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Suggest Treatment For Back Pain
Question: I would specifically like to ask Dr.Wachsman about my arthritic condition. Can lower back pain on the opposite side of the afflicted hip teated with tradional otc medications. If so ...which ones.
Brief Answer:
oh hey ! it worked!
Detailed Answer:
but the notification system messed up and normally they should send me a text immediately and they didn't.
MY apologies for not answering IMMEDIATELY. Generally I will.
Ah! lower back pain.
Several points. First is it is possible to distinguish hip from back pain/sciatica. The hip is especially sore from weight bearing and moving the leg straight OUTWARD. the sciatic nerve runs down the back like a fishing line and yanking on it by kicking the leg straight out gives pain there. Also, the hip is bone (dull, constant) and the nerve is a nerve (shooting, often with an electrical or temperature sensation).
each can be due to quite a lot BUT if there are x rays showing degeneration of the joint of the hip. THat is going to be one source of pain. It just might not be the ONLY source of pain.
Ok. Treatment of pain depends a bit on the cause. Regular bone/muscle/joint pain is often helped by heat, non-steroidal anti-inflammatories and physical therapy. Also deep water pushes fluid out of joints. Best with knee and ankle, mediocre on deeper joints like the hip. a lot of people wind up on narcotics. That is a problem. Joint replacement works pretty well with hip. They wear out in about 15 years.
oh hey ! it worked!
Detailed Answer:
but the notification system messed up and normally they should send me a text immediately and they didn't.
MY apologies for not answering IMMEDIATELY. Generally I will.
Ah! lower back pain.
Several points. First is it is possible to distinguish hip from back pain/sciatica. The hip is especially sore from weight bearing and moving the leg straight OUTWARD. the sciatic nerve runs down the back like a fishing line and yanking on it by kicking the leg straight out gives pain there. Also, the hip is bone (dull, constant) and the nerve is a nerve (shooting, often with an electrical or temperature sensation).
each can be due to quite a lot BUT if there are x rays showing degeneration of the joint of the hip. THat is going to be one source of pain. It just might not be the ONLY source of pain.
Ok. Treatment of pain depends a bit on the cause. Regular bone/muscle/joint pain is often helped by heat, non-steroidal anti-inflammatories and physical therapy. Also deep water pushes fluid out of joints. Best with knee and ankle, mediocre on deeper joints like the hip. a lot of people wind up on narcotics. That is a problem. Joint replacement works pretty well with hip. They wear out in about 15 years.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
first, the pain feels muscular on the right side. but two weeks ago I was virtually crippled in the right hip..mostly localized midway down the ouside hip. I could only walk or waddle a step or two at a tme. went to urgent care anf then to orthopedist. it hurt so bad it was all I could do to not cry. they gave me a cortisone shot and pain and muscle relaxer pills. after agony for ten days ..the pain cleared up in about 3 days of the shot and it has not returned. concerned because onset of the episode was immediately procedded by the back pain I am experiencing now...finnall, I left a reply to your last response in our last conversation and had one final question...the getting drunk thing was a joke!!!!!! iam sorry you took it seriously. ithought you see I was being facetious when I used the word spray. pleases read resonse and try to forgive me. seriousl, you kept talking about hand sanitizer...I did not use hand sanitizer and I am not prepared to lie about it. so for the last time..is it likely and plausible...knowing the contents of the spray that is the reason for the discrepancy in the test , I have the can..i can show them the can I can not show them hand sanitizer please respond for the record I do not drink I am an alcoholic that is why I am in counseling.to address the problem not to "beat the system" again I have the highest regards for your opinions and greatly appreciate your help and hard workin this matter, please forgive me for a joke in poor taste..i thought we were developing a great doctor/patient relationship...sorry I overstepped my bounds. please respon/confirm about the spray it is important that know for sure talkto you later..forgot to mention ..to busy apologizing for being stupid...sorry.......pain in left hip is almost exclusively in the groin knew is also affected.oftenthe pain is simply a dll . deep throbbing pain it doesnot go away simply varies in intensity...occasionally they kee throbs like the hip but the ortho has not addressed it or taken xrays. the right hip was exclusively on the outside no knee pain. while right mainly throbs it will ocassionally issue a sharp electric like pain this usually occurs when I make a sudden movement or twist also sometimes the knee will "bucle" on me with no warning. iam takingdiclofenac-misoprost 2x a day as needed. can not tell if it actually does anything or not. I try heatng pad at night...mixed results. difficult to sleep every 15-20 min must shift position...I call it brotessirree sleeping. I have extreme difficulty extending the leg often I must lay with bent knee. when I turm there is anaudbke, multiple click, click like someone craking teir knucles. what can you tell me about the procedure itself, recovery to be at least functional, post operative recovery plans, etc. thanks me
Brief Answer:
Oh I did think it was a joke.
Detailed Answer:
but I have to make certain things rather clear.
No, nothing to apologize for. Just wanted to be quite clear and have it explicit that you are innocent and it's from the spray, etc. Yes, I got it was a joke but I wanted to make things clear. No you didn't overstep any bounds etc. Just I'm serious that I might represent you in court and I wanted to get some points out in the open.
So, we know it most likely is hip arthritis and that's it because the shot worked. There isn't anything over the counter that is that good. Here's the thing on the shots: the injection tends to stay put in the joint. So, if it works (and it does in most people but nowhere near 80%... closer to 50/50) then it will tend to last for a month even if the person 1) has bad arthritis and 2) has a very active life that 3) makes the inflammation come back as fast as it could (1 month). if someone isn't so active and the inflammation/pain was due to something that isn't necessarily isn't going to repeat daily, then the effect of the shot generally lasts 3 months. Then, if you're getting pretty good results every 3 months, it's a reason to hold off a bit on the operation. Which is what most surgeons will say.
Frankly, all I know about orthopedics I learned from being an internet answerman. The first time I did work like this was prior to the internet in a physician call center. We got thousands of questions. I would holler out for advice from the orthopedists next to me and I learned a lot.
Oh I did think it was a joke.
Detailed Answer:
but I have to make certain things rather clear.
No, nothing to apologize for. Just wanted to be quite clear and have it explicit that you are innocent and it's from the spray, etc. Yes, I got it was a joke but I wanted to make things clear. No you didn't overstep any bounds etc. Just I'm serious that I might represent you in court and I wanted to get some points out in the open.
So, we know it most likely is hip arthritis and that's it because the shot worked. There isn't anything over the counter that is that good. Here's the thing on the shots: the injection tends to stay put in the joint. So, if it works (and it does in most people but nowhere near 80%... closer to 50/50) then it will tend to last for a month even if the person 1) has bad arthritis and 2) has a very active life that 3) makes the inflammation come back as fast as it could (1 month). if someone isn't so active and the inflammation/pain was due to something that isn't necessarily isn't going to repeat daily, then the effect of the shot generally lasts 3 months. Then, if you're getting pretty good results every 3 months, it's a reason to hold off a bit on the operation. Which is what most surgeons will say.
Frankly, all I know about orthopedics I learned from being an internet answerman. The first time I did work like this was prior to the internet in a physician call center. We got thousands of questions. I would holler out for advice from the orthopedists next to me and I learned a lot.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thank you Doctor for everything. have not slept in over 40 hours going to bed.. see what you can find out for me about the actual procedue aftermath and recovery plan. really do appreciate your help talk to you later good night...me
Brief Answer:
whhoops sorry.
Detailed Answer:
I actually answered it about 7 hrs ago, but I was about to hit the send button and got an emergency medical call from the wife. She is fine now after being treated by one of the finest ER physicians in the area.
Ok....
The operation takes ou tht eentire hip. The leg part is replaced by a titanium ball on a spike that is cemented into the leg. The top part is replaced by a socket of titanium. After the cement hardens, the person is up doing physical therapy in about a day and usually is out of the hospital certainly in under a week.
One of the best dancers at my ballroom place wasn't dancing for over a year and now dances every dance after getting her knees replace by Dr. Cook at the Harford/Balto county line.
is another good place.
If someone is not majorly improved in 1 to 2 weeks after replacement, then something was very wrong. Mostly, the patient didn't need the surgery enough.
whhoops sorry.
Detailed Answer:
I actually answered it about 7 hrs ago, but I was about to hit the send button and got an emergency medical call from the wife. She is fine now after being treated by one of the finest ER physicians in the area.
Ok....
The operation takes ou tht eentire hip. The leg part is replaced by a titanium ball on a spike that is cemented into the leg. The top part is replaced by a socket of titanium. After the cement hardens, the person is up doing physical therapy in about a day and usually is out of the hospital certainly in under a week.
One of the best dancers at my ballroom place wasn't dancing for over a year and now dances every dance after getting her knees replace by Dr. Cook at the Harford/Balto county line.
is another good place.
If someone is not majorly improved in 1 to 2 weeks after replacement, then something was very wrong. Mostly, the patient didn't need the surgery enough.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
good afternoon: wanted to ask Dr. Wachsman a question. What is the fee for hiring an expert to testify in a court case?
Have been reading a little on hip replacement...apparently there are more than one type of procedure. Is blood poisoning (metal in the blood) a real possibility? Also, what are the risks of the leg coming out shorter than it was before the procedure
Have been reading a little on hip replacement...apparently there are more than one type of procedure. Is blood poisoning (metal in the blood) a real possibility? Also, what are the risks of the leg coming out shorter than it was before the procedure
Brief Answer:
several answers.
Detailed Answer:
200 an hour or 1000 a day is pretty standard. Basically about 1 grand at worst; 200 at best and often just a statement is given not an appearance, so, 200. I'd copy a lot of it.
There isn't really a titanium poisoning, so, blood metal poisoning can't really be a thing. There are a lot of people who've gotten these procedures.
The leg can come out shorter or longer. Of course lots of people are generally built that way and people adjust. The difference would certainly have to be over an inch off and probably 2 inches or more before it would be an issue. If it were that far off it would be tricky to fix it.
several answers.
Detailed Answer:
200 an hour or 1000 a day is pretty standard. Basically about 1 grand at worst; 200 at best and often just a statement is given not an appearance, so, 200. I'd copy a lot of it.
There isn't really a titanium poisoning, so, blood metal poisoning can't really be a thing. There are a lot of people who've gotten these procedures.
The leg can come out shorter or longer. Of course lots of people are generally built that way and people adjust. The difference would certainly have to be over an inch off and probably 2 inches or more before it would be an issue. If it were that far off it would be tricky to fix it.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you ....am going now to see counselor to discuss situation and take another test...will talk to you later...hope your wife is doing better.
Brief Answer:
Good. Keep in touch.
Detailed Answer:
Apparently there is something called DIRECTED QUESTIONS that get to me directly. I have no idea how they work.
I'm available as expert witness. The hip depends mainly on how bad somebody is. If they can walk fairly normally, the surgery isn't going to make as big a difference as if they cannot walk due to pain. It's going to get worse over years, so, waiting will put someone into a bad situation with it. x ray findings of bone on bone mean that. But, oddly, bone on bone is read ad "Moderate disease". This is because the bone eventually wears out too. So, I can't say if the operation is needed today. I can say it's going to be needed sometime. Best of luck with that. Some good orthopedists were mentioned!.
Good. Keep in touch.
Detailed Answer:
Apparently there is something called DIRECTED QUESTIONS that get to me directly. I have no idea how they work.
I'm available as expert witness. The hip depends mainly on how bad somebody is. If they can walk fairly normally, the surgery isn't going to make as big a difference as if they cannot walk due to pain. It's going to get worse over years, so, waiting will put someone into a bad situation with it. x ray findings of bone on bone mean that. But, oddly, bone on bone is read ad "Moderate disease". This is because the bone eventually wears out too. So, I can't say if the operation is needed today. I can say it's going to be needed sometime. Best of luck with that. Some good orthopedists were mentioned!.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello again....just got back from counselor...took another test... after showing him the spray, the dip test and a transcript of our conversation he agreed that this is a plausible explanation. He called the po in my presence and said this simply a mistake and should be overlooked. I see po tomorrow and still have my fingers crossed but I wanted to thank you again and will stay in touch with other health questions.....including smoking cessation. thank you again...jff
Brief Answer:
Glad to help
Detailed Answer:
and 1) I really think it is seriously the most likely possibility and 2) calling you out forcefully for a very minor joke meant that you would put down in writing that you were NOT drinking and for us to EXPLICITLY and completely say all sorts of things that make the overall transcript work really well for you. Yeah, I thought that might happen. and 3) there's all the scientific references you could need to back up the whole thing.
So, I'm sure it will go quite well.
Glad to help
Detailed Answer:
and 1) I really think it is seriously the most likely possibility and 2) calling you out forcefully for a very minor joke meant that you would put down in writing that you were NOT drinking and for us to EXPLICITLY and completely say all sorts of things that make the overall transcript work really well for you. Yeah, I thought that might happen. and 3) there's all the scientific references you could need to back up the whole thing.
So, I'm sure it will go quite well.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
The back pain above the "good" hip continues to be annoying.....smokng...tried gum, patch, Chantix....thinking about hyptnotism (sic)...any thoughts? let you know (if I am not in jail) how it went with po. By the way I was and will continue to be completely honest with you. I have learned two absolute truths....never lie to your doctor or your lawyer it ALWAYS will come back and bite you in the ass. Talk to you later (I hope) jf
Brief Answer:
Not sure on the back pain.
Detailed Answer:
I'm sure this is both the strongest defense you can get for the PO and also the truth.
THe back, I'm really not sure that it isn't ALL the hip. Sciatica, pain from a pinched nerve in the back has certain characteristics as mentioned: it is sharp, shooting, goes THROUGH the hip and down the leg from the back, etc.
The cigarettes is another topic entirely.
Not sure on the back pain.
Detailed Answer:
I'm sure this is both the strongest defense you can get for the PO and also the truth.
THe back, I'm really not sure that it isn't ALL the hip. Sciatica, pain from a pinched nerve in the back has certain characteristics as mentioned: it is sharp, shooting, goes THROUGH the hip and down the leg from the back, etc.
The cigarettes is another topic entirely.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello....went to po this am....he did not even bring up the test....(remember counselor called after he looked at your transcript)... do not have to go back to po until November. I continue to research hip replacement, but want to find best options ie: local surgery or another facility...have to consider technique...time down, and recovery plans. I would like to start a separate thread to continure health care questions to include hip, smoking cessation, and ( I hate this one) health care insurance... currently, since I recently retired I have extremely great coverage through "Cobra"...but it only lasts 18 months. Since I am now receiving XXXXXXX disability I would be eligible for medicare after two full years. Not sure if receiving XXXXXXX is a second "life event" or if I need to fill in the "gap" also, If I have surgery does that disqualify me from XXXXXXX benefits. Do not want to take advantage of system...but still need to make well informed decisions to ensure survival. I am willing to make an office appointment if you think that this forum is inappropriate for these types of conversations...however, I want you to realize that of all (6) "computer" doctors that I contacted you are the only one who went out of their way to be diligent and seek the answers to the questions I asked. Thank you again! Not to be personal...I hope your wife is doing well.
Brief Answer:
You could do better than me on the insurance questions.
Detailed Answer:
On the hip, while I can make an assessment with an office visit, you will have a better life if we go over some points and then you make an appointment with an Orthopedist with the necessary special training and experience on the hip.
1) on diagnosis, the back and the hip pain might be different problems or the same. This can be differentiated by both the type of pain with back pain from a pinched nerve
The hip is especially sore from weight bearing and moving the leg straight OUTWARD. the sciatic nerve runs down the back like a fishing line and yanking on it by kicking the leg straight out gives pain there. Also, the hip is bone (dull, constant) and the nerve is a nerve (shooting, often with an electrical or temperature sensation).
each can be due to quite a lot BUT if there are x rays showing degeneration of the joint of the hip. THat is going to be one source of pain. It just might not be the ONLY source of pain.
Diagnosis is by MRI.
Hip replacement is a common procedure that I personally have never seen fail. Back pain surgery I have seen fail very frequently BUT there is a bias in that if it works great I won't see that person on a back pain complaint but only those where it failed. Still, it doesn't work as often as hip replacement.
Dr. Cook and The Medstar Orthopedist group are two orthopedists that are fine.
I really like the topic of cigarette addiction (and other addiction questions; I am board certified in it).
There are several potential parts to any addiction. The withdrawal from the drug and other direct effects of the drug are one set of important features that can be handled by taking the addictive chemical in another way that makes less damage (nicotine substitution therapy). Also Vaping.
Then there is the psychological issues. These generally aren't quite the problem and ....
The learned response and behavioral issues are often the main thing with cigarettes. One gets used to taking them in a particular way after a particular set of circumstances.
You could do better than me on the insurance questions.
Detailed Answer:
On the hip, while I can make an assessment with an office visit, you will have a better life if we go over some points and then you make an appointment with an Orthopedist with the necessary special training and experience on the hip.
1) on diagnosis, the back and the hip pain might be different problems or the same. This can be differentiated by both the type of pain with back pain from a pinched nerve
The hip is especially sore from weight bearing and moving the leg straight OUTWARD. the sciatic nerve runs down the back like a fishing line and yanking on it by kicking the leg straight out gives pain there. Also, the hip is bone (dull, constant) and the nerve is a nerve (shooting, often with an electrical or temperature sensation).
each can be due to quite a lot BUT if there are x rays showing degeneration of the joint of the hip. THat is going to be one source of pain. It just might not be the ONLY source of pain.
Diagnosis is by MRI.
Hip replacement is a common procedure that I personally have never seen fail. Back pain surgery I have seen fail very frequently BUT there is a bias in that if it works great I won't see that person on a back pain complaint but only those where it failed. Still, it doesn't work as often as hip replacement.
Dr. Cook and The Medstar Orthopedist group are two orthopedists that are fine.
I really like the topic of cigarette addiction (and other addiction questions; I am board certified in it).
There are several potential parts to any addiction. The withdrawal from the drug and other direct effects of the drug are one set of important features that can be handled by taking the addictive chemical in another way that makes less damage (nicotine substitution therapy). Also Vaping.
Then there is the psychological issues. These generally aren't quite the problem and ....
The learned response and behavioral issues are often the main thing with cigarettes. One gets used to taking them in a particular way after a particular set of circumstances.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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