Dolor de cadera y tratamientos: La Guía SilverSneakers

El dolor de cadera es una dolencia frecuente entre las personas mayores. Here's what might be causing your problem and what may help.

Hip pain is one of those health issues that sidelines a lot of older people. Nearly 15 percent of people over age 60 report significant hip pain on most days, according to research. So if you don't have it, it doesn't mean that you will.

Painful hips can make it rough to get through the day. It makes it hard to find a comfortable sleeping position, walk longer than a short distance or climb stairs.

And when your mobility is restricted this way, it can have a ripple effect on your overall health. That means both physical and mental. Here’s a closer look at the causes of hip pain and how you can find relief with treatment.  

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What’s the difference between acute and chronic hip pain? 

Hip pain is split into two different categories, acute and chronic. Here's how to recognize the difference:

Acute pain comes on suddenly and feels sharp. It’s tied to a specific cause, like an injury or infection. If you fell on the ice and landed on your hip, for example, that’s acute pain. It tends to go away after the problem that caused it heals. 

Chronic pain can start out as acute pain, but it sticks around longer than six months and can come and go. What you did over the course of a day makes a difference. If you walked more than usual, that could cause a dull pain in your hip.

A dull ache or stiffness also counts as chronic pain. It might be paired with muscle weakness, a restricted range of motion, swelling, trouble sleeping in certain positions or crunching or popping noises in your spine.

Although acute hip pain hurts and messes with your day, chronic hip pain is more likely to harm your quality of life for a longer amount of time.  

How is hip pain diagnosed? 

According to Mayo Clinic, the location of your hip pain can give you clues about what caused it. For example, pain in your groin or the inside of your hip is often due to problems with the hip joint itself. Pain on the outside of the hip, outer buttocks or upper thighs is usually caused by issues with the ligaments, tendons, and muscles around your hip joint. 

There is another issue called "referred pain." This means the problem is not actually in your hip, but in another area of your body, like your lower back. That can change how the muscles and joints in your hips work.

For your doctor to diagnose your hip pain, they will get a complete medical history from you. They will also perform a functional assessment that looks at how you walk, sit and move.

The doctor might look at how well your hip rotates, whether one leg is longer than the other, and if the issue might be related to your spine.   

The doctor may order these imaging tests to get a better look at what’s going on so she can identify the problem: 

• X-rays 
• Magnetic resonance imaging (MRI) 
• Computed tomography scan (CT or CAT scan) 

These tests can show cartilage tears, infections, tumors or bone issues. Getting a proper diagnosis is a key step toward treatment and pain relief, but it may take time to get to the root of the problem.

What are the causes and risk factors for hip pain? 

Hip pain can occur at any age-especially if it's caused by an injury. But your risk does go up as you get older. There's a long list of things that can cause it:

• Arthritis, including osteoarthritis, psoriatic arthritis, and rheumatoid arthritis 
• Bursitis, which is inflammation in the sacs of fluid cushioning the hip joint 
• A fracture or tear from an injury 
• Tendinitis or sprain 
• A compressed nerve condition like sciatica, sacroiliitis or meralgia paresthetica 
• Bone cancer or metastatic cancer 
• Limited blood flow 
• Osteoporosis 
• A bone infection, like osteomyelitis 
• A lack of exercise, which lowers muscle mass  
• Excess weight 
• Smoking, which causes decreased blood flow and ups the risk for osteoporosis  

Lower back pain and hip pain can happen together, especially if arthritis is the trigger. One type of arthritis called ankylosing spondylitis causes lower back pain issues, and one of its main symptoms is hip pain and stiffness.

What medications or products can bring relief? 

There are both prescription and over-the-counter medications that may help reduce your pain. These include:

• Topical gels and creams that reduce inflammation 
• Pain relievers such as ibuprofen 
• Ice packs to reduce inflammation, particularly for acute pain and injury 
• Heating pads 
• Supplements like glucosamine and chondroitin 
• Injections like corticosteroids or plasma    

Talk with your health-care provider about what type of treatment might be right for you. This discussion is helpful whether you have acute or chronic pain.

Your doctor may also recommend physical therapy. This helps strengthen the muscles around the spine and hips to support the soft tissues in your hip joint. Your physical therapy sessions may include learning how to adjust your daily activities so you're not placing too much strain on your hip.

Recommended reading: 5 Ways to Manage Chronic Pain Without Opioids   

Are there more advanced treatments for hip pain? 

Yes, there are. If your pain isn’t getting better after trying other fixes, your doctor may suggest a surgical option:  

Arthroscopy: This is a minimally invasive surgery that repairs joint damage with a few small incisions inside the hip using long, narrow tools. This type of surgery is less serious than open surgery that cuts through your skin and tissues. 

Core decompression: This surgery is also minimally invasive. The procedure injects pelvic bone stem cells into the hip to grow new bone tissue. 

Osteotomy: This surgery is a little more complex. It involves cutting bone to realign or reshape it. It is sometimes performed after a fracture has healed poorly. 

Hip replacement: This is what everyone with hip pain hopes to avoid. But if your hip can’t be repaired or treated in another way, you may be a candidate for this surgical procedure that replaces your hip joint with a prosthetic implant. 

Your doctor may recommend hip replacement surgery if your everyday activities are seriously limited, you're in pain while you're resting, or the stiffness in your hip keeps you from moving your leg properly. It may also be an option for people who don't find relief after trying physical therapy and anti-inflammatory medications.

Recommended reading: Joint Replacement Surgery: Options to Try First
Prehab: Su guía para una cirugía electiva exitosa   

Can exercise improve hip pain? 

Yes, it can! And SilverSneakers can help. It may seem like a bad idea to exercise when you're hurting, but it's not. Inactivity can cause your muscles to weaken, which also weakens your hips, lower back, knees - and every other part of your body.

You don't need to exercise too strenuously to see the benefits of movement. Talk with your doctor about what kind of exercise is right for your situation, especially if you have arthritis or sharp pain. (It's always a good idea to talk to your doctor before beginning a new exercise program.)

Once your health-care provider gives you the greenlight, here are some move-more options to try:  

• Gentle stretching 
• Restorative yoga and chair yoga 
• Pilates 
• Taichí 
• Nadar 
• Caminar  
• Strength training using light weights and high repetitions 
• Low-impact group fitness classes 

SilverSneakers classes may be high energy, but most aren’t high impact. That means they don’t put too much stress on your hips.   

If you find that some movements make your hips hurt, ask your teacher to modify the moves or give you different exercises to try. SilverSneakers instructors are trained in the unique fitness needs of older adults, and can show you modifications that will help you exercise safely.  

One of our more gentle and joint-friendly classes is SilverSneakers EnerChi. It’s a modified tai chi class with a slow, flowing sequence that doesn’t put too much pressure on your hips. It’s offered both in-person at participating fitness locations and online through SilverSneakers LIVE (view the schedule and RSVP here).  

Press play to try a mini version of an EnerChi class 

Recommended reading:
Los mejores y los peores ejercicios para problemas de cadera
7 Exercises that Strengthen Your Hips
6 maneras sencillas de fortalecer las caderas todos los días
Yoga Flow to Ease Tight Hips and Back 

What other lifestyle habits might relieve my pain? 

Exercise is great for everything, of course. But there are other things you can do that can make a big difference:

Maintain a healthy weight: Every extra pound puts additional strain on your joints, including your hips. Being overweight or obese also increases your risk for an injury and osteoarthritis. 

Reduce your risk of a fall: Hip pain impacts your balance because it can make you move differently. Take a look at your living space and remove anything that may cause you to trip, like throw rugs, clutter or even low lighting. 

Eat healthy foods: Nuts, seeds, fatty fish, fruits, vegetables, beans, and olive oil can lower inflammation throughout the body. Lower levels of inflammation can lead to less pain.  

Quit smoking: Lighting up may aggravate joint pain and increase pain sensitivity, according to the Cleveland Clinic. That means not only do you feel more pain, but you feel it even more than a nonsmoker would. 

Recommended reading: 5 Ways to Manage Osteoarthritis Pain Without Surgery 

I'm not sure if my hip pain is serious. When should I talk to my doctor?

It's never a bad idea to talk to a health care professional if you're in pain. This is particularly true if the treatments you've tried haven't helped or your pain is getting worse.

Your doctor can help you with the next steps. If your mobility is getting worse because of your hip pain, make an appointment sooner rather than later. A slip or fall can cause a hip fracture that can lead to even bigger problems.

There are certain times where you should seek medical help right away. Those include:

• You can’t move your leg or hip 
• A joint appears deformed 
• Intense pain 
• You can’t stand on the affected leg 
• Signs of infection like fever or chills 
• Sudden swelling 

Whatever your level of hip pain, it doesn't mean you have to grit your teeth and put up with it. The sooner you start doing something about your hip pain, the more likely you are to make it better.

Recommended reading:
Find Your Place: Check Your Hip Health
8 Steps You Should Take After a Hip Fracture  

See our sources: 
Prevalence of hip pain in older adults: American Family Physician  
Acute vs. chronic pain: Cleveland Clinic 
Chronic hip pain in adults: Journal of Anesthesiology and Clinical Pharmacology
Causes of hip pain: Mayo Clinic
Diagnosing hip pain: Hospital for Special Surgery
How smoking worsens chronic pain: Cleveland Clinic 
Ankylosing spondylitis facts: Cleveland Clinic 
Non-surgical hip pain treatments: Penn Medicine
Severe hip pain and hip replacement surgery: Penn Medicine  
Total hip replacement facts: American Academy of Orthopaedic Surgeons 
Tips for strong and healthy hips: Northwell Health 
Outcome of falls and hip fractures in older adults: Journal of Orthopaedics and Traumatology 

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