How to Choose Hip Pain Medication

Hip pain can be a debilitating condition, significantly impacting daily life, mobility, and overall well-being. From a dull ache to sharp, shooting sensations, the discomfort can range widely in intensity and character. The hip joint, a marvel of engineering, supports our body weight and facilitates a vast range of movements, making it susceptible to various issues – from wear and tear over time to sudden injuries or inflammatory conditions. When pain strikes, the natural inclination is to seek relief, and for many, medication becomes a crucial part of the strategy.

However, navigating the vast landscape of hip pain medications can be overwhelming. There’s no one-size-fits-all solution; what works for one person might be ineffective or even harmful for another. The optimal choice depends on a multitude of factors, including the underlying cause of the pain, its severity, individual health history, potential drug interactions, and lifestyle. This comprehensive guide will delve deep into the world of hip pain medication, offering clear, actionable explanations and concrete examples to empower you to make informed decisions in consultation with your healthcare provider. We’ll strip away the jargon and superficiality, focusing on practical insights to help you find effective and safe relief.

Understanding the Root Cause: The First Step to Effective Medication

Before considering any medication, identifying the precise cause of your hip pain is paramount. Medications are designed to target specific physiological pathways or conditions, and a misdiagnosis can lead to ineffective treatment, unnecessary side effects, or even worsening of the underlying problem. A thorough medical evaluation by a doctor is indispensable.

Common causes of hip pain include:

• Osteoarthritis (OA): This is the most common form of arthritis, characterized by the breakdown of cartilage cushioning the hip joint. The pain is typically worse with activity and improves with rest.
  • Example: An individual experiences a persistent ache in their groin and outer hip, particularly after walking or standing for extended periods. X-rays reveal narrowing of the joint space and bone spurs, consistent with osteoarthritis.
• Rheumatoid Arthritis (RA): An autoimmune disease where the body’s immune system attacks the joint lining, leading to inflammation, pain, swelling, and potential joint deformity. Pain is often worse in the morning or after periods of inactivity.
  • Example: A patient wakes up with stiff, swollen, and painful hips that take over an hour to loosen up. They also experience similar symptoms in other joints, such as their hands and knees.
• Bursitis: Inflammation of the bursae, small fluid-filled sacs that cushion bones, tendons, and muscles around the hip joint. Trochanteric bursitis (on the outer hip) is common, causing sharp pain with movement or direct pressure.
  • Example: A runner develops sharp, burning pain on the outside of their hip that flares up when they lie on that side or climb stairs.
• Tendinitis: Inflammation of a tendon, often due to overuse. Common hip tendinitis includes iliopsoas tendinitis (front of the hip) or gluteal tendinitis (side/back of the hip).
  • Example: A dancer experiences pain in the front of their hip when lifting their leg or performing lunges, consistent with iliopsoas tendinitis.
• Sciatica: While not directly a hip joint issue, sciatica, caused by compression of the sciatic nerve, can manifest as pain radiating from the lower back through the buttocks and down the leg, sometimes perceived as hip pain.
  • Example: A person experiences a shooting pain that starts in their lower back, travels through their buttock, and extends down the back of their thigh, mimicking hip discomfort.
• Hip Fractures: A break in the upper part of the thigh bone, often due to falls, particularly in older adults with osteoporosis. This causes severe, sudden pain and inability to bear weight.
  • Example: An elderly individual falls at home and immediately experiences intense hip pain, rendering them unable to stand or walk.
• Avascular Necrosis (Osteonecrosis): Occurs when the blood supply to the bone tissue in the hip joint is interrupted, leading to bone death and collapse. This can cause severe pain and joint destruction.
  • Example: A patient on long-term corticosteroid therapy develops persistent, worsening hip pain that doesn’t respond to typical pain relievers. An MRI reveals areas of bone death in the femoral head.

Once a diagnosis is established, the choice of medication becomes more targeted.

Over-the-Counter (OTC) Medications: Your First Line of Defense

For mild to moderate hip pain, particularly that associated with inflammation or muscle strain, OTC medications are often the first recommendation. They are readily available and generally safe when used as directed.

1. Acetaminophen (Paracetamol)

• How it works: Acetaminophen (e.g., Tylenol) is a pain reliever and fever reducer. Its exact mechanism in pain relief isn’t fully understood, but it’s thought to work primarily in the central nervous system, reducing the perception of pain. It does not reduce inflammation.

• Best for: Mild to moderate pain without significant inflammation, such as general aches, or pain from osteoarthritis. It’s often recommended for individuals who cannot take NSAIDs due to stomach issues or other contraindications.

• Dosage & Considerations:

  • Adults: Typically 325 mg to 1000 mg every 4-6 hours, not exceeding 3000 mg (or 4000 mg in some cases, but lower limits are safer) in 24 hours.

  • Example: For a dull, persistent ache in the hip from early osteoarthritis, taking 500 mg of acetaminophen every 6 hours might provide adequate relief.

  • Caution: Exceeding the recommended dose can lead to severe liver damage. It’s crucial to be aware of acetaminophen in combination cold and flu remedies to avoid accidental overdose. Avoid or limit alcohol consumption while taking acetaminophen, as this increases the risk of liver damage.

2. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

• How they work: NSAIDs (e.g., ibuprofen, naproxen, aspirin) reduce pain, inflammation, and fever by blocking enzymes called cyclooxygenases (COX-1 and COX-2) that produce prostaglandins, chemicals that promote inflammation, pain, and fever.

• Best for: Mild to moderate pain accompanied by inflammation, common in conditions like bursitis, tendinitis, and inflammatory arthritis (e.g., rheumatoid arthritis). They are also effective for osteoarthritis pain where inflammation is present.

• Types and Dosage (OTC):

  • Ibuprofen (Advil, Motrin IB):
    • Adults: Typically 200-400 mg every 4-6 hours, not exceeding 1200 mg (or 3200 mg under medical supervision) in 24 hours.

    • Example: A person with trochanteric bursitis might take 400 mg of ibuprofen every 6 hours to reduce pain and inflammation, particularly before activities that aggravate the hip.

  • Naproxen Sodium (Aleve):

    • Adults: Typically 220 mg every 8-12 hours, not exceeding 660 mg in 24 hours.

    • Example: For longer-lasting relief, especially overnight, a dose of 220 mg of naproxen sodium might be beneficial for someone with persistent hip tendinitis.

  • Aspirin (Bayer, Excedrin – for pain):

    • Adults: For pain and inflammation, typically 325-650 mg every 4-6 hours, not exceeding 4000 mg in 24 hours. Note: Low-dose aspirin (81 mg) is for cardiovascular protection and not typically used for pain relief.
• Caution: NSAIDs can cause stomach upset, heartburn, ulcers, and bleeding. Long-term use or high doses can increase the risk of kidney problems, fluid retention, and cardiovascular issues (heart attack, stroke). They should be used with caution in individuals with a history of gastrointestinal issues, kidney disease, high blood pressure, or heart disease. Always take with food to minimize stomach irritation.

3. Topical Pain Relievers

• How they work: These creams, gels, patches, or sprays deliver active ingredients directly to the site of pain through the skin, minimizing systemic side effects. They can contain NSAIDs (e.g., diclofenac gel), counterirritants (menthol, capsaicin), or salicylates.

• Best for: Localized, superficial hip pain, such as that from muscle strains, minor tendinitis, or bursitis. They can also be a good option for those who cannot tolerate oral pain medications due to systemic side effects.

• Example: Applying a diclofenac gel (an OTC topical NSAID) directly to the outer hip for trochanteric bursitis can provide targeted anti-inflammatory and pain-relieving effects without the systemic risks of oral NSAIDs.

• Caution: Always follow application instructions. Wash hands thoroughly after use. Avoid applying to broken or irritated skin. Some topical products can cause skin irritation or allergic reactions.

Prescription Medications: When OTC Isn’t Enough

If OTC medications fail to provide sufficient relief, your doctor may consider prescription-strength options. These generally fall into several categories, each with its own mechanism of action, benefits, and potential side effects.

1. Prescription NSAIDs

• How they work: Similar to OTC NSAIDs, but available in higher doses or different formulations. Some are non-selective COX inhibitors (blocking both COX-1 and COX-2), while others are COX-2 selective inhibitors (e.g., celecoxib). COX-2 inhibitors were developed to reduce gastrointestinal side effects but may carry a higher cardiovascular risk for some individuals.

• Best for: Moderate to severe inflammatory hip pain, chronic conditions like osteoarthritis, rheumatoid arthritis, or persistent bursitis/tendinitis.

• Examples: Diclofenac, meloxicam, celecoxib, indomethacin, naproxen (higher dose than OTC).

  • Example: A patient with significant osteoarthritis pain not controlled by OTC ibuprofen might be prescribed a daily dose of meloxicam to manage inflammation and pain more effectively.
• Caution: All NSAIDs carry risks. Prescription NSAIDs, especially with long-term use, require careful monitoring for gastrointestinal bleeding, kidney dysfunction, high blood pressure, and cardiovascular events. Your doctor will weigh the benefits against the risks, especially if you have pre-existing health conditions.

2. Corticosteroids (Oral or Injected)

• How they work: Potent anti-inflammatory medications that mimic hormones produced by the adrenal glands. They suppress the immune response and reduce inflammation throughout the body.

• Best for: Acute, severe inflammatory hip pain, often from conditions like bursitis, tendinitis, or inflammatory arthritis (e.g., rheumatoid arthritis flares).

  • Oral Corticosteroids (e.g., Prednisone): Used for short durations (e.g., a “burst” of a few days to a week) for acute, severe inflammation.
    • Example: A sudden, excruciating flare-up of bursitis might warrant a short course of oral prednisone to rapidly reduce inflammation and pain.
  • Corticosteroid Injections (e.g., Cortisone shots): Directly injected into the inflamed area (e.g., a bursa, joint, or around a tendon). This delivers a high concentration of medication to the site of pain, minimizing systemic side effects.
    • Example: For persistent trochanteric bursitis that hasn’t responded to oral NSAIDs and physical therapy, a corticosteroid injection directly into the bursa can provide significant, often long-lasting, relief.
• Caution:
  • Oral: Short-term side effects can include insomnia, mood changes, increased appetite, and fluid retention. Long-term use carries significant risks, including osteoporosis, weight gain, high blood pressure, diabetes, increased infection risk, and adrenal suppression.

  • Injections: Generally safe when administered by a trained professional. Potential side effects include temporary pain at the injection site, infection (rare), skin discoloration, and damage to surrounding tissues with repeated injections. They are typically limited to a few injections per year.

3. Disease-Modifying Antirheumatic Drugs (DMARDs) and Biologics

• How they work: These medications are specifically used for inflammatory autoimmune conditions like rheumatoid arthritis. DMARDs (e.g., methotrexate, sulfasalazine) work by suppressing the immune system to slow disease progression and reduce inflammation. Biologics (e.g., adalimumab, etanercept) are a newer class of DMARDs that target specific components of the immune system involved in inflammation.

• Best for: Managing chronic inflammatory hip pain caused by autoimmune diseases like rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis. They aim to prevent joint damage, not just relieve symptoms.

• Example: A patient with active rheumatoid arthritis affecting their hips, despite NSAID use, might be prescribed methotrexate to control the underlying autoimmune process and prevent further joint destruction. If methotrexate is insufficient, a biologic might be considered.

• Caution: These are powerful medications that require close medical supervision. They can increase the risk of infections and have various potential side effects, which vary depending on the specific drug. Regular blood tests are often required.

4. Opioid Pain Relievers

• How they work: Opioids (e.g., tramadol, oxycodone, hydrocodone) work by binding to opioid receptors in the brain and spinal cord, blocking pain signals and altering the perception of pain.

• Best for: Short-term, severe acute hip pain (e.g., after surgery, severe injury) or for pain that is refractory to other treatments in specific, carefully managed chronic pain situations.

• Example: Following a hip fracture or hip replacement surgery, a short course of an opioid like hydrocodone might be prescribed to manage intense postoperative pain.

• Caution: Opioids carry significant risks, including addiction, dependence, withdrawal symptoms, constipation, nausea, drowsiness, and respiratory depression. Due to the opioid crisis, their use for chronic non-cancer pain, including hip pain, is highly restricted and generally discouraged for long-term management. They are typically used as a last resort and for the shortest possible duration.

5. Antidepressants

• How they work: Certain antidepressants (e.g., duloxetine, amitriptyline) have pain-relieving properties, particularly for chronic neuropathic pain (nerve pain) and musculoskeletal pain. They are thought to modulate pain signals in the brain and spinal cord by affecting neurotransmitters like serotonin and norepinephrine.

• Best for: Chronic hip pain, especially if there’s a neuropathic component (e.g., sciatica-like pain) or if the pain has led to depression or anxiety. Duloxetine is FDA-approved for chronic musculoskeletal pain, including osteoarthritis.

• Example: A person with persistent hip pain from osteoarthritis, also experiencing generalized chronic pain and low mood, might find duloxetine helpful for both conditions.

• Caution: Side effects can include nausea, dry mouth, drowsiness, and constipation. They may interact with other medications and require careful titration of dosage.

6. Muscle Relaxants

• How they work: These medications (e.g., cyclobenzaprine, tizanidine) work in the central nervous system to reduce muscle spasms and tightness, which can contribute to hip pain, especially from muscle strain or piriformis syndrome.

• Best for: Acute muscle spasms or tightness around the hip that contributes to pain. They are typically used for short periods.

• Example: For a sudden, painful muscle spasm in the gluteal muscles contributing to hip pain, a short course of cyclobenzaprine might be prescribed at bedtime to help relax the muscle.

• Caution: Can cause drowsiness, dizziness, and dry mouth. They should be used with caution, especially when driving or operating machinery. Avoid alcohol when taking muscle relaxants.

Factors Influencing Medication Choice: A Holistic Approach

Choosing the right hip pain medication is a highly individualized process that goes beyond just the diagnosis. Several critical factors must be considered:

1. Severity and Duration of Pain

• Acute (sudden, short-term) pain: Often responds well to OTC NSAIDs or acetaminophen, or a short course of stronger anti-inflammatories.
  • Example: A minor hip flexor strain from a workout might be effectively managed with rest, ice, and OTC ibuprofen for a few days.
• Chronic (long-lasting) pain: Requires a more sustained and multifaceted approach. This might involve long-term use of specific NSAIDs (with monitoring), antidepressants, or medications targeting underlying conditions (DMARDs for RA).
  • Example: For chronic osteoarthritis, a doctor might explore daily meloxicam, physical therapy, and potentially periodic injections, rather than relying solely on immediate-release pain relievers.

2. Underlying Cause of Pain

As discussed, the diagnosis is the cornerstone. Medications for inflammatory arthritis differ significantly from those for mechanical issues or nerve pain.

3. Patient’s Overall Health and Medical History

This is perhaps the most critical factor. Your doctor needs a complete picture of your health to avoid adverse effects and drug interactions.

• Kidney Disease: NSAIDs can worsen kidney function. Acetaminophen may be a safer choice, but even then, dosages might need adjustment.

• Liver Disease: Acetaminophen must be used with extreme caution or avoided.

• Heart Disease/High Blood Pressure: NSAIDs can elevate blood pressure and increase the risk of cardiovascular events. COX-2 inhibitors may carry a higher risk for some.

• Stomach Ulcers/GI Bleeding: NSAIDs are generally contraindicated. Alternatives like acetaminophen or COX-2 inhibitors (with caution) might be considered, or NSAIDs prescribed with a stomach-protecting medication (e.g., proton pump inhibitor).

• Allergies: Any known allergies to medications must be disclosed.

• Other Medications: Crucial to list all prescription, OTC, and herbal supplements to check for potential dangerous interactions (e.g., NSAIDs with blood thinners can increase bleeding risk).

  • Example: A patient on warfarin (a blood thinner) for a heart condition must avoid NSAIDs due to a high risk of severe bleeding. Their doctor might recommend acetaminophen or other non-NSAID options for hip pain.

4. Potential Side Effects and Contraindications

Every medication carries risks. Understanding potential side effects and discussing them with your doctor is vital for informed consent and adherence.

• Gastrointestinal: Nausea, indigestion, stomach pain, ulcers, bleeding (common with NSAIDs).

• Cardiovascular: Increased blood pressure, risk of heart attack/stroke (with NSAIDs).

• Kidney: Impaired kidney function (with NSAIDs).

• Liver: Liver damage (with acetaminophen, especially in overdose).

• Neurological: Drowsiness, dizziness (muscle relaxants, opioids, some antidepressants).

• Addiction/Dependence: A significant concern with opioids.

5. Individual Response and Tolerability

What works for one person might not work for another, or might cause intolerable side effects. Medication selection often involves a degree of trial and error, closely monitored by a healthcare professional.

• Example: A patient might try ibuprofen for hip pain, but experience significant heartburn. Their doctor might then switch them to naproxen or a topical NSAID.

6. Lifestyle and Activity Level

Your daily activities can influence medication choice and timing.

• Example: Someone needing pain relief to participate in physical therapy for hip rehabilitation might require a medication that offers sustained relief without excessive drowsiness.

7. Patient Preferences and Goals

Your personal preferences and what you hope to achieve (e.g., complete pain eradication vs. manageable pain to return to a hobby) should be part of the discussion.

Beyond Oral Pills: Other Medication Delivery Methods

Medication for hip pain isn’t limited to swallowing a pill. Various delivery methods offer targeted relief or different pharmacological profiles.

1. Topical Medications (Already discussed under OTC)

2. Injections

• Corticosteroid Injections: As mentioned, these provide potent, localized anti-inflammatory effects.
  • Example: For chronic piriformis syndrome causing hip and buttock pain, an injection into the piriformis muscle can reduce inflammation and muscle spasm.
• Hyaluronic Acid Injections (Viscosupplementation): These “gel shots” involve injecting a substance similar to the natural fluid in joints (hyaluronic acid) into the hip joint. It’s thought to lubricate the joint and reduce pain. Primarily used for osteoarthritis, though less common in the hip than the knee.
  • Example: A patient with mild to moderate hip osteoarthritis might receive a series of hyaluronic acid injections if oral medications aren’t sufficiently effective or tolerated. Relief can take several weeks to become noticeable but may last for months.
• Platelet-Rich Plasma (PRP) Injections: Involves drawing a patient’s blood, concentrating the platelets (which contain growth factors), and injecting them into the injured area. The theory is that these growth factors promote healing and reduce inflammation. Still considered experimental for many hip conditions but gaining traction.
  • Example: An athlete with chronic tendinitis might explore PRP injections as a potential aid to healing and pain reduction.
• Nerve Blocks/Radiofrequency Ablation: For persistent nerve-related hip pain, sometimes a nerve block (injecting an anesthetic and/or steroid near a nerve) can diagnose the pain source and provide temporary relief. If effective, radiofrequency ablation (using heat to create a lesion on the nerve, interrupting pain signals) can offer longer-term pain relief.
  • Example: A patient with chronic hip joint pain that is not surgical or other treatments have failed might be considered for a femoral-obturator nerve block, followed by ablation if the block is successful.

3. Infusions

• Intravenous (IV) Medications: In severe cases of inflammatory arthritis, certain biologics or other immune-modulating drugs may be administered via IV infusion in a clinical setting.
  • Example: A patient with severe, uncontrolled rheumatoid arthritis might receive regular IV infusions of a biologic medication like Remicade (infliximab) to manage systemic inflammation and prevent hip joint damage.

Integrative Approaches and Non-Pharmacological Strategies

It’s crucial to remember that medication is often just one piece of a comprehensive pain management plan. A truly effective approach to hip pain relief integrates medication with non-pharmacological therapies and lifestyle adjustments.

1. Physical Therapy (PT)

• How it helps: PT focuses on strengthening the muscles around the hip, improving flexibility, correcting posture, and optimizing movement patterns. This reduces strain on the joint and improves overall function.

• Example: For hip osteoarthritis, a physical therapist might guide exercises to strengthen the gluteal muscles and hip abductors, which can offload stress on the joint and reduce pain. They might also use manual therapy techniques to improve joint mobility.

2. Heat and Cold Therapy

• Heat: Increases blood flow, relaxes muscles, and can soothe chronic aches or stiffness.

  • Example: Applying a warm compress or taking a warm bath before stretching can help alleviate morning stiffness in an arthritic hip.
• Cold: Reduces inflammation and numbs the area, effective for acute injuries or post-activity pain.
  • Example: After a long walk that aggravates bursitis, applying an ice pack to the outer hip can reduce swelling and pain.

3. Lifestyle Modifications

• Weight Management: Excess body weight puts significant stress on the hip joints. Losing even a small amount of weight can dramatically reduce pain and slow disease progression, particularly for osteoarthritis.
  • Example: A person with obesity and hip osteoarthritis may find their pain significantly reduced after losing 10-15% of their body weight through diet and exercise.
• Low-Impact Exercise: Activities like swimming, cycling, walking on even surfaces, and yoga strengthen muscles without excessive joint stress.
  • Example: Replacing high-impact running with swimming can allow an individual with hip tendinitis to maintain fitness without aggravating their condition.
• Assistive Devices: Canes or walkers can offload weight from a painful hip, improving mobility and reducing pain.
  • Example: Using a cane in the hand opposite the painful hip can reduce the load on the affected joint, allowing for more comfortable walking.
• Ergonomics and Body Mechanics: Adjusting how you sit, stand, lift, and perform daily tasks can minimize hip strain.

4. Complementary and Alternative Therapies

• Acupuncture: Involves inserting thin needles into specific points on the body. Some studies suggest it can help with chronic pain, including osteoarthritis.

• Massage Therapy: Can help relax tight muscles surrounding the hip, reduce spasms, and improve circulation.

• Nutritional Support/Anti-inflammatory Diet: While not a direct medication, an anti-inflammatory diet rich in fruits, vegetables, lean proteins, and healthy fats can complement other treatments by reducing systemic inflammation.

• Supplements: Glucosamine and chondroitin are popular for osteoarthritis, though scientific evidence for their effectiveness is mixed. Turmeric (curcumin) and fish oil (omega-3 fatty acids) are also explored for their anti-inflammatory properties. Always discuss supplements with your doctor due to potential interactions or contraindications.

When to Consult a Doctor: Don’t Delay

While OTC options can provide temporary relief, it’s crucial to know when to seek professional medical attention for hip pain. Consult a doctor if:

• The pain is severe and sudden, especially after an injury or fall. This could indicate a fracture or severe sprain.

• You cannot bear weight on your leg.

• The hip appears deformed or significantly bruised.

• You experience numbness, tingling, or weakness in your leg or foot. This may suggest nerve involvement.

• You have hip pain accompanied by fever, redness, or warmth around the joint. These could be signs of infection.

• The pain significantly interferes with your sleep or daily activities.

• Your pain persists for more than a few days, despite home remedies and OTC medications.

• The pain worsens or keeps coming back.

• You have a known underlying condition (e.g., arthritis) and your current treatment isn’t effective.

Developing a Personalized Hip Pain Management Plan

A definitive guide on choosing hip pain medication would be incomplete without emphasizing the importance of a personalized plan developed in collaboration with your healthcare team. This team may include your primary care physician, an orthopedist, a rheumatologist, a physical therapist, and potentially a pain management specialist.

The process typically involves:

1. Accurate Diagnosis: The foundation of effective treatment.

2. Discussion of Treatment Goals: What does “relief” mean to you? Is it reducing pain enough to sleep, or returning to a specific sport?

3. Review of Medical History and Current Medications: To identify potential risks and interactions.

4. Starting with the Least Invasive Options: Often beginning with OTC medications and non-pharmacological strategies.

5. Gradual Escalation: If initial treatments are insufficient, moving to stronger prescription medications or injections.

6. Regular Monitoring: Assessing effectiveness, side effects, and making adjustments as needed. This might involve follow-up appointments, imaging, or blood tests.

7. Integrating Therapies: Combining medication with physical therapy, exercise, and lifestyle changes for optimal long-term outcomes.

8. Patient Education and Empowerment: Understanding your condition and treatment options helps you actively participate in your care.

For example, a 60-year-old woman with moderate hip osteoarthritis, who also has a history of stomach ulcers and mild hypertension, would likely have a different medication plan than a 30-year-old athlete with acute hip tendinitis. Her doctor might avoid oral NSAIDs entirely and focus on acetaminophen, topical NSAIDs, physical therapy, weight management, and possibly a hip injection if conservative measures fail. The athlete, on the other hand, might start with oral ibuprofen and physical therapy, with a corticosteroid injection considered if the tendinitis is recalcitrant.

Choosing the right hip pain medication is a thoughtful process, not a quick fix. It demands a clear understanding of the pain’s origin, a thorough assessment of your individual health profile, and a collaborative approach with your healthcare providers. By empowering yourself with knowledge and engaging actively in your treatment decisions, you can navigate the path to effective and safe hip pain relief, ultimately regaining your mobility and improving your quality of life.