Hips Archive

An ad for an arthritis medication seems to suggest that taking it will alleviate or even eliminate morning stiffness, allowing you to hop out of bed. Like most drug ads, this one has unspoken messages and glosses over questions about side effects and cost.

Bring this article to your doctor appointment.

You've run out of options for hip pain and you're facing a possible hip replacement (see "Anatomy of a hip replacement"). Once your doctor has determined that you're a good candidate for surgery — based on your medical history, images of your hip, steps you've taken to reduce pain (such as weight loss and low-impact exercise programs), and how pain has affected your daily function — you'll need to ask lots of questions.

"This is not a time to be shy. Be aggressive and get answers. The doctor expects that," says Dr. Scott Martin, an associate professor of orthopedic surgery at Harvard Medical School and medical editor of the Harvard Medical School Guide Total Hip Replacement.

Gout, a debilitating form of arthritis, is on the rise compared with rates in prior decades. Obesity is probably a significant factor in this increase. Now, a new study suggests that three-quarters of gout cases in men might be completely avoidable by following certain protective health habits.

These painful flare-ups can occur suddenly and for no apparent reason. Here's what you can do about them.

Have you ever woken up with a mysterious egg-shaped swelling on your elbow or knee and have no clue what caused it? There is a good chance you have bursitis.

"Bursitis is definitely more common as you get older and just comes with the territory of living a longer and more active life," says Dr. Robert Shmerling, senior faculty editor at Harvard Health Publishing and Corresponding Member of the Faculty of Medicine at Harvard Medical School.

New guidelines suggest doing more of the same. The problem is that many people don't.

You never forget your first gout attack. The severe pain, swelling, and redness hits hard and fast. The initial attack often strikes your big toe's large joint, but later ones might affect the foot or ankle. Other hot spots include the knees, hands, and wrists.

First-line treatment is quite effective and includes anti-inflammatory medications, ice therapy, and rest. A combination of diet and lifestyle changes and prescription drugs — an approach called urate-lowering therapy, or ULT — is typically recommended if attacks recur or become more severe.

Currently no medication can slow the progress of osteoarthritis. And while a reanalysis of a study of people with heart disease suggests a promising approach, more definitive research will be necessary to confirm this.

On call

Q. My knees have been cracking for a long time, but lately I've noticed my ankles and elbows sometimes crack and pop. Is this a sign of early arthritis?

A. The good news is that the usual painless joint cracking or popping does not represent an early form of arthritis, nor does it cause joint damage (despite what our mothers told us about cracking our knuckles). The cracking sound appears to come from tendons or muscles moving over the joint or from the popping of nitrogen bubbles normally found in the joint space.

Ask the doctors

Q. Is there anything I can do at home to ease sciatica pain?

A. Sciatica is a condition that causes pain that radiates down the buttock and the leg. It occurs when one of the two sciatic nerves in your body, which run from your back down to your toes, is compressed or irritated. Most often the problem is triggered by a ruptured disc or arthritis in the lower spine. This condition can be quite painful, but there are some strategies you can use at home to ease your discomfort.