Dear Doctor, I normally experience some pains in my thighs and waist, but the pain comes and goes. Could there be a problem? Rachel Dear Rachel, You have not mentioned your age. Does this pain occur regularly or is it intermittent, does it come after walking? As one grows old, the weight bearing joints start becoming stiff due to degenerative changes in these joints. This causes pain around waist, back and hips while walking and is aggravated after lifting heavy objects. Obese people, including women, are prone to develop these changes and suffer from pain. One can develop such pain due to herniation of intervertebral disc (where one disc enters the intervertebral space below. This along with severe pain, there may be tingling or numbness, abnormal sensations in the thighs or legs due to compression of nerves. Inflammation or injury of structures surrounding and supporting the joint like tendon orcartilage, can cause pain around waist, thighs. Women are more prone to osteoporosis (softening of bones), with advancing age. This makes them more prone to pathological fractures of hip or backbone. These kinds of fractures occur with slightest injury or exertion. Wearing high heeled shoes can also cause pain around waist and thighs. Pelvic infections can also cause this type of pain. It can be due to infection and inflammation of uterus, its layers or its lower part (cervix) or its appendages. Cure of such pain depends on treating underlying cause. Diagnosis of cause of pain around waist can be established by imaging techniques like magnetic resonance imaging (M.R.I) and computerized tomography (C.T). In case of suspected infection, clinical examination and suitable lab tests help to establish the problem. If obese, one suffering from such pain should try to reduce weight by dietary changes and regular exercise. Calcium rich food and its supplements prevent osteoporosis. Drinking more water helps prevent urinary tract infections. Good menstrual and pelvic hygiene can prevent pelvic infections. High heeled shoes or sandals should be avoided. It is also advisable to keep the back straight and avoid bending. For sitting, straight backed chairs should be used in place of sofa chairs, where the back gets slumped. Avoid bending from the back. Pain killers can be used for relief in case of severe pain. Dr Rachna Pande is a specialist in internal medicine at Ruhengeri Hospital