28yo Male / Horrible Hip / Lower back pain 8months
Before I start, I would like to say THANK YOU for taking the time to read this thread. I am 28yo male in decent physical shape. I have been going through what can only be described as a mild living hell for the past 7-8 months and am in need of some serious assistance. I would also like to apologize for the length of this post. However, I want to make sure I give enough detailed information about my condition. It means alot of me that you are taking the time to read this, so again, thank you.
Starting at age 3, I played hockey year round until I was about 21-22 years old. I played baseball and football for many years in there as well. During my younger years I never had too many physical problems (fractured growth plate in my wrist, bruised collar bone).
Toward the middle of July 2011 I decided enough was enough. I was 27 years old had let my health deteriorate for the past 4-5 years. I was up at about 300 lbs and the toll it was having on my body was starting to take effect. I decided to join the local YMCA and do some working out. My entire life I have been really bad at 'overdoing' it, and this time was no different. I began to do laps around the outside track and then, after a couple of workouts, I decided to jog a little bit. The first symptom I had was groin pain (both sides). I chalked it up to being out of shape and just kept at it.
At the end of one of the weeks of going to the 'Y', I took a trip to Vegas with a buddy. The first night we were there we walked up and down the strip and played a bunch of poker tournaments (extended sitting periods). I woke up the next morning and didnt feel right. My groin and hips were in a great deal of pain. My testicles actually hurt (which scared the HELL out of me). The whole rest of the trip I felt nauseated (mostly due to the testicle pain).
Upon returning home I immediately felt terrible. The pain was horrible and the next day at work I had to leave early. I went to the ER because of the intense pain and nausea. Thinking it was something I ate, I was given Cipro and told me drink alot of water.
After about a day and a half I began to experience INSANE left testicle/lower back/abdominal pain and thought maybe it was a kidney stone. After going down that path, it turned out not being that.
During this time period I was seeing a urologist since my symptoms all pointed to something urological in nature. After describing the pain I was having (the pain was not bilateral (both sides, testicular, traveling down between my legs, lower back, buttocks, side of hips) the next diagnosis was epididymitis/prostititis. I tried a couple different antibiotics (one of which being Levaquin). While taking Levaquin, I developed debilitating shoulder pain and immediately stopped taking it.
After seeing this urologist for several weeks and pretty much getting no where, I decided to go a different way and see if it was my hips or back causing the problem. The first doctor I saw examined me for a few minutes and diagnosed it as a possible acetabular labrum tear. With this first doctor I had the following tests/procedures done (in chronilogical order:
1. Two X-Rays (first visit - doc stated he saw evidence of cam impingement, probable labral tear)
2.Bilateral MRI/Arthrogram (result - partial tear in right acetabular labrum, small paralabral cyst in my right hip socket, no tear in left, but signed of degrading)
3. Five weeks of physical therapy (helped very little, the stretching seems to help the most, could not perform hip thrusts as it hurt too bad)
4. Bilateral Hip Steriod injection (horrible response to steriods, acute anxiety/depressive state for 1-2 weeks, although I did experience a short steriod 'honeymoon' where I was pain free for about a week)
5. Two MRI's (lumbar spine, pelvic) (results lumber spine - two herniated disks (L5S1 area) which the doctor stated he did not thing it was causing the problem) (result pelvic - nothing out of the oridinary)
After finishing the physical therapy I was still in a great deal of pain on a daily basis. The next step, I was advised, would be surgery to repair the tear in my right hip. This doctor believe that I was having some 'alignment issues' in my pelvic (caused by the tear in my hip). He stated that if I decided to have the surgery he would also shaved down the excess bone (on the femur side of my hip).
I had a pretty invasive surgery a few years ago (wrist) and I promised myself that I would always get a second opinion before I have surgery.
At this point I was experiencing the following symptoms:
1. Testicular pain (both sides, sometimes one side)
2. Pain on the outside of each hip (right at the point where the socket is)
3. Buttock pain (center of buttocks, left side worse), pain travels up to the lower back)
4. Lower back pain (across lower back)(all muscles in lower back feel like they are being contracted)
5. Groin pain, groin weakness
Long story short (about the Testicle pain): I went back to the Urologist during all of this and he still thought the testicle pain was caused by something urological and that it could be prostititis. He put me on Doxycyline for a month and it actually made that pain go away. I still have some radiant pain (from groin -> testicle) but nothing like it was. So that took care of one of the symptoms.
What really bothers me about the first orthopedic doctor was that he is incredible arrogant and seems to not really listen to me when I tell him where I hurt (side note).
Before I scheduled a second opinion with an orthopedic surgeon, I contacted a doctor at the cleveland clinic (hip specialist). I told him my story and sent just the xrays to him. I informed him that I would like his professional opinion and that my doctor recommends surgery for cam inpingement and torn acetabular labrum. His opinion was that my xrays did not show a great deal of cam impingement and that I should NOT have surgery (great).
I then went to a second orthopedic surgeon (for a second opinion). This orthopedic surgeon specializes in spinal issues. He looked at my lumbar spine mri and felt the herniated disks may be what is causing my problems. With this doctor I have had the following test/procedures performed:
1. Diagnostic nerve block (using marcaine) (results - noted improvement in pain, not total relief)
2. EMG - no signs of nerve damage
This doctor (spinal ortho) stated that he could perform a minimally invasive surgery to shave down the disk in my back relieve pressure on the nerve.
Side note: Starting Jan 2012 I started a new diet. I currently weight 262lb (38lb loss).
Now, here I am, with the following symptoms:
1. Lower back pain (worse in the center, spanning outward, wrapping around my waist)
2. Pain at the outside of both of my hips (I can actually press exactly where it hurts)
3. Buttock pain (center of each buttocks)
4. Groin pain (constant for the past 8 months)
When the pain is the worst:
1. SITTING - by god, sitting is the worst. The muscles in my groin pull tight, intense pain in my back and side of hips
2. In the morning. My entire back and hip muscles seem like they are frozen in place when I wake up. Hurts to bend from one side to another. Hurts bending forward.
3. Pulling my knee to my chest causes intense pain in my groin AND an IMMEDIATE cramp at the side of my hip. What is very interesting is that I used to get cramps like that when I was younger. Not sure if this is connected.
3. There is absolutely no position (sitting, standing, lying down) that I can get relief.
I am very sorry for the length of this post. I really dont have anyone to speak with about this. My family and friends are sick of hearing about it.
Can anyone out there help me? I will be FOREVER indebted to you if you can.
Well, without a clinical evaluation it would be difficult to determine the cause of your symptoms. X-rays do not really depict acetabular tears or spoft tissue issues and the first second opinion you sought was probably inadequate (sending MRI’s across would have been a better option).
Well, what I understand that you have three main issues i.e back pain from herniated discs that seems to respond little to conservative management/ physiotherapy, hip issues with probably an acetabular tear and groin pain possible from a GU infection.
For the groin pain I would suggest getting a pelvic ultrasound and urine culture and sensitivity done and starting appropriate antibiotics. I would suggest getting the back and hip MRI’s reviewed by an orthopedician (or individual hip and spine specialists) for a second opinion. Meanwhile I would suggest continuing with physiotherapy to strengthen the muscles around the region.
Hope this is helpful.
Thank you for the reply. Your time is greatly appreciated. I just had an EMG performed on my back/legs which showed no damage to the nerves. I then went back to the new ortho doc (which specializes in spine). His opinion was that it is my hips causing the problem. He suggested that I have the hips done. If I am still having back,hip problems after that, then come back and he would discuss the herniated disks.
I have an appointment with my original ortho doc on 05/25 for a 3 month follow up. I am really leaning towards getting my hips scoped. This pain will NOT go away. I am still experiencing urological symptoms and orthopedic symptoms. The groin pain (both sides) seems to be originating from my hip. I am trying my best to stay positive but it is very hard.
To make this all worse, I will be buying my first house in the next couple of months.
The main reason for wanting to get my hips scoped is due to the intense pain and soreness in both hips (and surrounding areas), popping which occurs when lifting my lefts (every time) and the continual cramping on each side of my hip when lifting my knee to my chest. Furthermore, I have a weird pain at the base of my groin (where the top of the leg meets the buttocks). My doc said this was the hamstring insertion. Also, my doc told me that he would shave down any bony overgrowth in the region when/if he scoped my hips. I HATE surgery and I cant even believe I am considering it, but I cannot continue to live like this. Everytime I think about going for a walk (or jog) I just go nuts thinking about this pain I am having.
Besides this, I started having urological symptoms yesterday (burning urination). I just finished a few weeks of doxycycline about a month ago. Not sure if is it just urethral irritation or an actual UTI.
Probable plan of action:
1. See the ortho doc on 05/25 and discuss possible scoping of hips (worse on first, then see how it goes)
2. Possibly request a pelvic ultrasound (I did have two testicular ultrasounds, which came back normal, not sure if this is the same?)
3. Possibly request urine culture (with sensitivity again)
Anyways, thank you very much for the report Dr Kaul.
Does my plan of action sound avisable?
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