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Old 12-04-2009, 02:32 PM   #1
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continuing hip pain

I am cross posting this with the back forum as I don't know if this is my back, my hip or my lupus......all I know is that I am miserable. Currently I'm under the care of my spine doc but if this doesn't let up soon, I may try to see my rheumie before my 1/19 scheduled appt. Lupus patients seem to post a lot about hip pain so I thought I would run this by you people here, since that is the rheumie's working diagnosis.

I developed a raging bilateral sciatica, left being the worse down to my big toe, but this event was different as it also gave me severe hip joint pain. Time and 7 days decreasing prednisone eliminated most of the sciatica symptoms but I continue to have marked hip pain. What concerns me most is the hip pain is aggravated by rapid walking, shifting side to side, and especially if I bend forward and am putting pressure with my arms down onto something. I first feel it in my lower spine then the strong hip pain. On active days, my whole left leg just aches deeply. I've done the piriformis stretches and there is no problem there. Basic range of motion exam does not cause the pain. But I am most comfortable sitting - standing just seems to add pressure.

MRI shows stable buldges with mild stenosis. Doc is sending me for total body scan next week. I also have an autoimmune process, probably lupus, and am on plaquenil with great relief of fatigue and body stiffness. DEXA scan stated I have severe osteoporosis in L4 (-3.7) so I know bones are not the greatest.

Has anyone had something similar? I don't know if this is from my back or maybe I have a compression fracture at the hip, but it all happened together....... spine and hip x-rays were negative. Any thoughts would be greatly appreciated!! I'm really worried that doc might be looking for cancer with mets to the bone although he didn't say it.....I'm 63.

 
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Old 12-05-2009, 08:32 PM   #2
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Re: continuing hip pain

I just wanted to reply that I have a lot of hip issues as well. However, I have FMS and Lupus, so not certain which is causing the pain. I did some lifting last week of a glass table top (I knew I should not do it) and felt and heard a popping in my lower back, I think and have since that time been in excrutiating pain and I suspect from the area of migration that it has affected a nerve, probably sciatic. I was supposed to see the Rheumatologist yesterday but unfortunately the office called to reschedule as the doctor was not going to be in. So I am in limbo right now. I have no remedies for the pain but wanted to answer that at least you know you are not alone. I have wrapped two heating pads around my lower back and hip for the last few days and started on muscle relaxers I had on hand. But so far, it doesn't touch the pain. So I definitely feel for you.

 
Old 12-06-2009, 04:11 AM   #3
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Re: continuing hip pain

Thanks for your reply. Since the hip joint also has a synovial area, I just was wondering if this was inflammed......will just have to wait and see what the bone scan shows. If nothing else, it will identify areas of arthritis. I've come up with 2 working diagnosis....hip labral tear and sacral insufficiency fracture. At least 98% of the severe back pain and sciatica has resolved. I was just surprised that the prednisone didn't help my hip, which is a totally new symptom. I'll report back is anything comes of this.....Again, thanks for your reply. Sorry to hear of your own back and hip pain. I hope you start to feel better soon! When the pain is severe, it is a real bummer (no pun intended.) But I have learned over the years, that time does settle most episodes. I waited almost 4 weeks before going to the doc, and only because it suddenly escalated the last week, especially the hip.

 
Old 12-07-2009, 10:53 AM   #4
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Re: continuing hip pain

Hi, I have the same hip pain. Sometimes its so bad I can hardly walk. Hope you feel better soon

 
Old 12-11-2009, 12:33 PM   #5
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Re: continuing hip pain

Your symptoms sound identical to mine and I was a mystery diagnosis for almost 5 years. I had unbearable sciatica problems, but UNLIKE most people with sciatica sitting was also the most comfortable I could get. Walking and shifting positions while laying down are also the worst/impossible for me.

One place we differ is they tell me I have piriformis syndrome also.

BUT, I had a different kind of MRI done (arthrogram where they inject dye into the hip). And they found an anterior and posterior labral tear in my hip. I was so relieved to have an MRI finally show something!

I also have had no injuries or anything that could have caused this, and I don't know where I go from here because this was recently discovered but I highly recommend an arthrogram of the hip.

 
Old 12-11-2009, 03:46 PM   #6
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Re: continuing hip pain

In my extensive internet searching, the labral tear seems to be the newest diagnosis of hip pain after eliminating all other possibilities.
I see the PT person Monday and want him to do a thorough exam. I have also read many people experience hip pain when having L5S1 disc issues, but have yet to find a reason why the hip is involved.
My bone scan was completely normal except for mild OA right medial knee. Nice to know at least nothing serious showed, but also very surprised that no other arthritis was seen. So if my bones are fine, then synovial issues may still be applicable?
The thigh pain is a little better today but then I wasn't as physically active as many other days at work.....and I also dipped into my vicodin last night (+motrin) to counter the bad pain I had yesterday. Breaking the pain cycle seems to help me over the next few days.
So I guess time is the best medicine. It is just so frustrating when the acute crisis hits with a new symptom, and technology doesn't show the problem, and doc does a fast curtsy exam.
When I look back in my pain journal that I started since my first visit with Rheumy, I see now that all this started in mid September. Even at that time, based on other issues, I began to wonder if I was starting another flare. The last one was 9 months long and just 2 days of prednisone set me free! Not this time.....
But thanks so much for responding. There are certain impingement 'tests' the PT can perform that might say +/- for a labrial tear. I sure hope it isn't cause I can't afford 2-3 months out of work post arthroscopic repair!
As many know, chronic pain takes a toll physically and emotionally. While I get moments of depression and teary, I just can't seem to cry. I just hope to feel better over the next hour....
I just keep reminding myself that this past year I DID have almost 3 months pain free!

 
Old 12-14-2009, 04:07 PM   #7
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Re: continuing hip pain

Met with my PT person today and after extensive and thorough testing, he does feel that I am having referred pain (hip & groin) from the sciatica. It is not the typical picture, but that was how he presented and it took 3 spine docs to figure it out. So I have just 2 exercises to start with and will see him again Wednesday. He also feels that MRIs when laying flat do not reflect what is really happening when I stand - compression on the spinediscs/nerves. I could have had another annular tear and had a chemical neuritis, like I had 3 years ago.

So I feel emotionally better having some 'real' explanation. I'm just glad it is not a major flare starting!

 
Old 12-15-2009, 08:08 AM   #8
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Re: continuing hip pain

Sorry for not getting back sooner. I am glad you have some answers now. I know the not knowing is so bothersome for us. I have to say that my back issue is resolving. I did get a Doctor's name for referral but they have not called back to schedule an appointment for me yet. I see my Rheumie tomorrow, probably will let the referral side since the issue is resolvings somewhat. At least my hip and thigh pain is now no worse than my usual pain! Hope you can see some improvement as well.

 
Old 12-15-2009, 04:38 PM   #9
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Re: continuing hip pain

Glad to hear your pain is resolving too! I think we get so impatient when we have acute pain and just want relief - NOW! Chronic low grade pain is still very wearing emotionally and physically, so I feel for you with the fibro and lupus. While I don't have fibro, mild SLE is still the unwritten diagnosis for me and certainly the plaquenil and Vit D has helped with my presenting symptoms.

And my spine doc putting me on prednisone for a week 40 down to 10 mg did resolve most of the burning pain down my legs - just that it left me with the hip and groin pain that I couldn't understand. I guess that will take a little longer.

Sciatica (a catch word for a symptom per se) does usually resolve over several weeks.....just that those weeks can be a real bummer. Unless of course there has been a significant disc issue etc.

So I hope you continue to heal!! Thanks for responding.

 
Old 01-19-2010, 07:21 AM   #10
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Re: continuing hip pain

I'm still waiting on my Lupus DX but am on Plaquenil. At first it seemed to help the joint pain i had when i woke in the morning and the stiffness. But in the last month or so i've developed pain in my shoulders, lower back and hips. Mine is a constant ache. Sometimes bad enough i take a pain pill. Even right now as i sit both hips ache. And if i lay on one side for too long that side starts to ache and i have to roll to my back or other side. It's terrible!!

 
Old 01-19-2010, 09:15 AM   #11
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Re: continuing hip pain

Are you on your original dosage of Plaquenil? I know after a few months, my Rheumatologist bumped up my dosage. I am now on the maximum dosage for my weight. Might want to check that when you go back.

 
Old 01-19-2010, 06:11 PM   #12
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Re: continuing hip pain

I'm on 200mg 2x a day...so 400 mg

 
Old 01-20-2010, 02:57 AM   #13
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Re: continuing hip pain

A couple of thoughts.....do you exercise or stretch at all or even do specific walking exercise? How is your mattress? My girlfriend didn't relize how bad hers was till she stayed overnight in my guest room and realized how much better she slept!
I still need to take prednisone 5mg 1-2x a week for aching - my doc leaves it to my good sense.... Another thought is water retention. All sorts of things can cause you to retain fluid and impact your joints.
I wonder if the aching is a flare? I'm on max plaquenil for my weight and when it finally kicked in, the morning stiffness and daily fatigue did resolve initially. But now am having stiffness in my hands again.....see rheumy on 28th and will ask him about it. My labs point to lupus but he doesn't want to label me as such at this time....it can impact insurance issues.

 
Old 02-04-2010, 08:17 AM   #14
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Re: continuing hip pain

Thank you all for the great info.

After 6 months of different doctors, chiropractors, ART specialist who told me I had piriformis then sciatica and then threw their hands in the air, I had an MRI which showed an annular tear at L5 S1 (no arthritis and very slight disc degeneration at L5 but nowhere else.. That was in late August of last year. I have maintained low activity and done some basic stretching as recommended ie: stretching the spine backwards but nothing forward. Unfortunately just when I think things are getting better, boom I start walking like a penguin. My pain is not in my back but in my groin/hip area which makes lifting the legs especially the right one, or turning in bed extremely painful. The pain and symptoms remain for a few days 3-5 and then return to normal. Being an extremely active person this is running me down as I cannot exercise and mentally it's taking it's toll. When it's bad it radiates part way down my legs but no further than mid thigh. Lifting legs or moving sideways of doing lunge motions create the worst effect.

I am at the end of my rope. Any thoughts appreciated.

Last edited by tallrunner; 02-04-2010 at 08:17 AM.

 
Old 02-04-2010, 03:48 PM   #15
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Re: continuing hip pain

Ironically, I did my own self test and this is basically the problem for me.....I had gotten new shoes and orthodics for my job. Feet and knees felt great, but had the awful hip and groin pain with the episode of bilateral sciatica (November.) I got the new shoes thinking it would help.....wore them on and off and after the sciatica finally settled down, I was left with the continuing hip and groin pain. PT really didn't help per se, and it did seem to be slowly getting better. Several weeks ago, I changed back into my old shoes as I noticed on weekends my discomfort was less. So 3 days ago, feeling good, I thought I would go back into the newer work shoes. Bingo! First I developed a burning ankle (thought peroneal tendinitis) but today was the clincher - the hip, groin, lower back on the left side came back. I think the orthodics pitched me a little too far lateral. Great for the knees, but the left leg didn't need the same pitch and threw me all out of whack. Right leg is fine. Lesson learned - think simple before thinking complex/serious.........Just thought I would share this with you all.

Since your pain is also intermittent, did you at any time change your shoes?
I also had a lumbar L4-5 Annular tear a couple of years ago that was misdiagnosed for almost 5 months. Was told it can take up to a year for the tear to heal. The pain was due to the chemical irritation from the tear. Had intraforaminal and then facet steroid injections and I think it helped calm things down a little. It just took time to fully heal.

 
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