Hip And Leg Pain Persist Ever Since An Active Trip To France
DEAR DR. ROACH: In 2022, I took a trip to France to visit friends and sightsee. My hip/leg pain started after I spent my days walking and climbing stairs in Paris. (I walked 16 miles one day!) I rested during the evening and took ibuprofen before going to bed. I did not stop my activities because this was a special trip.
Later during my vacation, I hiked trails in the Alps. There are stairs everywhere in France with very little adjustments for those who have mobility issues. It was very debilitating. When I came home, my doctor ordered an X-ray, then diagnosed me with hip bursitis on both sides.
I was in physical therapy for many weeks. Every now and then, if I pursue activities like hiking or long walks, I can feel some pain. I don't like limiting my activities because I am relatively healthy. Now I am 60 years old and returning to France. What can I do to prevent this pain from happening again without restricting my activities? Or what can I do to alleviate the pain if it occurs? I don't want to become sedentary. -- J.M.C.
ANSWER: Greater trochanteric pain syndrome is still mostly called "trochanteric bursitis," despite the fact that the hip bursa really isn't inflamed, but this condition does sound like your diagnosis. It is caused by the overuse of the muscles and tendons in the hip, particularly those of the gluteus medius and minimus muscles.
Stair and hill-climbing are the activities that are most likely to cause a recurrence of your symptoms. However, you may be able to prevent symptoms from recurring. The muscles you want to strengthen are your hip abductors (those that move your leg away from the midline of your body).
By strengthening these muscles, the abnormal forces on your gluteal muscles and tendons can be avoided. Your physical therapist can show you how to do this, either with a spring-resisted sliding platform or an elastic resistance band. This should prevent the recurrence of GTPS.
DEAR DR. ROACH: My 84-year-old husband takes 10 mg of amitriptyline at bedtime and 100 mg of sertraline in the morning. I'm concerned about these drugs. Alzheimer's runs in his family, and he's beginning to have issues with his memory.
Are amitriptyline or sertraline used for other health issues? I don't understand why he's on antidepressants, and I am concerned about his mental health. What are your thoughts on these? -- C.W.
ANSWER: Amitripylene can be taken as an antidepressant, but your husband is not taking amitriptyline as an antidepressant. The antidepressant dose of amitriptyline is usually 300-600 mg. A 10-mg dose is most commonly used for chronic pain, although there are other uses.
Sertraline (Zoloft) is commonly used for depression, and 100 mg is the typical dose. But it can also be used for anxiety, obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder, and other reasons.
The memory issue is complex. It is possible for medicines like sertraline and amitriptyline to bring on memory issues, which sounds like a major (and reasonable) concern for you. However, depression can cause symptoms that look exactly like early dementia. It's possible that his doctor is treating underlying depression, and treatment may help, rather than hurt, his mental health.
As you see, the situation is potentially complex. If it's OK with your husband, you might go with him to visit the doctor who is prescribing these medications.
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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.
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