DEAR DR. DONOHUE: I have a pain in the upper, outer part of my right thigh, about midpocket level. If I touch that spot, it hurts. My neighbor is a physician’s assistant, and he says I have trochanteric bursitis. How is it treated? – V.H.

ANSWER:
The thigh bone is the femur. At the spot you indicate, the femur has a bony projection, the greater trochanter. Between that bony projection and the muscles and tendons that pass over it is a bursa. The body has hundreds of bursas. They’re in places where friction develops when muscle or tendon passes over bone. Bursa inflammation – bursitis – is a common condition. Trochanteric bursitis happens to many people.

Overuse is the major cause of bursitis. In this case, too much walking or jogging could have brought yours on. If you have even a slight touch of hip arthritis, you might be walking in such a way that protects the hip but puts stress on the trochanteric bursa.

Rest is the primary treatment. Rest doesn’t mean you have to take to your bed or be immobile. It just means you shouldn’t be doing anything that aggravates the pain. Anti-inflammatory medicines – aspirin, ibuprofen, indomethacin – relieve pain and calm inflammation. You’re past the period when icing the area helps. Heat would – hot compresses or a heating pad.

If, in a week, the pain hasn’t gone, see your family doctor, who can confirm the diagnosis and inject the area with cortisone, which almost always puts an end to bursitis.

DEAR DR. DONOHUE: I have a bulging disc in my back. It’s somewhat painful, but it hasn’t stopped me from doing anything I want to do. I am going to leave it alone. Is that a sane policy, or should I have surgery now to remove it? – B.C.

ANSWER:
Yours is a very sane policy.

Discs are shock absorbers placed between adjacent backbones. They have a gellike core. A bulging disc is one whose core protrudes through the disc’s rim. If the bulge presses on an adjacent nerve, back pain results. The pain can run down the leg.

Ninety percent of people who have your condition and are in pain will experience a remission of symptoms within a month by doing nothing.

During this period, you don’t have to be inactive. Do whatever you can do without causing intolerable pain. Don’t sit for long periods. Sitting is harder on the back than standing.

The booklet on back problems presents the many causes of back pain and their treatments. Readers can order a copy by writing: Dr. Donohue, No. 303, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I developed a bulge on the back of my knee. It was soft and painful. I feared it might be cancer, so I saw my doctor. She said it was a Baker’s cyst. She told me to go easy as far as walking goes and to take ibuprofen, and it would probably go away.

How did I get it? What if doesn’t go away – what then? – P.O.

ANSWER:
A Baker’s cyst is a bursa that has filled with fluid. In the case of a Baker’s cyst, the fluid most often comes from the knee. Something has gone wrong with the knee. The knee and the bursa are connected by a tunnel with a one-way valve. Fluid can pass into the bursa from the knee, but it cannot return to the knee from the bursa.

If your current treatment doesn’t take care of matters, the doctor can drain the fluid with a needle and syringe. At the same time, she can inject the bursa with cortisone, which soothes any inflammation in the bursa. Surgery is necessary only in extreme cases.

For many years I thought the “Baker” of Baker’s cyst referred to bakers, because they were on their feet all day. It refers to William Baker, a British surgeon who lived in the 19th century.

DEAR DR. DONOHUE: What’s the meaning of “MCV” and “MCH” on a blood report? – G.T.

ANSWER:
“MCV” is “mean corpuscular volume,” the average size of red blood cells. “MCH” is “mean corpuscular hemoglobin,” the average content of hemoglobin within red blood cells. The values aid in determining what kind of anemia a person has.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com


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