Manage Your Leg, Knee and Hip Pain for Safer, Better Sex

Pain anywhere in the body can be a burden, but it's particularly inconvenient when it occurs in a body part we use a lot, such as our legs and feet.

Persistent pain can happen to anyone, though incidence does increase with age. In fact, while about 36.5 percent of American adults overall are living with leg and hip pain, the prevalence is higher, 50.3 percent, in the 65 and older age group. Knee pain is common, too, with about 25 percent of adults afflicted.

All of these body parts are in close proximity and have underlying connections—along with their pain.

Where is the pain coming from?

There are several types of lower extremity pains, according to David S. Pereira, M.D., a sports health orthopedic surgeon at NYU Langone Health in New York City.

"Acute joint pain can occur in the hip, knee or ankle due to an injury to the ligaments, cartilages or articular surfaces," he said. "Chronic joint pain can occur due to gradual degeneration and development of arthritic changes in the joint."

According to Pereira, both chronic and acute lower body pains are usually associated with inflammation, swelling and loss of motion.

"Non-joint pain of the thigh or lower leg can also occur as the result of a muscle injury," he added. "It can also occur as a result of a bony injury such as a fracture."

Pain in one area transferring to another is known as referred pain.

"Referred pain can also pass through the lower extremity from a distant problem such as a pinched nerve," Pereira continued. "A common example of this is sciatica, which is due to a pinched nerve in the lower back."

Leg pain can stem as far as the foot, and hip pain as low as the knees, said Andrew Konen, M.D., medical director at the Baylor University Center for Pain Management and co-founder of Dr. Riggs' Rhelief, a pain management product.

Both chronic and acute lower body pains are usually associated with inflammation, swelling and loss of motion.

"If pain is located on the side of the knee, this usually indicates injuries such as tears [or] sprains; pain at the back of the knee usually means conditions such as arthritis, and pain can also come from under your kneecap," Konen said.

The type and severity of pain can reveal critical clues about the ailment at play. "Leg pain can range from dull and numb to sharp and even burning/tingling sensations. The severity of pain is a good indicator of whether the injury/pain is short term or a chronic issue," Konen continued.

However, not every kind of pain is clear-cut.

"Knee pains present either sharp pains, aches, tenderness, etc., and/or swelling. Conversely, hip pain can make anywhere between the hip and the knee feel stiff, swollen or tender," Konen explained.

He encouraged people to be particularly cautious about pain originating in the hip area, because it can lead to a degenerative breakdown of protective cartilage around the bone over time.

According to both Pereira and Konen, some of the most common medical conditions associated with leg, knee and hip pain include:

• Dislocation (bone placement shift from injury)
• Tendinitis (inflamed/aggravated tendons)
• Arthritis/osteoarthritis/rheumatoid arthritis (joint inflammation)
• Bursitis (inflammation of bursa, or sacs filled with fluid in the hips and knees)
• Sciatica (pinched nerves in the lower back radiating to legs/hips)

The risk factors and consequences of these conditions are exacerbated for people who have frequent injuries and stress on the joints.

What you can do about it

Living in pain is tough but definitely manageable. Making a few adjustments to your behavior and routine can help, along with improving your quality of life.

Collaborate with your care team

For milder pain, Konen and Pereira recommended lots of rest, elevating and/or icing the painful area, and compression. Medications and over-the-counter drugs such as ibuprofen and acetaminophen are sufficient temporary fixes.

If you have severe symptoms, you may be prescribed other medications. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the first choice and, according to Pereira, can be very helpful. Bisphosphonates, which reduce the rate of bone loss, can also be used—just be sure to check side effects which could interfere with your personal life.

The most imperative consideration for lower extremity pain is to protect yourself—that goes for past, present and future ailments. Seeing a physical therapist (PT) and/or occupational therapist (OT) is an excellent approach to treatment that can be sustained over time for additional improvement.

While making these decisions, you should also consult your primary physician and other specialists within your care team. Together, you can track pain levels in-depth and identify any underlying medical causes.

If the pain is severe, you may need more intensive treatment.

"In case of advanced degenerative pain, injection therapies or joint replacement surgery may be needed to eliminate the pain of bone-on-bone arthritis," Pereira said.

Get physical—safely

If you're in pain or injured, err on the side of caution regarding physical activity. This doesn't mean you have to stay bedridden, which can actually make leg, knee and hip pain even worse because muscles become weak and inflexible.

Moderate, low-impact physical exercise directed by a PT or OT is your best bet for a safe workout.

"You can significantly reduce your risk of injury and pain with regular exercise to keep your legs and core muscles strong and flexible," Pereira said. "Exercise also helps to avoid excess body weight that can add a tremendous amount of stress and strain to your lower body."

Your sex life can also be impacted by hip, knee and leg pain, but counterintuitively, having sex can actually be beneficial, as pleasure increases levels of feel-good chemicals oxytocin and endorphins. But be careful: Even without stunt-level acrobatics, the mere act of intercourse is strenuous on lower extremities, so you may want to consider sexual alternatives, including using pillows and opting for the positions that feel most comfortable.

"In general, the higher up the leg that the injury or pain is, the harder it is to ignore during sex," Pereira said. "For example, having a painful and stiff hip due to arthritis or due to a labral tear can make it very difficult to enjoy sex, whereas an ankle sprain or a swollen knee can be more easily ignored with minor adjustments."

Don't overdo it

If you suffer from hip, leg and knee pain, don't push your body further than it can go. It's OK to take time off from your usual exercise routine if you're having extra discomfort, and it's OK to let a partner know when you're tired out—it's better to take a break now than face the repercussions later. If you have any new or worsening pain, contact a member of your care team.

"One should always consult their healthcare provider for any severe or recurrent pain or if they think they've suffered an injury," Konen said.

Even if it doesn't seem like a big deal at the time, you never know when pain could be the sign of a deeper problem. In the case of leg, knee and hip pain, it is always better to be safe than sorry.