send your ideas - chronic hip/glute/low back pain

csplatt

I'll start this with the disclaimer that I fully know that most of the people on this site are not physicans and will just be taking shots in the dark. I'm welcoming shots in the dark in case there's something I haven't thought of. Maybe you've had similar experiences and found answers.

I've had chronic right sided low back, hip, and glute pain for five years. For the first two years, I couldn't even walk well. I cried all the time. I took a heating pad to work. Ibuprofen, etc. didn't help. I tried a prescription NAISAD for a month then stopped because it didn't work and I got terrible sunburns from it. I had multiple xrays and MRIs with contrast. I did 9 months of physical therapy. I saw a spine specialist multiple times. I saw a hip specialist multiple times. I went to a pain clinic a few times for numbing injections into joints (spine / hip), but the results were confusing. I could report some relief but only for a few weeks when they would have expected up to a year.

What was confirmed in all that:

• there is a little cartilige tear in my groin, but all in office tests and injections suggest that is not actually the source of my pain. just normal wear and tear and location is a coincidence.
• i have spondylolisthesis at L5S1 with a little bit of foraminal stenosis. so I'm probably have some sciatica. Occasionally I'll have a biting/stabbing pain in one of my toes, which also confirms I'm probably having a nerve bump here and there in my lower spine. However, I've known about this condition since I was in college, and it never did anything like this when I was younger.

After those two years, I stopped all physical activity and rested. I quit the gym. I stopped going to the doctor. I stopped lifting weights. I rested for a long, long time. I occassionally would have a little flare up, but I felt very much in control of my pain — I could bring it back down with lifestyle choices. I can't sit for too long, but I also can't stand for too long. For fitness, I just walk (although hills can cause pain) and do exercise videos in front of my television. I was really sad to let go of my old hobbies, but at least I felt more in control.

This week, it's flaring back up like it did in the beginning. Glute, side and front of hip, hamstring, groin. I think it's from a lower body strength set I did with dumbells, plus a weekend of car rides. I'm panicking and really frustrated.

I AM OPEN TO ANY IDEAS OF WHAT I'M NOT THINKING OF YET. I'm so desperate and wondering if there's something really simple I could look into. I know SI joint dysfunction is a possibility, but I also know there's not much to do about that besides physical therapy. I honestly get confused about what is muscular pain and what is potentially nerve pain. I think it starts out muscular then changes / evolves / diversifies.

A few thoughts I've had:

1. Maybe I have one leg shorter than the other. When I walk on a treadmill, I feel like my pain-free side strikes early and my pain side strikes late.
2. Maybe I need to look into orthotic shoe inserts — have someone watch me walk and make some kind of custom shaped padding for my shoe if I'm pronating, etc.

I welcome all shots in the dark. Ready set go.

BTW - I'm 43, 129 lb, been active my whole life. I do remember having right sided QUAD pain as a high school athlete, which is interesting and possibly related.

susanrlee66

wondering if you may have some scoliosis? A good podiatrist would watch you walk and use water casts to see how your feet strike the floor. I would suggest you start with a chiropractor and have him look at your mri to see what’s pinching

AnnPT77

I don't know whether any of my lesser experience will suggest anything or not, but I'll comment just in case there's something.

Was your spine specialist a D.O.? If not, that might be a modality you could try - specifically a D.O. specialized in manipulative medicine. They're fully qualified medical doctors similar to M.D.s, so different D.O.s have specialties across a wide range, similar to M.D.s. I've been seeing a D.O. at a large university's osteopathic manipulative medicine clinic for literal decades, which has kept my back pain under good control. However, I don't have issues as complex or serious as yours sound.

Other things that have helped me with musculoskeletal issues, some of which you say you've already tried: Physical therapy, professional massage from therapists with serious therapeutic credentials, acupuncture (I had skepticism and low expectations, but it was helpful).

A medical intervention would be better than this, but as a lower-level possible option, hereabouts there's an athletic shoe store that offers actually good gait analysis for free, of course with the hope they'll be able to fit and sell you shoes.

claireychn074

Defo a shot in the dark but - I had groin and buttock pain and it turned out to be QL stress. The QL connects your hip to your ribs (simplified explanation as I’m not a skeletal specialist) and it apparently gets over used in stabilising a lot of the body. It gives bizarre referred pain - put it this way, doing QL stretches won’t cause any harm!

cmriverside

I'm really sorry you are struggling. Chronic pain is really difficult. I hope you have systems in place to relieve your fear about this latest flare.

Have you been continuing your PT at home on a daily basis? I don't have ongoing pain WHEN I continue my PT, but if I stop, it doesn't take long for it to return.

csplatt

https://community.myfitnesspal.com/en/discussion/comment/48697007#Comment_48697007

No, my hip specialist had me discontinue the PT because I actually had flare ups after visiting them once I got to a once a week and every other week in office session. He advised against some of their exercises (like clamshells) and told me if I wanted to try again it should be in conjunction with a clearer diagnosis. But so far all I have are guesses. I could try again with my back problem as the consideration I suppose instead of looking to “strengthen” my hips.

cmriverside

https://community.myfitnesspal.com/en/discussion/comment/48697070#Comment_48697070

Yeah, I don't know what your PT entails, but you could always try modified versions gently but regularly and see if you get any relief.

Also, if I skip a couple or three days of stretching it messes up my whole musculoskeletal system.

Retroguy2000

That sounds awful, csplatt.

Claire's comment about the QL is a coincidence. Before seeing her comment, I was thinking about some Athlean-X vids over the years where he has shown QL stretches as a solution for back pain. Here are a couple of links below.

Have you tried dead hangs? Maybe 30s+ a few times a day might help.

You don't mention core work or weights. It sounds like you did more of that before. If you can find a way to get back into that, after your current flare-up recedes, I think that would help. My lower back is definitely improved since getting back into weights six years ago, and while I could surely do more core work in general, I do include barbell RDL, barbell row, and back extension while holding a plate on a slight incline bench.

https://www.youtube.com/watch?v=gW4nggoR-N8

https://www.youtube.com/watch?v=TXh1oLXb6zk

cmriverside

I do those dead hangs. They're fantastic.