Ask the Doctor: Hip Arthritis; Sinusitis Treatment; Boosting Metabolism

Q: How do you tell the difference between back pain and a bad hip?

A: If you have hip arthritis, the symptoms can often mimic those of sciatica or a similar cause of back pain. Sciatica, which usually results when a herniated disk or bone spur compresses on part of a nerve in the spine, can cause pain to run from the back, through the hips and down one or both legs. Typically sciatica affects only one side of the body.

The pain from hip arthritis is usually felt in the buttock, groin and sometimes in the front of the thigh. An-other common symptom of hip arthritis is stiffness, especially after standing up after sitting or lying down in the same position for a long time.

A physical exam and a detailed description of your symptoms can usually help a physician determine whether the source is a problem with a hip or the spine. A simple X-ray of the hips can usually detect arthritis. An X-ray of the spine, as well as an MRI, can usually reveal whether a bone spur or herniated disk.

Regardless of the source of your pain, you should seek a comprehensive evaluation of your symptoms and treatment to manage symptoms and improve your quality of life. Remember that treatment for arthritis and spinal conditions can often be successful without surgery.

Q: I experience occasional bouts of acute sinusitis. But I don’t want to take a lot of antibiotics. My doctor also doesn’t think I need them. What are some effective alternatives?

A: Acute sinusitis is a condition in which the cavities around the nasal passages or sinuses become swollen and inflamed. As a result, mucus builds up and drainage becomes more difficult. Breathing through your nose also becomes tougher, and pressure inside the sinuses can contribute to facial pain and headaches.

There are actually several over-the-counter medications that can relieve symptoms of sinusitis. Decongest-ants, such as Sudafed and Actifed, can help narrow blood vessels that will reduce the swelling that causes congestion. Pain relievers, such as aspirin, acetaminophen and ibuprofen, can also minimize the sinus pressure that accompanies this condition.

Other remedies include placing warm, damp compresses across your nose, cheeks and eyes. That may ease some facial pain. Saline irrigation or other sinus rinse can also be very effective.

If you have frequent episodes of sinusitis, you may actually have chronic sinusitis, rather than bouts of acute sinusitis. The causes may still be the same. Common causes include allergies and viral or bacterial infections. But you may also have a deviated septum (the wall between the nostrils) that is blocking your nasal passages, or you may have nasal polyps. If you haven’t already, talk with your doctor about these possible sources of your sinusitis. If there is blockage in your nasal passages, minimally invasive surgery could be the best solution.

Q: It seems my metabolism has slowed a lot as I’ve gotten older. Is there a way to improve it to help lose weight?

A: It is true that our metabolism slows with age, and that’s because the mitochondria, the cells’ energy factories, slow down as we get older. But there are other factors that contribute to metabolic changes and the tendency to keep weight on the older we get.

One of the primary causes is a reduction of muscle mass that occurs with age. The greater muscle mass a person has, the more efficiently he or she burns calories. That’s why older adults are encouraged to in-clude weight-bearing exercises and resistance training in their workout routines. More exercise in general will not only rev up your metabolism, so you burn calories more efficiently. It will also help you burn more calories, period. Face it, most of us aren’t as active at 65 as we were at 25.

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