My father is having continuous hip pain. How to evaluate this?

Question

Hi doctor,

My father is having a continuous pain in his hip for the past four months. The pain can only be ease by consuming painkillers. The pain has prevented him from walking by himself. Most of the time, he cannot sleep throughout the night because of the pain. He is a diabetic and on regular Insulin. He went to the hospital several times and had a hip x-ray. But, there is nothing wrong with his bones according to the doctors. We do not know what to do to help him killing the pain. Please help.

Answer 1

Hello,

Welcome to icliniq.com.

There are two possibilities, joint pain or nerve pain like sciatica. There can be multiple problems in the joint like age-related degeneration or arthritis, so we need to evaluate. What kind of pain is it? Is it a burning or pins and needles kind of pain? Does it travel from hip to lower limb? Is there any associated back pain? If yes, then it could be a nerve pain called as sciatica and treatment would be different. He can get prescribed from the local doctor a nerve vitamin Neurobion forte once a day and nerve stabilizer like tablet Pregabalin 75 mg bedtime. The next step is MRI scan of hip, SI joint (sacroiliac) and LS spine (lumbosacral). It will explain the picture regarding diagnosis, and we can go ahead with treatment. Also, he will need some blood test like ANA antibody test (antinuclear antibody), ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), rheumatoid factor, calcium and vitamin D level. At this moment, he should have calcium and vitamin D supplements like tablet Shelcal HD twice a day after giving a sample for a blood test and Diclofenac gel or spray for local application and pain whenever needed. In pain, the safer one is tablet Ultracet 50 mg (Paracetamol and Tramadol) whenever needed along with antacid like tablet Pantoprazole 40 mg once a day before breakfast. Please discuss my opinion with your treating doctor and take treatment with consent.