Tuesday, February 28, 2012

Hip Pain

Hip pain may be caused by many factors. The location of the pain gives a clue as to the cause of the pain. Many factors can contribute to the underlying cause.

Enthesitis is an inflammation at the insertion point of a muscle. There is a strong tendency for calcification. There is usually pain only when the muscle is used.

True hip pain caused by the hip joint, is located in the groin area. It is usually located over the inguinal ligament. Occasionally iliopsoas bursitis may mimic true hip pain. 

The iliopsoas bursa lies between the psoas muscle-tendon and the pubic bone on top within the femur. 

Meralgia paresthetica is usually felt on the outer part of the thigh and is characterized by tingling, numbness and a burning pain. It's caused by compression of the nerve and can be caused by tight clothing, obesity, pregnancy, trauma or disease.

Sacroiliac pain can range from sharp to an ache and it may radiate out into the buttocks, low back, and groin. The sacroiliac joints are located in the back on either side of the spine and help form the pelvic girdle.

Buttock pain is usually referred pain from the lumbo-sacral spine or lower back.

Trochanteric bursitis is usually localized to laterally over the trochanteric bursa. Due to the depth of this bursa, warmth and swelling are usually absent. Diagnosis can be confirmed by inducing point tenderness.

Ischiogluteal bursitis is inflammation of the bursa covering the ischial tuberosity. (the bone that protrudes on the buttock when sitting) This type of bursitis causes pain in the buttocks.

Sciatic is pain, numbness, weakness and tingling in the thigh. It may be caused by injury to or pressure on the sciatic nerve.

Tuesday, February 21, 2012

When Should A Cane Be Used with RA?

In one of our on-line support groups we have been discussing when to use a cane or walker with RA.

After doing some research, I found an article that urges RA patients to use a cane as soon as standing up and walking becomes challenging. Canes may protect the joints, even before significant damage is evident. Using a can also helps relieve pain in the hips, knees, and ankles.

It is important that your cane be the correct height. If it is too short, you will be hunched over and if it is too tall, your shoulder will be hiked up. Either will cause unnecessary pain. 

To measure a cane, hold your arm straight. The handle of the cane should come to your wrist. When using the cane, your arm will be crooked at a 30 degree or less angle.

Also make sure the handle is comfortable. RA hands have special needs and the grip should not hurt when it is used every day. I have two canes. My first cane had a wooden handle and it hurt after a few hours of use. I now have a gel-handled cane and it is much more comfortable.

So why do we balk at using this assistive device? Is it because when we use a cane, our disabilities become more real, more visible? 

While it is difficult to take the next step and begin using a cane, it is important for those of us who suffer from RA to think about long-term consequences. Use of a cane provides stability and few falls and also helps prevent joint damage.