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    Old 08-16-2015, 09:01 AM   #1
    lars7779
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    Constant Hip Pain

    Hey guys, I posted this a few days ago but my topic dissapeared with a name change so this is a repost. I'll include a transcript from the old one below with a few modifications so it's less to read.

    Original post:

    I'm actually writing this for my wife who is in almost constant pain from her right hip. It has progressively gotten worse since 2012 when she was treated for bursitis.

    She's dealt with pain over a year now. The pain is almost constant and even though she's been taking small amount of pain killers (she don't like to, so she only halves them most of the time) the pain gets so bad that she spends all her evenings in bed after work.

    Her hip swells up, it seems to me around the muscle and the thigh, sometimes as big grown man's fist, other times it's more like a tennis ball.
    She can move her right leg up and down ok, but when she twists/turns it sideways there is excruciating pain. The pain has started to radiate down to her knee now. She doesn't have a fever with it.
    She had some MRI's before, and a bunch of x-rays. Nothing shows up. She was told she doesn't have any necrosis.
    She does have a extra disk in her back, and also a herniated disk.

    She sees a general ortho doctor, but tbh he doesn't seem to care much. Here's why: after seeing him several times this year, he says he *doesn't know* what causes the pain. He literally told us that come back in 6 months to see if it gets better - after not doing anything at all. Even though her hip is Swollen!
    After four months of nothing changing we went back last week, desperate.

    He now wants to try and give her a shot that goes into the bone, I can't think of the name. I'll find out the name later...but I'm just kind of nervous. She says she is tired of seeing doctors and just wants the pain gone, ready to try anything. I, on the other hand, has begged her to see another doctor for a second opinion, or a specialist.

    I'm worried since her ortho doctor said that he doesn't know what the problem is but wants to try this shot...I mean, what if it doesn't work; what if it's something else? What if *trying* the shot gives her more pain?

    As a side note, she sees a therapist who mentioned that maybe the muscle is torn and suggested massaging it and letting it heal, but the ortho doctor disputed this. Well, we massaged it some and it's not gotten any better being so tender to the touch.

    Guys, I'm sorry for rambling. I guess I'm blowing off some steam. I know looking online for answers isn't the best idea sometimes but maybe someone has gone through something similar or can offer me a bit of advice.
    Thanks for listening.

    Bummerdownthere 08-14-2015 08:43 PM
    Re: Constant Hip Pain

    I have never before posted to a forum like this. I read them frequently in my search for pain relief but never joined or posted. I tried to find a way to send a private message but I am just not experienced enough to find the right button.

    I am sure you are searching for your wife because the last thing she feels like doing is sitting in the front of the computer looking for answers that her docs don't have. Tell her not to do any more injections or let them do anything invasive until you or she search some more. I guess I would also say she needs a second opinion.

    Anyway the first item is to start with getting the swelling down. It would take to long to go into the physiological reasons but I suggest you start with googling 'alternate ice and heat treatment', adjust according to tolerance but try 8 - 10 minutes of ice followed by 3-5 minutes of heat. Repeat numerous times up to an hour or more. Again you will need to adjust as needed. The medical, scientific benefits for this can be found online.

    Another method for the swelling (and don't scoff at this), is to soak a rag or flannel scrap in apple cider vinegar enough to cover the worst of the swollen area and cover that with plastic. Other bursitis sufferers swear by castor oil packs but I found enough relief before I tried that one. And yes, I scoffed at numerous suggestions I read and later had to choke on my words of scoff.

    I was also in too much pain to get much help from PT. Later I returned to PT after I found a 3 step back relief program that helped my hip and leg. Luckily my hip specialist said replacing the hip now wouldn't be a good idea because most of the pain I was experiencing was likely coming from my back issues - even though my back hurt very, very, little. I found a website that got me moving better and helps release the some muscles and constricted nerves that affected my hip and leg pain.

    Search google images for ' lumbar nerve dermatome map'. You will find that the lumber nerves radiate to the hip and legs and feet. I have bulging discs and problem facet joints and numerous other things going on in my back but the hip and leg pain was excruciating. I was at the point of purchasing a cane. I also came home from work and hit the couch until bedtime. It was the worst thing I could have done.

    Search online for images, videos, and function, on the IT band and its connection to bursitis and hip and knee pain.

    Search online for images and function of the psoas (iliopsoas) muscle and note its connection between the vertebrae and hip. Search the term iliopsoas bursitis.

    I have much more info but I don't think I can send links or images of exercises through the forum. I will tell you that so much has improved and I doubt I will be needing any hip or back surgery for years to come. My improvements were slow and halting at first and I had to make my twice daily routine top priority of every day at first. I also had to do a few things during the work day to keep myself functioning. I would use the conference room at work and take about 4-5 minutes for some simple release moves to keep me going without meds. I gave up the monic med early on after reading the some of the danger of long term use. I did use tramadol (sp) but since I hate to take pain pills I would also break them in half and add Tylenol. I seldom use any meds anymore except to take some MSM capsules. Research MSM also.

    If possible see if there is the option of private messaging. I would like to give more information and detail. Your message caused me to break my cardinal rule of not posting to forums. I have a job similar to your wife and can picture the agony she is in. She is lucky to have you searching for better answers and will need you to assist with some home plans and home therapy because, like me, she will be able to do very little to assist herself in the beginning.

    If there is


    Bummerdownthere, thanks for your reply.
    Guys, yesterday we tried the alternate ice-heat treatment but not sure if it's worked yet. Like you said, bummer, it might have to be adjusted somewhat.
    She read your post yesterday and I think it helped her a bit knowing someone else has gone through something similar. I hate it, hate this pain she's in!
    I am hoping that she will reconsider taking this shot the doctor wants to give her, and get a second opinion instead first. She's at her wits end, really. Not sure what kind of doctor she can see since this ortho doctor is supposed to know this stuff and he doesn't. We're just afraid and tired, really.

    Last night, she seems to have begun developing a smaller knot/swelling closer to her knee too.

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    Old 08-16-2015, 10:55 AM   #2
    Bummerdownthere
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    Re: Constant Hip Pain

    Mike;

    I reread your original post and can't believe the doctors have not done and MRI or other scan with the obvious external swelling. Bursitis won't show on an Xray and labral tears or damage to hip cartilage won't show much on an X-ray. Did the X-ray show any loss of cartilage space in the hip? Or bone spurs? Or congenital hip structures that would lead to FAI (femoral acetabulum impingement), conditions?

    The docs told me 8 years ago (after X-ray and MRI), that I had nothing wrong with my hip and the recent X-ray showed my hip was a total loss and they referred me to a surgeon who agreed but said that my hip alone probably wasn't causing all the nerve pain in my hip, thigh, knee, calf, foot. He also looked at my lumbar MRI from 8 years ago and wondered why they had never sent me to a back specialist. He said I need to get some review and treatment for my back to differentiate what other issues were driving the pain. I didn't want a hip replacement to begin with so I went to a physiatrist for evaluation of my back and new lumbar MRI. The sent me for PT which I couldn't do much of because of the pain. I gave up for a while and used Tramadol and Tylenol to get through the work day and then crashed on the couch each evening and spent hours with my mini iPad researching back and hip and the connections. I stumbled on a great website by some chiropractor who suffered from failed back surgery. He calls himself the chiro geek. I read every single tab in his website menu and printed them all out and studied all the pics and explanations. I couldn't do his exercises at that time but I learned everything about the back that I could until I could actually pop my MRI CD in the computer and start to make sense out of the MRI images of back. I was still miserable at the time but continued my research and stumbled on a website by an Australian physiotherapist by the name of Sarah Keys. I read things on there that contradicted back treatment warnings given by US docs. I kept reading and watched her video of a 3 step plan that is the mainstay of her treatment. She calls it back appeasement. I watched that (from my comfy couch and pillow position), and thought - this woman is crazy (although my thoughts included descriptive words I won't use here). However; being crazy and desperate myself I tried to do the three step back release exercises. I had to improvise a 'back block' for the first step and also make sure what I was using was only about an inch high and very soft under my SI joint.
    I could not hold this position for the recommended time and was in pure agony in my hip and all the way down my leg but I managed to hold the first position for 10 seconds and moved onto the 2nd position which felt wonderful as long as I limited the range of motion. Then the third position - again limited in motion. Then I repeated the whole thing and manage to roll myself off the floor and upright again and ! OMG ! I felt a flood of warmth running through the agonized hip and leg. I purchased her book on ****** - The Back Sufferers Bible and have read it at least 3 times - plus her book 'Body in Motion' which covers other joint systems - HIP also. Once I got my back somewhat better my stenosis issues decreased and I was able to start doing the PT exercises that were impossible before.

    Anyway - the story is too long to type but my initial improvement came with her 3 step back appeasement routine every night before bed and sometimes in the morning and also during the work day (but shortened routine at work). The other thing that helped was the purchase of one of those fit balls - 65 centimeter diameter works for me. And every night after the back appeasement I sit on the ball and bounce gently - very small bouncing movements - bottom never leaves the ball on the upward bounce) for minimum of 5 minutes. That was the beginning of improvement until I could start working the hip. There were many more things adds as I progressed. The main thing is that in spite of the pain you have to move the joint for improvement. It doesn't matter if it is arthritis or bursitis, you have to move the back and hip and get the fluid transfer in the vertebral discs and the hip joint. Start with baby steps. I quit the Tramadol after the first week of doing the back appeasement and went to Motrin and ice only. I had some bad days mixed in there but never quit trying. I recommend that you don't use prescription pain meds to attempt the beginning of the program because they mask the pain and you want to be aware of your limits so as not to do damage or set up a later flare of issues.

    I will continue more because there is much more once I got my back and hip in motion (limited, but better), again. Later I had to start researching all the muscles that support the hip and also the IT band turned out to be critical to progression and more pain relief. The glute muscles are critical for the hip joint and the TFL and hamstrings and the iliopsoas muscle. Later I concentrated on the multifidus muscle arrangement and discovered how critical it is in regards to spinal stenosis issues. I continue to work at it.

    Check out Physical Therapists and Chiropractors for hip bursitis and hip arthritis and lumbar issues. I totally failed the Ober Test I did at home. I think I was also dealing with bursitis that was being irritated by totally tense IT band.

    Again - I want to add that I would be concerned about the amount of swelling that your wife has and the fact that ruling out hip bursitis with possible bursitis sac/fluid infection. If the bursa sac is inflamed or infected that would have to be dealt with before you attempt too much on your own. If she can't do certain motions on her own the you gently assist the painful movement and provide support to get through a certain range of motion just to get the joint lubrication fluids moving in there so the joint can do it's self cleaning and repairing it was meant to do.

    Why would her doctor want to inject something directly into her hip bone without any diagnosis or other imaging besides and X-ray? Seems to me an MRI and or CT Scan (too much radiation but sometimes you have to do it anyway) would be in order before you start injecting stuff into the bone. Steroids injections should not be routine without complete imaging and some idea of what's going on.

    Hope something in this long and rambling of words proves to be helpful.

    I'll stop for now

    Bummer.

    Last edited by Administrator; 08-16-2015 at 07:03 PM.

     
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    Old 08-16-2015, 11:45 AM   #3
    Bummerdownthere
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    Re: Constant Hip Pain

    Just an FYI to add. I looked through some other threads on this board and found something interesting that you may want to google. Synovial Chrondromatosis.
    The one thing about your wife's symptoms that has me mystified is the mention of lump swelling or nodules. I looked up this term that was referred to another post and thought if you knew more about it you might want to ask her doctor or find a new doctor. Most insurance plans allow for second opinions.

    Bummer

     
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    Old 08-18-2015, 12:40 PM   #4
    lars7779
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    Re: Constant Hip Pain

    Bummer,
    thanks again for your time and advice. Thank you so much.
    I have found some pages and reading about possible issues and watched some videos too that look good.
    I'm glad you have found some relief with your pain. It gives us hope.

    Either I forgot to mention it or it got deleted but my wife does have sciatica. And the reason my wife can't have an mri is because she has an implant stimulator in her back (unrelated to the sciatica issue) and it can be dangerous to have scans with it. However, she did have one or two mri's a year or two ago and the ortho doctor didn't mention anything then. Granted, her leg wasn't swollen as much, but she did complain of this pain.
    That's when he mentioned necrosis (which there was none present).
    She has also had a lot of x-rays, the last one on our last visit a few week ago. Nothing is showing up.

    I did read up on chiro geek's page about sciatica. It seems plausible with the pain radiating down here leg, even down to her feet sometime (I didn't know sciatica could do that!). It's just frustrating because we havn't got any answers from the doctor about this (or even a hint of it being a possibility). I think she's finally convinced about getting a second opinion though. It's scary and tiring, but must be done.

     
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    Old 08-18-2015, 02:03 PM   #5
    noevr
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    Re: Constant Hip Pain

    Hi no one has mentioned a pain management specialist yet. If you can find one with a psysio background that is your best bet. I imagine with the stimulator you may have one? Not sure if it's a good one or not.

    Cathy

     
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    Old 08-20-2015, 07:17 PM   #6
    Bummerdownthere
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    Re: Constant Hip Pain

    Lars,
    Thanks for further information. I must start off by saying sciatica without any back pain was the beginning of my entire set of pain issues that started 8 years ago. It started within the hip/groin area and eventually wrapped around the front of the hip and then to the lateral side and then advanced down to my knee, calf, and foot. I saw many doctors and had multiple tests but they could never identify a cause or point of origin. I was in severe pain and taking pain meds but basically it was at that point that I first had a major downshift in activity to avoid the high pain levels. The only way I could sleep was to place 2 pillows between my thighs. I slept that way for 3 years and had many tests and just gave up and did the bare minimum to get through the day. I used pain meds to do my shopping or mow the lawn. Eventually I reached a point where I could sleep with just 1 pillow between my legs, but always the same sleep position. Couldn't sleep on the bad side, couldn't sleep on my back, or my stomach. So I know sciatic pain in and out.

    I wanted to reply by giving you 3-4 basic movements/exercises that turned things around and gave me hope; but I hesitate because I am not sure what restrictions might be in place with the implant. I have read a little about it because a couple of times an implant was mentioned as a possible treatment if other things did not work. I am not sure of the location or the depth of the implant and whether or not care has to be taken to not put pressure near the area, etc. Also you mentioned a herniated disc and I wondered if there was any surgery for that such as a laminectomy or spinal fusion.

    Since I am just a self help seeking patient myself I don't want to recommend things that would aggravate any past surgical interventions.

    I recently read a book that I wish I found years ago (but I probably would have scoffed at it then): "End Back Pain Forever: A Groundbreaking Approach to Eliminate Your Suffering". By Norman J. Marcus. The entire book is excellent with the view that most back pain and other joint issues are caused by muscle pain and weakness. I never would have opened this book 8 years ago because my initial nerve pain and eventual disability came at a time when I was very active and working out on a regular basis. I felt great in every way but then the nerve thing started and grew into a monster.

    Dr. Marcus has a a few chapter of very basic exercises/movements to break up the muscle pain and joint pain and gently build strength while also learning the necessity of slow and easy retraining to get things back in balance. I have added his exercises to my collection.

    I want to give your wife hope but also want to share what I have learned the hard way. When the pain is bad and you shut down and give up and become a recluse of sorts (I did, except for going to work), then you will keep sliding down (as I did). Chronic pain is so very depressing. I worked on pain management and meditation. I have books and CD to help with this. I read all the John Kabat Zinn books out there and I down loaded his pain management/meditation sets. But…in the end I could not let go of the fact that the docs were missing something very important and they weren't treating the whole person with a pain issue that was causing multiple new issue to crop up. When it came down to it I didn't want to live the rest of my life with pain management (not that some of it isn't helpful) where I felt like my life had stalled. I wanted to reduce my pain and get my life back. I grew increasingly depressed and gained weight which compound all the issues. Being depressed is a dead end road and it made me very angry. That is when I went full blast with hours of research and watching videos and reading and trying new techniques to restore function. And yes it was painful at first but range of motion started to improve which then helped me move more and it was a self generating return from the half dead state I was in.

    Since I started with the Sarah Keye back appeasement exercises (although modified very much at first), and then little by little adding more stretches and exercises, my nerve pain receded from my foot, them my calf, then my knee, then my thigh and just recently it has started to recede from the upper thigh and hip area. Tonight I went to my son's high school open house and walked all the way through the parking lot and took the long walk up the outdoor walkway(slightly inclined), and stood and walked from table to table and teacher to teacher and various sections of the high school to visit with people - all without a twinge of nerve pain and without the stenosis going full blown and causing me to lean forward when I walk. My hip still doesn't have the greatest range of motion but I am not walking like a broken person anymore and the hip didn't hurt much tonight. When I returned to my car I said to myself YES!!! It can be done! Granted it is a slow process with setbacks along the way and much trial and error and good days and bad days that made me question what I was doing. I am glad I have persisted.

    Thanks for letting me share - I want you to have hope and know that it can be done if you have support and are willing to try things that you never thought would help with your particular problems and painful areas.

    Bummer (Name seem inappropriate somehow :-)

     
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    Old 08-20-2015, 08:33 PM   #7
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    Re: Constant Hip Pain

    I forgot to mention that I did not find the Chiro Geek and Sarah Key appeasement exercises until March of this year. I never did buy the drug store cane that I kept eyeing, but I do have this super long shoe horn I bought when I couldn't even get my slip on shoes to slip on.

     
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    Old 09-01-2015, 09:03 AM   #8
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    Re: Constant Hip Pain

    You need an MRI-a to properly diagnose a labrum tear. demand the arthrogram injection!

     
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