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Hip Pain, Bursitis - Sciatica - Muscle imbalance

Not sure really what is going on. In June '09 my outside of the hip down my thigh to my knee pain was diagnoses a trochantic (sp?) bursitis. The pain was not really bad just annoying after being waitress / dish washer for 4 hours then walking down a block to be the small town grocery store working shift supervisor (cashier, carry out, stocking . restocking, and closing duties) for another 4 to 6 hours. So I was doing alot of walking, pivoting, bending, and squating.  I decided to let the family phyicisian take a look though I supected an iliotibial band strain yet he thought it be trochantic burstis and gave me a cortisone injection.  The injection flare big time and after 4 days my hip, thigh and buttock hurt so bad I could not even sleep and no pain over the counter NSAIDs were not touching it.  I also started to have other health issues that need more attention (rapid heart rate|loss of sensation|sky high blood pressure|and unintentional weight loss plus diagnosed with moderate to severe cervical displacia) so my hip pain was pushed aside by the physicians to address the other concerns first well into October.  

One day after a few very busy days Mid October at the cafe I developed right side pain so bad I could bearly want to stand up.  I waited 4 days before deciding that what ever it was was not going to go away so went to the ER and they did a CT scan w/o contrast and came back with everything okay organ wise, you could have a problem it just not life threatening and possibly muscular or skeletor.   My next stop was a Chiropractor....since the pain in my hip, buttock and now my lower back + abdominal was making my leg fall asleep, tingling, and loss of leg strength.  He did of few muscle tests and found I could bearly walk on my right heal.  Seems like MAYBE you have a herniated disk in your lumbar area so that is how we are going to treat this.  After two visits for three weeks... there was no relief what so ever.  So I went back to the family doc and he ordered a MRI of the lumbar.  The MRI results was okay accept for a posturer annual tear in L5-S1 which would not be pinching the sciatic nerve. And I had a few back ligaments pulled a little... nothing that would stand out as being the source of the problem.

Got a second opion, at the end of Nov., just due to I could not believe trochantic hip burstis could cause this much of a fuss and for so long.  The Ortho (specialized with the back) took xrays and read over the MRI and said I did not have a back problem.  I figured he meant something not bad enough to cause you this much pain in the hip area. He did the same phyiscal examine as my family doc did and said trochantic hip burstis. He followed through with another cortisone injection - not in the same place the first one administered (more to the back of the trochantic head and buttock muscles) were I pointed it hurt the worse.  And he prescribed phyical therapy.  The second injection did not do much for the side of the hip and thigh but it got my severly aching butt muscles on fire for a week.... then the pain slowly subsided in my butt, TG!.

Throught out this 8 months I have been doing stretches and exercises for burstis and piniformis syndrome - using heat and then ice on the inflammed muscles and hip daily.  I did loose my waitress job so going down to 25 to 28 hours of work a week did help a little... but it still is not better.   I scrapped up some money and decided to get a phyical therapists assement on this problem.  Her assement astounded me and now more confused the ever.  She noted that I was still strong on the right side (though that is were all the pain and inflammation is) and extremely week on my left side during abduction strength testing... causing a severe muscle imbalance which in turn is giving me these over use injuries to the right.  She said I could actually have a problem in the left hip thus the right is compensating.  I looked at her and asked... why? I do not pain in my left side.  She replied you could have a left hip dislocation, a tilted / rotated pelvis or something else that is causing your left hips small muscle groups to be inactive.

So now it is a few weeks in Jan '10 and yep the butt pain is coming back... injection if wearing off.  So anyone out there ever experience such a problem just from trochantic hip burstis?  I have done all exercises and stretching I am suppose to do for around 6 months now, adding in the PTs left side strengthening exercises too.  I cut down the number of hours doing walking, bending, and rotating activity. I have been taking presciption NSAIDs (naproxen and ib alteration) for the past 8 months.  I just do not understand... should I go back to the Ortho or seek out some one else?
11 Responses
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Avatar universal
I have exact problrems xray n arthogram showed norhin they either think bursitis ir dont beluve me it us unbearable
Helpful - 0
Avatar universal
Finally I have gone through all you long explanation. initially I was thinking about not to read this. But then I thought let's go through this, If I can help you about this. But all I can say is just to one good doctor instead of changing every time.
Helpful - 0
Avatar universal
I work as a nurse and had back, leg, and hip pain.  It moved to arms and knees.  I was MRI'ed, xrayed over nad over.   I was told that they could not find a reason for " The pain I say I have."   I just wanted to punch them..  I was offered pain killers, anti-anxiety meds, P.T.    After ten years I was so fed up.  I decided to take a fresh approach.  I saw a different doctor.   One that took the time to LISTEN to me.   What I have is fibromyalgia.   I didn't feel less pain when I walked away from her office that day.   I did feel a Hugh sense of relief that someone knew what the problem was.   I take meds, life isn't perfect, but I can go on.  I live a quality life.   I dont dread getting up in the morning.
Maybe a fresh look with fresh eyes is the answer.
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Avatar universal
As a person who has been through a lengthy hip pain diagnosis the best advice I can give here is you have to be methodical, chopping and changing doctors and specialists is a waste of time and money. Ruling things out in the right order is the way to go. Hip arthrogram with contrast under MRI, lower lumbar MRI and a blood test that analyses for everything (most importantly rheumatoid factor and ankylosing spondylitis) are worthwhile initial steps. Common hip issues are labral tears, bursitis and arthritis these will all be seen in the arthrogram - if something is seen next step is cortisone injection into the joint capsule (guided under film) to confirm that it is actually the source of pain. Hip pain can be referred from lower lumbar, problem is most older people (30+) will have degeneration so it is an easy out for a doctor to say it is probably your back. If a lower lumbar MRI shows say L5-S1 degeneration and your hip arthrogram is negative then it is worth going to a pain specialist and getting advice, they may send you for an epidural block in L5-S1 to confirm whether that degeneration is the source of pain. Chiros and physios are only useful once you have a real diagnosis. For me it was a labral tear, but the first radiologist missed it on the original arthrogram so I had to do a full circle -18 months of pain and dollars. Good luck and ask doctors a lot of questions, like any profession there are a lot of incompetent ones out there. Never let a GP give you a cortisone injection or anything other than referrals, medication and sick notes.
Helpful - 0
1110049 tn?1409402144
Even seeing a rhematologist has not really helped.  She stuck needles all over me to see if I had nerve damage, but everything OK.  Only thing she can suggest is sending me to see a physiotherapist.  Waiting for an appointment.

Oh Milly it is so hard if you are working and have all this pain.  I think if doctors don't know what causes hip pain they say bursitis.  Rhematologist told me she does not think it is.  

Chiropractor thought it was bursitis.  I am tender if touched.

No way to go now.  Just have to put up with the pain.

Are you going to take disability Milly?


Helpful - 0
1193998 tn?1265117597
Have you seen a rheumatologist, Milly?

Can you tell me exactly where the pain is? If it feels like it is in your groin, it's likely the hip joint itself. If it's anywhere else - like the side or the back, I'm thinking pinched nerve or some spinal problem. It could be a problem nowhere near the hip, but is causing you to walk, stand, sit and/or lay in such a way that your hip hurts.

Maybe try someone who's a D.O. rather than an M.D.

Everyone's pain tolerance level is different. What may look minor on an x-ray could cause one patient minor pain, the next one debilitating pain. Don't give up until you get to the root of the issue.
Helpful - 0
1110049 tn?1409402144
Well I am having same problem.  Just been back to rheumatologist at the hospital.

I had two sessions with chiropractor, which made pain worse.  She thought I had bursitis, but the rheumatologist said she didn't think I had.  Oh, to get a firm diagnosis.  What is causing this hip pain.  Consultant said it was coming from my back, but it is deep in my waist area.  Perhaps it is my back problem that is causing hip pain.  Everywhere touched is so tender, yet I have full movement of hip joints.

No relief, like you say.  I refused injections and strong pailn killers as I know would make me worse.  Nothing to be done.  So I have to pace my activities.

Milly so hard for you with your physical job.  How are you coping?

Keep in touch.
Helpful - 0
Avatar universal
I am a 51 yr old felmale. I work in an ER, My pain started in the left hip everynow and then around Aug 2009. I just didn't think anything of it. As time went by the pain can more often and nothing helped Ibpro. etc.. By December the pain was so strong and came several times a week. The new near january 2010 pain almost every day by the end of the month i could hardly walk. I new if i went to my ortho he would give me and injection and i have had them before in my foot and elbow. sometimes they work and sometimes they don't. So i ask to leave work so i could go to a chiro. the beginning of jan. i had a xray and a MRI it showed nothing. he was treating me with heat eletric stim and ultra sound. By the end of Jan. I could not work I thought it was from pushing pts. in there hosp. beds to the rooms. They had just opened a express admit unit in the er and made us transfer pts. some time 5 in a row So I an My chirop thought iot was bursitis every time i thought i was feeling better the pain can back worst then ever. I have had 2 Mri's 2 xrays they ashow nothing a little arthristis I went to the ortho 5 mins he came in moved my hip and leg and gave me a big needle. I was extra sore for a few days but no releif from the injection. I told the ortho i was seeing my chiro so he said follow up with him since he put me out of work. the rothiman inst. in EHt. stated several time they do not put anyone out of work for bursitis. I am thinking they are crazy they don't know the pain was so bad i could hardly walk, sleep, stand, or any of my daily chores.My didibility co. priviate is horrible They want more reports now i go to see an other ortho my sister said was good the ins co. sent me with papers to be filled out . we waited and waited. once i got to a room thern was not very nice and here comes the doc. first thing out of his mouth I an not filling out any papers for disibility. there is nothing i can do for you. I told him my other hip is starting to hurt i did not come just to have you fill out paper work i need help. He took my $20.00 dollar copay. That was April 9th. No one gave me pain meds. One day i was near my pcp's office and the pain was so bad i stoped in to see if she had any openings. they were on lunch the girl said no openings i told her i just wanted to get some pain meds. so i coulde at least sleep at night. Doc. told her to tell me follow up with my ortho. i call and get an appointment with rothiman again. i waited and waited finnaly i am in doc comes in said stand up he pushes on my leg and asked if this hurt i yelled out yes . He said"you have what my wife gets": do this streach and gasve me tramidol it made me itch. could not take it. I called the disibility co. and told them and i asked if they had a doctor i could go to one that want to see me. Her reply I zam in Maine sorry nothing i cvan do for you.Now i try Phycial THYP. after 3 or 4 times i had to stop it was to painful. Now i go to the universwity of penn to another ortho. MY chrio suggesteed i get a lynwes test . my chlestrol went sky hing i don't know why and there was only one thing positive for lymes the P41was  present the pcp doc starts me on chlestrol meds. i went to the doc in Pa he said he beleived i have Lymes even though i only have onr test pos.he startes me on 5oo mg of amixicolin 2x's day. and if it is lymes i shopuld start feeling better in about 3 weeks. Ok 1 and a half gone by i can not stand the pain it's not getting any better. Now i amj sick and tired of being like this I made an appointment with a infedtious deasise doc i go monday The rothiman inst. wrote on my disibility paper that they never put any one out of work for bursitis. well maybe i don't have bursitis. I have beenout of work since Feb. 1st. i need some one to help me.
Helpful - 0
483733 tn?1326798446
Have you been checked by a rheumatologist?  I have Lupus and get this kind of pain which does not show up on x-rays and MRI's.  
Helpful - 0
1110049 tn?1409402144
Hi, I have had right hip pain for 18 months.  My doctor told me it was bursitis.  He gave me two injections in my hip 6 weeks apart.  After the second one I could hardly walk for three weeks, and the pain was still there.  Physiotherapist doctor sent me to could not work out what was causing the pain.

I had a CT scan and it shows quite a lot of degeneration in my spine.  I am told I have what is called referred pain.  Sounds like you have something similar.  You compensate and get pain in other parts of the body.  My hip pain is caused by a nerve being pinched in my back.  Hip pain dreadful but no pain in my back.  

I am having blood test to rule out ovarian cancer because the pain could be due to that, although CT scan showed nothing wrong there.  I also had ultra scan on all my internal organs.

Pain such a strange thing.  It has caused you and I such problems, and yours are still unresolved.  I now know I have arthritis and spondylosis, but mine is due to wear and tear as I am old.  I assume you are young.  

You must get this sorted out.  I wish you luck.  Let me know how you get on.
Helpful - 0
Avatar universal
Sorry to make this so long!  After doing the PTs suggested exercises to the left... the side of my left hip and down my thigh is in burning pain.  I eased off the exercises for a week and it still burns.  I also developed pain in the right hamstring and back of the knee over the past few weeks.  I also addressed my swollen and hurting upper right adbominal problem to the PT and she suggested I rule out a none muscluar condition first. So I went to the family doc, showed him my swollen ab, he ran pancreas and liver funtions test, result came back elevated lipase.  So ab sonogram next, all okay accept for a SLIGHTLY swollen liver and spleen.  

I do not know what the hell is going on... but I have got to find the right doctor to address this.
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