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hip pain and orthotics

Posted by brian on June 29, 1999 at 09:38:21
I'm 30 years old, 5'11" and 160 lbs. Good health has always been a priority.
A few years ago, when I went to see a doctor about random knee pain, he told me that I pronate (specially with my left foot) and that I have flat feet (specially the left). Soon thereafter, I bought orthotics and have been fairly happy with them. But recently, my left foot has begun to develop a bunyon on the small toe. I went to see a podiatrist who told me that my shoes are too small for me (specially the left one since it is bigger than my right). He suggested that I try some better fitting shoes and if that didn't help, he'd suggest new orthotics. I bought bigger shoes and my bunyon does feel better, but my right hip has begun to hurt. The pain began on the side of my hip, but it has spread to my buttock and groin.
It's not unusual for my hips to feel a bit funny for a couple days after buying new shoes, but this time it has lasted longer, and I'm worried that I may be damaging the hip joint. Since the shoe are bigger, the orthotics lie flatter. Do you think that that could be the cause of my hip pain? Is there some tests I can do to rule out arthritis or to check hip joint integrity? What should I do?
Thank you for your time.

Posted by CCF Neuro MD msf on June 29, 1999 at 13:26:01
Dear Brian,
Certainly, using new shoes may cause pain in the hip area, because it changes the dynamics of your gait. Usually, this type of temporary pain is due to inflammation around your joint. If it resolves spontaneously within a couple of days, this is not worrisome. If it lasts longer, you may try a short course of antalgic and anti-inflammatory medications. The easiest way to check the integrity of your hip joint is to perform an X-ray, which could also tell if there is anything in the conformation of your hip that might explain why you have recurrent hip pain. I would recommend to discuss these issues with your family physician. Remember that this information is disclosed only for the purpose of general medical education.

Posted by brian on June 30, 1999 at 09:29:48
Thank you so much for your response.
I have something to add to my description.
The pain I feel in the groin is mostly when I'm sitting. It seems to be caused by my weight resting on a bone. The painful spot is just to the right of the perineum (between the legs, just under the right buttock). I've been working on my seated posture lately so I've been sitting up straight with my pelvis tilted forward. It is in that position that I most notice the groin pain. I have rather thin legs so I don't have much padding down there.

I don't think this is the spot of the hip joint. Is it?
Does the hip joint rest on the seat of the chair when seated?
Regarding an X-ray, I just had my feet X-rayed about a month ago (6 pictures in total). Is it safe to have another X-ray so soon?
Finally, I don't feel any pain in the groin when walking or climbing stairs. Shouldn't walking or climbing stairs cause pain if the pain is originating from the hip?
Thank you again.

Posted by CCF Neuro MD msf on June 30, 1999 at 10:07:57
Dear Brian,
Orthopedics is not really my specialty, but I can give you at least partial answers. A hip problem can cause pain radiating to the groin, but you are right, it should increase when you are actually using the hip, and should be less intense or absent when sitting. The hip joint itself does not directly rest on the chair when sitting. The pain may be related to your pelvic bone. I would maintain my recommendation: if the problem persists and is annoying, it is better to be examined by a physician, who will decide whether it is useful to get X-rays or not. Being exposed to X-rays always represent a risk in itself, but if there is a good reason to perform them, a one-month interval does not represent a major increase in risk, especially if done on different parts of the body. I hope this helps.

Posted by brian on June 30, 1999 at 11:21:15
Thank you.

Posted by CCF MD... on July 20, 1999 at 11:24:46
We wish you the best of luck

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