DEAR DR. GOTT: I am a 54-year-old female with osteoarthritis in both hips. My general practitioner sent me to an out-of-state specialist who recommended cortisone injections. When I tried to have cortisone injections done by a local specialist, I was told that they would not help me because I don’t have bursitis.
I am most uncomfortable when I stand still, sit or lie down for any length of time. Using a heating pad several times during the night helps alleviate the muscle cramping, though. I have more pain in my lower back/sacral area, knees and thigh muscles than in the hips themselves. Who is right? Would the cortisone injections really help?
DEAR READER: I must side with the out-of-state specialist. Cortisone injections are often beneficial as one of the initial steps toward relieving the pain of arthritis. A randomized placebo-controlled trial of glucocorticoid injections for osteoarthritis of the hip demonstrated benefits lasting up to three months. Over-the-counter medications such as acetaminophen, ibuprofen or naproxen, topical capsaicin or menthol ointments (especially those made with castor oil), and ice packs or heat may also provide relief. If these options fail to provide satisfactory results, consider physical therapy, low-impact exercise programs or enter a chronic-pain class to learn other ways to manage the pain. A final option for those with severe joint deformity, pain and dysfunction is surgery, such as joint realignment or replacement.
Seek out another local specialist or return to the out-of-state physician for further advice and treatment.
To provide related information, I am sending you a copy of my Health Report “Understanding Osteoarthritis.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.
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