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View Full Version : Hip injury (poss piraformis?)



Hards
26-01-2006, 10:46 AM
Sorry for the length of post - nearly 6 years of stuff to cover here :eek:

Grew up playing every sport imaginable, mostly footy, cricket and basketball.

Mid-2000 I was having a lot of pain in my right knee, so I had it checked out by a doctor, who put me on to an orthopedic surgeon, who did some scans and diagnosed me with a back problem that was giving me referred pain down my right leg. In the previous year I'd had groin and ankle injuries, so this made sense. After consultation with another surgeon, I was told to rest for 6 months.

This only made the problem worse, as I was getting worse back and hip pain as well. 2001 a different surgeon put me onto a physio, who started treating me with ultrasound, heat and stretches. Unfortunately this didn't present a long term solution, and even between weekly treatments the injury would degenerate into severe back pain.

I put up with this through year 12 (2003) with physio treatment, just to get VCE out of the way. 2004 I saw Bruce Reid, the Essendon footy club doctor, who put me on cortisone tablets. They worked well, but once off them all the pain in my hip and back returned.

To cut a long story short, I then went on a saw a number of back and hip surgeons, as well as a couple more physios, none of which could provide a diagnosis, let alone a long term treatment. In recent times I've had local anesthetic trigger point injections into my back, as well as a nasty sacro-ill joint injection, which didn't work.

I've now seen 18 people about this, with a 19th to come next week. I'm hoping someone has had something similar and has some ideas. The closest to a diagnosis has been piraformis, which would explain the pains down my right leg, as it is hitting the siatic nerve.

In summary:
-sharp lower back pain
-sharp pain higher up, between the shoulder blades
-hip tightness (r)
-sharp pain around buttock, just above hamstring (r)
-pain in groin (r)
-When running - ok for first few minutes, then back/hamstring/hip all kick in, become a lot worse after cooling down, no matter how much stretching/heat/ice/anti-inflam gel used
-Can't sit for long periods (ie studying for exams results in a painful few weeks)

Scans have all come back negative, so issue is muscular. Bone structure is all fine. I've had this since I was 15, I'll be 21 this year, it's shit me for long enough. I've had days where I've sneezed and felt a pull in my back.

Any ideas at all?

Unregistered
27-01-2006, 11:53 AM
Sounds like a nightmare mate. Sadly nightmares like this are not uncommon especially when there are a variety of symptomatic areas and when the problem has been present for a while. At then end of the day assessing and treating this has to be done based on the underlying pathology or injury. Reading your current symptoms and without seeing you, most probably there is more than one thing causing your pain. However the primary problem may be your hip joint. Now I know you've probably been X-rayed and MRI'd to high heaven with negative results but thankfully these are not the gold standard for assessment of soft tissue hip joint injuries. I have many patients with this sort of history and one sided symptoms. The gold standard assessment is a local anaestetic injection to the hip joint and if positive then an exploratory arthrosocpy to clean up the damage. There are many orthopods who do this with varying degrees of success (John O'Donnell and Rob Howells are the best I''ve seen) and any sports physician can order the injection. After that you need a good physio who can loosen your hip flexor and deep butt muscles as well as teach you how to properly load your pelvis and spine without overloading your hip (Pilates can be good - don't trust anyone with an ultrasound ;) ). Hope that helps - sorry about the long post.

Hards
29-01-2006, 05:44 PM
Thanks mate, I appreciate your help.

As I said I'm seeing someone new this week so we'll see what they come up with, I'll enquire about the local injection to the hip joint while I'm there.

Thanks again.

Unregistered
07-02-2006, 03:36 PM
How'd you go with the new specialist? Who was it if you don't mind me asking? I have similar problems to yours, but perhaps not quite as severe. I am looking to address the problem soon to ensure it doesn't worsen.

Hards
09-02-2006, 08:07 PM
G'day mate.

I saw Jane Fitzpatrick at Epworth Med Centre. She was excellent.

I've been sent to get some accupunctre which at first attempt has been good, but obviously will need a lot more.

Seeing a rhumologist or whatever they're called to get blood stuff looked at.

After I've seen the accupunctre more and got the results of the blood tests we're going to reassess and see what the best course of action is.

If you've got something like mine it's a lot of muscle and joint tightness - my advice is keep moving, don't stop and do nothing, it'll only make it worse. At least keep gentle exercise going.

Unregistered
02-03-2006, 07:14 PM
I am suffering the same sort of problems. I have worked in child care for 10 years and had a fall on 5th dec. I have been shuffled around dr physio hydro and specialists and they are still trying to figure out what the problem is if you find out any info on it let me know. They tell me that i have a wide spread bulge on my lowest disc and my pelvis is all out of wack. They are doing some physio and massage on it and i am going to hydrotherapy 3 times a week which seems to be helping a bit. I know how you feel it is never ending

Hards
13-03-2006, 09:43 AM
I'm having accupunctre and manipulation at the moment and they feel the root of my problems are tight joints, puting pressure on tight muscles, and former a never ending cycle of problems.

Manipulation is good, but obviously with 6 years of stuff to work out it's going to take time.

Unregistered
20-03-2006, 12:04 PM
thanks for your suggestions. The physio has been manipulating the area and the pira muscle and the sacrum and it seems to release a bit but it is short lived. They have also now told be that my abdominal muscles are working to hard when i breath and it is makijg things worse in my back bit hard to change when you have been breathing that way all your life!

Hards
20-05-2006, 02:18 PM
Just as a quick update on this:

Had an MRI on the hip two weeks ago and it's shown two ligament tears (one on the inside the other on the outside of the hip) as well as a small hernia, all on the right side where I've had a lot of pain.

General feeling is that one or both of those tears has been there the whole time I've had problems. The scans show a lot of degeneration around the ligament, hopefully that can be cleared up when it's operated on.