What is the treatment for hip and ankle pain in a teenager?

From the Guidelines

Treatment for hip and ankle pain in a teenager should initially focus on conservative management, including rest, ice, compression, and elevation (RICE protocol), as well as over-the-counter pain medications like ibuprofen or acetaminophen, with a strong emphasis on physical therapy and proper footwear. According to the most recent and highest quality study available 1, physical activity, which may include sport, is recommended for people with hip-related pain, with the goal of enabling patients to return to pre-injury sport and activity. This approach is supported by the expert consensus, despite the lack of specific evidence, highlighting the importance of individualized treatment programs that consider patient preferences and goals.

When considering treatment options, it's essential to prioritize the patient's symptoms and respect their limitations, while also aiming to improve strength, cardiovascular fitness, and basic athletic movements. The use of a biopsychosocial approach, as recommended by the 2013 EULAR guidelines 1, can help identify the underlying causes of pain and develop a comprehensive treatment plan. This approach includes assessing physical status, activities of daily living, participation, mood, and health education needs.

In terms of specific treatment recommendations, the 2019 American College of Rheumatology guideline 1 suggests that initial therapy with a DMARD is strongly recommended over NSAID monotherapy for patients with juvenile idiopathic arthritis, which may be relevant for some cases of hip and ankle pain in teenagers. However, it's crucial to note that each patient's situation is unique, and treatment should be tailored to their individual needs and circumstances.

Key considerations for treatment include:

• Rest, ice, compression, and elevation (RICE protocol) for 48-72 hours after pain onset
• Over-the-counter pain medications like ibuprofen or acetaminophen
• Physical therapy focusing on strengthening and stretching exercises
• Proper footwear with good arch support and cushioning
• Individualized treatment programs that consider patient preferences and goals
• Respect for patient symptoms and limitations during treatment

By prioritizing conservative management, physical therapy, and proper footwear, and considering the individual needs and circumstances of each patient, healthcare providers can help teenagers with hip and ankle pain achieve optimal outcomes and prevent long-term complications.

From the FDA Drug Label

DOSAGE AND ADMINISTRATION Carefully consider the potential benefits and risks of ibuprofen tablets and other treatment options before deciding to use ibuprofen tablets. Mild to moderate pain: 400 mg every 4 to 6 hours as necessary for relief of pain.

The treatment for hip and ankle pain in a teenager may include ibuprofen. The recommended dose for mild to moderate pain is 400 mg every 4 to 6 hours as necessary.

• The dose should be tailored to each patient, and may be lowered or raised depending on the severity of symptoms.
• It is essential to carefully consider the potential benefits and risks of ibuprofen before deciding to use it 2.

From the Research

Treatment Options for Hip and Ankle Pain in Teenagers

• The treatment for hip pain in adolescent athletes includes various options, such as addressing intra- and extra-articular hip abnormalities, which have become more recognizable and treatable due to advancements in diagnostic imaging and surgical techniques 3.
• For ankle pain, there is limited information available in the provided studies, but it can be inferred that a similar approach to diagnosing and treating hip pain may be applied, considering the overall musculoskeletal health of the teenager.
• In cases where hip or ankle pain is related to juvenile idiopathic arthritis (JIA), treatment may involve the use of non-steroidal anti-inflammatory drugs, glucocorticoids, disease-modifying antirheumatic drugs, and biological agents 4.
• Biological agents have shown good efficacy and safety in the treatment of JIA, targeting cytokines and receptors involved in the disease's pathogenesis, and their application is becoming more common 4.

Considerations for Treatment

• A thorough assessment of the teenager's condition is necessary to determine the underlying cause of hip and ankle pain, whether it be related to athletic activity, JIA, or other factors.
• Treatment strategies should be tailored to the individual's specific needs, taking into account the severity of symptoms, medical history, and lifestyle factors.
• The use of biological agents in JIA treatment has significant potential and advantages, but its application should be carefully considered and monitored by a healthcare professional 4.