear. When this happens the symptoms gradually manifest.

In rheumatoid arthritis, stiffness and joint inflammation leading to pain. It affects many joints of the body, but most commonly the joints of the hand and feet are affected.

Symptoms of arthritis include swelling around joints, morning stiffness and pain in the joints; pain due to overuse of joints; repetitive motion, burning pain or dull pain in the joints of wrist and fingers; small cysts on the end of fingers; overextensions (changes in joints); grating, grinding or looseness sensations around finger joints.

Treatment includes medication to relieve pain and swelling; use of splints during the time of overuse; physical or occupational therapy; use of long-lasting anesthetics or steroids.

Lupus

It is an autoimmune disorder. The initial signs include joint pain, stiffness, and progressive inflammation. The other symptoms include fatigue, muscle pain, hair loss, an unexplained fever, swelling around the eyes or legs, and pale or purple fingers or toes.

Treatment can help manage the condition. It includes pain-relieving medications, the use of a warm or cold compress, physical therapy; avoiding painful activities, and resting painful joints.

Gout

It is an extremely painful joint condition and a complex type of arthritis. Most commonly it affects the joint at the base of the big toe, but it can also occur in the hands and wrists as well. The pain becomes unbearable and wakes you up at the night. In severe bouts of attacks, you will experience burning pain, redness, and tenderness. There are medicines to treat this condition.

Ganglion cysts

They look like a lump or mass coming out of the back of the wrist. They look unsightly but are not painful. They vary in size and change in size. When they become large, they can put pressure on the nerves and cause numbness, tingling, and pain in and around the hand or wrist.

These cysts usually don’t do any harm as they can go away with time. Using splints and taking rest can reduce their size. However, if they become large and cause pain, your orthopedic doctor will remove them.

De Quervain’s tenosynovitis

In this condition, tendons around the base of the thumb swell and cause inflammation. You will experience pain, numbness, and swelling around the base of the thumb due to the build-up of pressure on the nerves.

Symptoms of de Quervain’s tenosynovitis include swelling near the base of the thumb, pain around the thumb-side of the wrist; trouble making a pinching motion or grasping something.

The treatment for this condition may include the application of cold or ice packs; splinting; avoiding pinching motions and painful tasks; taking OTCs; occupational or physical therapy; use of steroid injection and in severe cases, surgery.

Bottom Line

In addition to these, there are many more hand pain causes, if you have any of the above symptoms related to your hand and wrist, don’t delay in seeking medical help. Consult Dr. Praharsha Mulpur for a comprehensive diagnosis and effective treatment of your hand pain.