Except for stable angina I am a relatively healthy 68-year old male. But today I woke up with excruciating pain near my right hip. I noticed the pain a few days ago; it was severe yesterday; horrifying this morning.
For several years I’ve had various back pains come and go, which I attribute to sitting long hours in front of a computer. But those were always in the center: center of upper back or center of lower back. This new unusual pain is on the right side, beginning near the top of the hipbone (call this pain A) and extending down the (top, bottom and outside of the) upper right thigh (pain B).
Pain A is minor and has been present for a few weeks. The excruciating Pain B is much more recent. I have trouble describing particular pains, but this morning I decided Pain B is slightly similar to muscle cramp. The two pains are different; perhaps Pain A is an indirect cause of Pain B.
I can use my right leg OK; in fact some simple movements seem to reduce the pain. Last Saturday I drove for 7 hours without cruise control (and another seven hours 3 days before that); I drove another hour and half yesterday — could pushing the gas pedal with right foot be part of the problem? Yesterday we tried hot water bottle and then cold pack with no effect. My wife massaged the painful area with hands and a balm and that helped a lot; but I just woke up in excruciation. (Last night I stupidly binged on a large chocolate bar. Could that be related? )
Recently a friend had strange pains near one shoulder and a Chinese acupuncturist solved his problem completely after studying the pain for a session or two and inserting one needle! The acupuncturist doesn’t work weekends but I plan to see him Monday morning.
SDMB is now my go-to source of information and I started to write this post almost as soon as I woke up, taking a break to call my friend and double-check acupuncturist’s location and hours. I’ve also been walking and doing some simple leg motions. Pain A is still present, but Pain B is somewhat relieved. (I also have a slight cramping sensation in *lower *right leg.)
What do I have? What is the solution? Help, please!
The fact that the leg moves freely without amplifying the pain may argue against some possible diagnoses.
“Captain Morgan position” is confusing. (And gets many wrong Google hits! :eek: ) Are the (1) placing foot on stool and (2) complicated procedure with knees requiring a partner, two unrelated ideas? (For a few nights, I have been bending my right knee to relieve pain at bedtime, though I suppose the position is quickly lost with normal toss-turning.)
In addition to the acupuncturist on Monday plan, we’re going to a “bone specialist” in a few hours. (Though finding high-quality physicians is a problem here in rural Thailand.)
I’m about to watch a “Captain Morgan” YouTube with my wife and see if we can try it.
It certainly sounds like the sciatica I had (which did ease away in the end, but it took time). These are the exercises that are recommended to us, which worked for me:
The other thing I found useful was to float around in a warm swimming-bath trying to keep the legs gently moving - that, and getting pummelled by the jets in a jacuzzi.
But you really should see your doctor, since it could be so many things.
Outside of the hip (for “Pain B”). The Pain A is just above the right buttock, as expected for piriformis, if I understand correctly.
I watched the video. I think it confirms that I do indeed have piriformis. The tender spot on upper buttock is what I called Pain A. Pressing that spot does seem to associate the Pain B. I’ve done the first exercise a few times and it seems to reduce the pain! Is this normal to get improvement so quickly? (Of course I’ll repeat regularly.) I’d just eaten 1mg of Lorazepam muscle relaxant before reading your post; perhaps that’s masking the pain.
I’d left before you posted, to visit two clinics for muscle pain etc. but both were closed on Saturdays. I went to a pharmacist, said “the pain is similar to muscle cramp” and she gave me some magnesium … which had little or no effect. I think my brain was just trying to map my present pain to some previous experience; I came up with ‘muscle cramp’, but the connection was faulty. (Does this agree with others’ experience? The pain in leg associated with piriformis is somewhat similar to muscle cramp?)
A very very big Thank You to all who responded!!!
Given my age and pessimism, I often wonder “Is this the final pain that will never go away?” Thus my excruciation was terrifying! It now appears there are simple exercises to alleviate the pain. The video says “Do this three times 30 seconds each.” Does this mean three times per session with several sessions per day?
I did them three times once a day, before attempting a little swimming, and as it eased a bit of movement on the treadmill. But yes, it could well be that, if it is simply the nerve caught between muscle fibres, stretching the hamstrings and glutes will start to ease the associated spasms - if only by distracting the brain a bit with a new sensation. I still do them from time to time if I sense muscles tightening up in that area and small twinges starting.
Repeat stretch 3 times in a session of stretching. Give it a good rest but you could repeat 2 or 3 sessions per day.
The sciatic nerve is a bundle of nerve fibers that pass between the various muscles and tissues down in the buttocks and pelvic region. The pain from piriformis is when one of those muscles pinches the sciatic nerve. It can produce massive pain which, in some cases, can be substantially relieved by a fairly simple stretch.
In my case the other point that helped me was to pain a bit of attention to my gait. I was walking a bit duck footed, with toes pointed away from one another. By forcing myself to point my toes more directly forward I managed to stretch things out in the right places to keep that pain from coming back.
The captain morgan position just meant stand with the affected leg standing on something like a stool and the other leg on the floor. If the pain is caused by compression of the lateral femoral cutaneous nerve then standing like that may take pressure off the nerve.
I visited the respected muscle pain/bone pain doctor today. I will make a report.
My spine X-rays were good! Except for the missing gap between L5 and S1 which he thought quite normal in a man my age.
He didn’t bring up the subject of physical exercises, but early on I demonstrated the first exercise from the Schrupp-Heineck video. He liked it but positioned my affected knee farther away (making the shin perpendicular to my body, and suggested five seconds of hold (vs. 30 secs. from the YouTube), but I suppose these are just details!
I will be getting physiotherapy at the local hospital three times a week: traction, heat, ultrasound massage. I will start there tomorrow.
He gave me an appointment for seven days hence, with seven days’ supply of these medicines:
[ul]
[li]Zobrex (a nonsteroidal anti-inflammatory drug) 200 mg after breakfast[/li][li]Norgesic (aspirin/caffeine/orphenadrine) for pain after breakfast and after supper[/li][li] Pregabalin (for nerve pain etc.?) 75 mg at bedtime[/li][li] Omeprazole (Zecid) 20 mg before breakfast. (I suppose this generic Prilosec is to counter a problem of one of the other drugs. )[/li][/ul]
With all the physio and drugs, I hope something reduces the pain. (The pain just now is in lower leg rather than upper leg! Does it result from the exercise rather than the sciata?) I was in enough pain after return from doctor that all I wanted was to sleep even though unsleepy.
This sounds a lot like what happened with my hip for a bit, and it was indeed piriformis syndrome. I didn’t get any medicines for it, just those exercises. I was told he might give me anti-inflammatories, but to try just taking Aleve at prescription strength (basically take the 24 hour version twice a day). Between that, the exercises, and just changing positions as soon as it hurts (and not just bearing through lesser pains), I got back to normal in about a month.
Of course, this was after the doctor checked to see that the problem was not something worse. And I am less than half your age, so maybe that factored in.
PS: the best exercise I found was the one where you lay down and cross one leg almost “Indian” style and then lift the other leg. Then also lifting the crossed leg and pulling over my body. Though, again, don’t overdo it, or it can add pain.
I’ll report on my physio visit today. Recall the prescription:
“traction, heat, ultrasound massage.”
I decided to postpone the traction and just have the heat and ultrasound massage.
However instead of the ultrasound they just did a “short wave” deep heat treatment, implying they would do ultrasound only if necessary.
The male technician also reviewed my main exercise and showed me another one, while pressing my affected knee way down, and exerting much lifting force on the other leg.
I’d learned (via doctor and Googling) that I should apply all forces myself to avoid unnecessary pain. Instead, although I’d arrived at the clinic almost pain-free I left with severe pain from his pushing, though he pushed only for a few seconds. :eek: :mad:
Two doctors and that technician all insist I do NOT have sciatica, despite that, IIUC, the exercises are specific to piriformis syndrome, a type of sciatica. They claim it is nerve-pinch at L5-S1 that is causing my pain. Their reason? If I had “sciatica” I’d be numb in parts of my right leg. (Actually I have had slight numbness sensations there for years.)
Based on what I’ve learned in this thread and Googling, I think these doctors are wrong! Who’s right? Be aware that the quality of public-sector physicians here is FAR below U.S. standards.
Excellent advice, I think. I actually took swimming suit with me today, as there are two swimming pools ($2 admission or such) near the hospital. But I didn’t swim; for one thing we ran into a neighbor at the hospital and offered her a ride home.
I’m making another visit to the city tomorrow (unrelated to sciatica). I’ll take my swim-suit again.
(We have no less than three large water holes on our property; and I’ve swum in each in the past. We don’t swim in any anymore: they’re overgrown now with weeds and probably snakes! :mad: )
)
Is this normal to get improvement so quickly? (Of course I’ll repeat regularly.) I’d just eaten 1mg of Lorazepam muscle relaxant before reading your post; perhaps that’s masking the pain.