Knees and Hips: A troubleshooting guide to knee and hip pain

• Knees in motion
  • Evaluating knees
  • Overuse injuries
  • Bursitis
  • Tendinitis
  • Iliotibial band syndrome
  • Tears in supporting tissues
  • Ruptured tendons
  • Meniscal tears
  • Ligament damage
  • Kneecap problems
  • Knee pain syndrome
  • Osteoarthritis of the knee
• Hips
  • Evaluating hips
  • Overuse injuries
  • Hip muscle strains
  • Tendinitis
  • Bursitis
  • Labral tear
  • Hip fracture
  • Osteoarthritis of the hip
• Testing for knee and hip problems
  • Imaging techniques
  • Laboratory tests
• Nonsurgical treatments for knees and hips
  • RICE
  • Heat
  • Ultrasound, phonophoresis, and iontophoresis
  • Therapeutic exercise
  • Medication
  • Alternative approaches
• Arthroscopy
• Joint replacement
  • Choices in joint replacement
  • Undergoing joint replacement
  • Recovery in the hospital
  • Recovery and rehabilitation
  • Living with a replacement joint
  • Revision surgery
• Glossary
• Resources
  • Organizations
  • Books

Have you always dreamed of playing a round of golf at Pinehurst? Or strolling Newport’s famous cliff walk? Or maybe you’ve reached the point where simply climbing a set of stairs is a dream. If these goals seem to be further away than ever, you may be one of the millions of people with pain in the knees or hips. Pain in these joints can impede the simplest act such as walking, bending, or just rising from a chair. Golfing, hiking, or even gardening may be out of the question.

Your knees and hips are your largest joints. They support your body’s weight and they must work in close coordination to provide the mobility most people take for granted until injury, arthritis, or other problems interfere. One in 5 Americans age 60 and older have experienced significant knee pain on most days over the last six weeks, and 1 in 7 report significant hip pain. Each year, Americans make about 15 million visits to doctors for knee pain and 6 million visits for hip pain.

Depending on the cause of your pain, the solution can be a set of exercises designed to strengthen and stretch the muscles that support the joint, taking some of the stress off the joint itself. But for many people, knee and hip problems become so intractable that the best solution is to replace a worn-out knee or hip with a mechanical joint. In the United States in 2003, there were 451,000 knee replacement and 364,000 hip replacement procedures performed. The average age at which a person has such surgery is 65 to 70, although many people in their 80s and older gain pain relief and improved mobility from these procedures.

Physically, your knees and hips are closely interdependent, located as they are at either end of the thighbone. This proximity means the angle of your hip affects the pressure on your knee. A hip disorder may cause knee pain, and knee disorders can aggravate hip problems.

People live longer than they used to, so joints need to stay strong and healthy through those additional years. But both knees and hips are subject to repetitive trauma -- wear and tear -- as you age, and you can traumatize them further if you increase your physical activity suddenly.

Medical care has changed in recent years. Doctors used to follow surgery by immobilizing the joint with a plaster cast. Weeks of immobility caused the muscles to weaken and shorten, resulting in long-lasting stiffness and poor function. Today, you can wake up from surgery with your knee already being gently bent and straightened by a machine. In addition, knee and hip replacements have freed thousands of patients from life in a wheelchair or on crutches.

Surgical techniques have also advanced. More surgery is performed through tiny incisions using an arthroscope, often on an outpatient basis. Pain relief has moved away from mind-clouding narcotics toward an expanding variety of pain relievers that tackle the twin problems of pain and inflammation. Whether you've just starting experiencing pain or have been battling it for years, this report can help you make informed decisions to help maintain your mobility for years to come.