I am trying hard to lose weight but it is so painful!

Dr Flo,

I am 30 years old and a mother of a boy who is turning three in April. I currently weigh 77kg at 167cm in height. I am really struggling to lose weight. I was involved in a car accident in December 2010 and dislocated my left hip and also fractured my femur. I was fixed with pins, which I have to date. Recently I was diagnosed with osteoathritis of the same hip. I eat healthy and I have a demanding job, thus hardly get time to exercise. I also cannot bend my left hip due to pain or fear of pain. I have lost weight, from 85kg to 77kg, but seem to get stuck there. Your advice and help will be highly appreciated. Brenda.

Dear Brenda,

 I applaud for your efforts so far, and what you have overcome in the recent years. You are on the right path on your weight loss journey, and you are already halfway there! At the moment, you are slightly overweight, which is not too bad. I would encourage you to continue with the healthy eating, and consider visiting a dietician/nutritionist to figure out how best to eat.

However, you need the exercise, despite your busy schedule. This is because exercise will help manage pain in the left hip and also prevent stiffness of the joint. It also helps release endorphins which generate a feeling of wellbeing, and also reduce pain. As a bonus, exercise helps with weight control, which in turn might help reduce the pain in the joint.

The pain in the hip should be managed so that it does not interfere with your daily life. This can be through using hot and/or cold packs, physiotherapy and TENS (transcutaneous electrical nerve stimulation), massage therapy, supplements (glucosamine, chondroitin, hyaluronic acid) and medication.

You need to get a skilled personal trainer to help you figure out the exercises that would be useful and not harmful to your injured joint, with adequate periods of rest in between. Exercises that would be helpful include those that strengthen the muscles around the joint (strengthening exercises), those that improve the movement of the joint (range of motion exercises), aerobics to improve your breathing and circulation, swimming, hydrotherapy, and walking.

While it might seem like this will hurt you, exercise has multiple benefits, but being inactive will worsen the pain and stiffness in your arthritic joint.

Dr Flo, 

I find it difficult to sit for more than 15 minutes because of a numbing pain on my left buttock. Sometimes I can feel the pain all the way down my left leg. This condition is an extreme bother since my work entails lots of sitting. I feel the same pain also a few moments after I lie down on my back. The only relief is when I lie on my stomach. What could be the problem? Maraka.

Dear Maraka,

That pain and numbness is known as sciatica, derived from the sciatic nerve which starts at the lower spine and passes through the buttocks and down the leg before branching all the way to the toes.

When the sciatic nerve is compressed, then there is pain, starting either in the lower back or at the hip or buttocks, sometimes spreading down the leg, even to the toes.

The nerve can be compressed because of problems in the lower back — protrusion of the cushioning disc that is usually between the bones of the spine (disc herniation), or due to arthritis in the bones of the spine.

The nerve can also be compressed by contractions of the muscle called piriformis, which is in the buttocks, because the nerve passes through or near it. This is called piriformis syndrome. It can occur due to sitting for long durations of time, like you do.

You need to see an orthopaedic specialist so that you can find out exactly why the sciatic nerve is causing pain.

Treatment includes medications for pain — both oral and injections — stretching exercises, physiotherapy, massage, and even surgery if required.

You also need to get a comfortable chair and to stand and stretch, or do some exercises after sitting for some time. Prolonged sitting has many other health concerns in addition to the pain it is causing you.

Send your medical questions to [email protected] for absolutely free expert advice.