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Old 03-07-2009, 09:01 PM   #1
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brusistis? piriformis? HELP!! what is happening with my hip???!! advice please

Hello all: I am a 28 year old woman who just had to quit her waitressing job due to serious hip/buttock pain on my left side....I have so-so insurance, but the cost of the MRI to do diagnostics was $1,200 for a bi-lateral and half that for one leg.....Needless to say, without a job there is no way I can afford that so my Ortho Dr. (who I don;t really trust) prescribed me physical therapy for a month instead, to see if it helps, and then we will go from there...The thing is, in the meantime I am trying to determine how serious this is and what level of activity I can maintain, and how long I should expect the recovery peroid to be...since right now I have no clue, I feel as though it may be a long time till I can work again.
Anyways, I would greatly appreciate it if you could glace at my list of symptoms/injury history and see if you have any clue what may be happening, and how serious it is.....:

a brief history of my legs:

I broke my right femur in 1995 when I was hit by a car, had two surgeries done through my right hip to insert a titanium rod into my femur and BIG pin through my hip. (I should note that my hip was not injured at this time, just my femur, but they just went through my hip to do the surgery on my femur, and put a big screw in it.) Rod and pin were removed in 1998.

In 2001 I broke the back of my right hip socket and partially dislocated my hip just from hyper-extending it when i tripped on something....(so lame)
This injury caused a lot more problems in the long-run then my femur fracture...since this injury i have had to give up running, and I get sore if I walk too much, there is also a grinding in my hip at all times....the Dr.'s say different things, but I have been told and believe that there is damage to my cartalidge from the break. Also, it was never treated properly as I am quite young to have a hip fracture, so it was overlooked...the er told me it was impossible that i broke my hip and it was not until i had an MRI months later that the break was confirmed...i think i would never have broken my hip had they not done the surgeries THROUGH my hip to work on my femur.

and now....

I have been working a restuarant job that requires me to be on my feet for 4-8 hours at a time, the floors are hard concrete, and over the past several months I have had increasing pain in my left hip (the "good" one) The pain began in my buttock area and felt like a dull/strong ache that was sometimes icy-hot feeling, if that makes any sense...it then progressed down my leg, causing occasional numbness in my quad, along where i think the I.T. band it, the numbness accoured most commonly after long peroids of standing...it also had an icy-hot quality to it though....then most recently, in the past month the pain has gotten down to my left knee, and it feels as if I am not walking correctly, and my knee is being twisted or pulled funny, it is made much worse from walking...I cannot walk more than a couple blocks or stand for long without SERIOUS discomfort...it is also unconfortable to sit sometimes.....Lying down on my stomach seems to be the most comofortable. But I can hardly go through the day that way...
It is now the left hip/leg knee that I am primarilty concerned with. ...my left knee now seems to be taking the brunt of it. I mistakenly tried to power through the pain to keep my job, thinking it was just a matter of needing stretching...but now I have certainly injured it.

My orthopedic Dr. (who I am not a fan of) ordered x-rays, they looked normal, and he then ordered an MRI which I cannot afford.....So he then sent me to a physical therapist who I LOVE and have just began seeing last week. I have only seen him twice, and do not have a diagnosis yet (that is what they want to do the MRI for, but because it is VERY expensive, the Dr. wants to see if pyhsical therapy helps before I pay the high MRI cost)
Although I do not have a diagnosis, here is the P.T.'s assessment thus far:

very tight psoas muscles, especially on right side
very tight IT band on both sides
very tight piriformis muscles, both sides.....
slight curvature in my mid-back
pelvis is tilted--right side pulled down and frontward and right side pulled up and back

So I am working on stretch and self-massage at home...

So my question for you is: do you think this could be piriformis syndrome/brusistis??/ What is going on, and what in my hip could be causing my knee so much trouble? My left hip feels as if it is one GIANT knot and that my knee cap is being pulled funny (it is also very tight I have noticed, in comparison to the right kneecap which is wiggly and loose.



I am so worried!!!! I have't been able to do anything for almost a month....And i am so poor.
what is happening???

p.s. I should note that altough it has been achy for months it got considerably worse after pushing myself through some shifts at work when I was in pain....That is when it became a constant ache, before it was mostly just agitated after long periods of standing or walking...

 
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Old 03-08-2009, 07:35 AM   #2
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Re: brusistis? piriformis? HELP!! what is happening with my hip???!! advice please

You bought tears to my eyes reading your post. You are too young to be suffering in this way. Perhaps if you went to the thread "right gluteus medius tendon partial tear" you might find some messages of interest. You are not alone looking for answers. I hope others will be of assistance to you. Keep the faith. Bette

 
Old 03-08-2009, 11:37 AM   #3
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Re: brusistis? piriformis? HELP!! what is happening with my hip???!! advice please

What you described is exactly what my husband suffered when he had bad piriformis syndrome. He worked on a truck where he climbed up and down it all day and was in agony. At one point he was out of work for 2 months. The hallmark of piriformis as opposed to hip bursitis is that sitting down will stop the pain of bursitis but only laying down will help piriformis.

Did they explain what piriformis syndrome is? The piriformis muscle is used in raising the thigh so you use it all day long when you are on your feet. It runs right along the sciatic nerve....largest nerve in the body and affects the whole leg especially the areas you mentioned. In some people, the nerve actually goes THROUGH the piriformis muscle. So when that muscle gets inflamed and swells, it pushes against or squeezes the sciatic nerve and you've got PAIN. Let me ask...what does going UP stairs do to you? Should make for tons of pain.

Hip bursitis on the other hand is stationary. You can point to where the pain is and you do not want to sleep on that side.

Keep working with the PT. Hubby got the most relief learning how to stretch that muscle before he got out of bed every morning and when it acted up during the day. Muscle relaxants help too.

An MRI will show if you have a soft tissue injury but probably not if you have a piriformis problem. That just takes a lot of diagnostic work from a dedicated doc.Save your bucks.

I know how much my husband suffered and finally ended up changing jobs. but to this day his knee will suddenly give away due to that damage done to the nerve from the years it took to get a proper diagnosis.

Good luck............Jenny

 
Old 03-10-2009, 01:40 AM   #4
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Re: brusistis? piriformis? HELP!! what is happening with my hip???!! advice please

Thanks you guys!

I know, I feel so old and incapacitated from this!!
I am really worried tonight that I might not be able to live a normal life...
What is happening to my leg?

I mentioned before the knee pain, but today it is significantly worse. I could hardly walk most of the day. It feel as though my leg is twisting at a weird angle causing my knee to misalign. My kneecap is very tight, even when lying down.

I am having weird sensations down the back of my leg like tingling but sharper, not quite sciatic pain, I know what that feels like too though!

To answer your question about the stairs, I can go up them without a ton of pain, but it does hurt to sit on my butt, lying down on my stomach is really the ONLY comfortable position, standing and walking is quite painful, almost constantly, but made worse the longer i walk.

I think my muscles are just all really tight in my butt/hip, causing my pelvis to misalign and to make me walk incorrectly, and hurt my knee too.

So, my question is WHAT CAN I DO ABOUT THIS???
Am I GOING TO BE OK?
I am so scared.... I do not want to live my life lying on my stomach....
any idea how long it may take before I can walk normally again>

 
Old 03-10-2009, 11:57 AM   #5
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Re: brusistis? piriformis? HELP!! what is happening with my hip???!! advice please

Consider seeing a physiatrist(fiz-ia-trist). They are MD's who specialize in physical therapy and most big hospitals have one running their physical therapy departments. They are great at looking at all your muscles and decerning what is working right and what isn't. And they can then set up exercises for you to do to correct it. Or if you need any kind of surgery, they'll set you up with the best.

Good luck!

 
Old 03-10-2009, 06:16 PM   #6
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Re: brusistis? piriformis? HELP!! what is happening with my hip???!! advice please

So I went to the P.T. again today and he says that it is actually my left leg (the one that is killing me) that is longer, not my right as he initially thought. It seems that the excercises/stretching have helped my muscles relax a bit so that my pelvis is a little more even....thus revealing it is actually my left leg that is longer, and it was just all tight and knotted up before. So, this could explain why I am walking funny and why my hip and knee seriously hurt and are preventing me from walking or standing or even sitting comfortably. He thinks my left leg is getting jammed in weird places because it is too much longer than the other leg (the one I broke 13 years ago.)
So he gave me a few more excercises to try and strech/strengthen my hip flexers and improve my outward rotation. BUt it seems like that will not fix the height discrepency, just alleviate some of the pain. So my question is: how do I live a normal life? Can I? WHat is done to eliminate/improve length differnence in legs?
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Old 03-10-2009, 06:26 PM   #7
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Re: brusistis? piriformis? HELP!! what is happening with my hip???!! advice please

So, I went back to the P.T. today and it seems my pelvis has evened out a bit thanks to the strecthing and massage. He remeasured my legs and found that it is actually my left leg (the one that is hurting so much) that is longer, not my right as initially thought.
My right leg is the one I have had 2 surgeries and breaks on in the past, so it makes sense that it is shorter.
He gave me some more stretching/excercies to do to strentghtne and stretch the muscles in my left hip, particularly the ones that roatate it out, which are very tight.
So, this would explain mayve why I am walking so funny and having so much pain in my left knee/hip, because he thinks it maybe compensating for the length problems by jamming up...in my hip (causing my pelvis to skew) and my knee now, one my hip is more relieved, my knee than takes more pain..,if that makes sense?
So, my question is: what can I do? If my left leg is longer what can I do to make walking, sitting and standing bearable and possible again?
I am getting really stressed ovee this I feel so limited. I'm worried about my future and how much this may prevent me from doing things.....

 
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