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Pain Management/Arthritis pain management


X-ray of hip joints
X-ray of hip joints  
QUESTION: My mom is 54 years old. She is diabetic. Has hypothyroidism.

What could you infer from the X-ray attached with this mail?

She has pain on her left knee, though not permanently? And, 2 months ago, she had swelling of the leg heel and above.. She had acute pain around ankle and swelling persisted for nearly 10 days.

Her ESR is 35 (after 2 hr) and CRP is 8.0. Uric acid is 36.0 (when higher threshold limit is 43). Has positive rheumatoid factor though within limit.

Does it mean arthritis on hip, knee and ankle? What're the precautions to be taken?

ANSWER: Dear Bragadeesh,

The first precaution is for her to change her diet.  The combination of diabetes and hypothyroidism indicates improper diet -- to much carbohydrate, not enough iodine.  She should be treated for hypothyroidism. If thyroid hormone supplementation is used, synthetic forms should be avoided, as ineffective; bioidentical thyroid hormone should be used. This is a matter for her physician.

Diabetes (one form) thickens the blood through high concentration of blood sugar.  That impedes circulation.  However, the effects would be throughout the body, not localized, as in knee or ankle.

The likely explanation for the pain is musclebound muscles in those regions.

Plesae see this entry on arthritis:

Please see this article:

and this video for her ankles:

For pain in the hips, it's necessary to know the exact location of the pain and the movements that cause it.

Certain somatic education exercises can alleviate the muscular problems.  Ask, if you want recommendations.  Those would be the precautions for that pain.  The x-ray shows space between the head of the thighbone and pelvis, indicating presence of cartilage, so, not arthritis.

---------- FOLLOW-UP ----------

QUESTION: As far as knee is concerned, she seems to have pain on overuse. If she wears kneepad and walks, she doesn't feel pain. But, once she removes the kneepad she feels the pain: especially on her left knee. What does this mean?

As far as hip is concerned, she can't sit cross-legged at all on floor, even while sitting on a chair. While getting up from floor, she can't get up without using her hands as support on the floor. Please let me know on these.

It's tight hamstrings and (likely) psoas muscles.

Please read the article I linked in my first response about hamstrings.  It contains a self-relief video and an explanation.

As to tight psoas muscles, that should be verified by direct, manual examination.  However, I still need to hear from you the exact location of the hip pain.  

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Lawrence Gold


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In practice since 1990. Two years on staff at a hospital Wellness and Rehabilitation Center.

Townsend Letter for Doctors and Patients, American Journal of Pain Management, Somatics: Magazine-Journal of the Mind-Body Arts and Sciences. More complete listing at

Certifications: Hanna Somatic Education, the Dr. Ida P. Rolf method of Structural Integration (partial list)

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