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Hip or sciatica

BlueSkiesBBlueSkies Posts: 59
When I was standing washing pots and pans this morning, the pain I had in my buttock was so severe that I thought wasn't going to be able to finish the pans. I tried propping my leg up on the island behind me, straightening my leg, toes and foot sideways. It helped a lot, but obviously isn't a position I can hold for long. This made me wonder if maybe the pain in my rear isn't really sciatic...maybe it's a hip pain of some type. It doesn't hurt on the outside of my hip, but on the right upper buttock when I'm sitting, right mid buttock when I'm standing. The doctor said I had some arthritis in my right hip but that it was not significant compared to the back issues, but I was just thinking that if it is my hip, then maybe there's an injection or something that I haven't tried. Any easy way to discern between hip pain versus sciatic pain? I have been trying to wean off my Norco, and today is starting out quite difficult.


  • dilaurodilauro ConnecticutPosts: 10,038
    Some times it is difficult to distinguish between sciatic pain and arthritis pain in the hip.
    The biggest difference for me was that sciatica always went all the way down my leg. With my hip pain, it stayed around the buttocks and traveled just above the knee.

    Once I had my hip totally replaced, that pain went away
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • Hi BlueSkies,

    I am wondering if what you are feeling is sciatica due to your arthritic hip? I have heard that these two things can be linked--but I am not a doctor, so best look into it. What are your symptoms? Do you get burning pain? Tingling? I agree with the previous poster in that sciatica usually radiates right down below the knee. Also, if it is a feeling in the buttock, piriformis syndrome comes to mind, but I believe a number of other things can cause pain in the buttock as well, like a slipped spinal disk, etc. Perhaps, if you can, look into getting more testing to determine the cause of pain with your doctor. Like an MRI, etc. Good-luck!
  • BlueSkiesBBlueSkies Posts: 59
    edited 06/27/2012 - 8:32 AM
    I had pain going down my right leg and giving me a numb foot several weeks ago, and then I got 2 epidural steroid injections and the pain went away (except for my back). It is a boring pain, i.e., like a stake was hammered into my rear and is stuck there. I will look up piriormis syndrome (I don't know what that is). I go back to the doctor in a few weeks, and I may ask him to investigate the pain as a hip issue.
  • biobabe131bbiobabe131 Posts: 47
    edited 06/27/2012 - 12:25 PM
    I have heard of others who experience numbness can occur with sciatica. I don't get numbness so much, but tingling moreso. Piriformis syndrome has to do with the piriformis muscle in the rear being tight and pressing on the sciatic nerve (the longest nerve in the leg). You should be able to find some info. on it online.
    Best of luck to you! I hope you figure things out soon.
  • I have had many issues with hip pain. This is what I found out. Yes sciatica does appear in the hip area, sometimes in the groin depending on what level of your spine is involved. My personal experience is that I have nerve damage in my right leg (L5 nerve)and my glutes don't work very well. Therefore as I walk, stand. try to bend that leg at the hip, it is not working properly and the weak muscles themselves produce pain. I'm calling on many muscles to hold me up and that in itself has caused proplems. I now have a slight labral tear in my hip. So if your leg has any weakness due to compression in your spine, other things locally at the hip can be happening. But if the leg weakness continues, it's just a vicious cycle. How are you doing coming off your meds?
  • BlueSkiesBBlueSkies Posts: 59
    edited 06/28/2012 - 6:59 AM
    I am having pain in my groin! It's weird...that's new. I don't know if my leg has any weakness that would make me walk differently as you do. I haven't noticed it or been told that, but it could be that, as you say, other muscles compensate. I don't know. Will they fix your labral tear? Can you get some type of injection straight into that joint?

    The weaning off the meds isn't going as well as I had hoped. :( First off, it is too fast, and I have the "jibblies" as I call them (restless legs, etc). Secondly, I hurt. A lot. Even the massage hurt. I'm feeling a bit defeated about it at the moment, but I will figure something out. Someone on here recommended cognitive therapy, and I may look into that. When I start to hurt, I can't just take one 5 mg pill and wait to see what it's going to do because I get really scared that it won't work, get anxious, and take another one just in case...etc. Maybe therapy will help me at least nix that. Thank you for asking though.
  • dilaurodilauro ConnecticutPosts: 10,038
    About 18 months before we realized I needed a hip replacement, my initial pain was in the groin area. We all thought it was a groin pull , so my physical therapist and deep tissue Thai man worked on that. About 9 months into this, my Deep tissue guy didnt think it was the groin, he started working on the I-Band in my thigh (that hurt). Finally, he said, no to both of those.

    Then the sciatica type pain in my buttocks started daily. Finally, a MRI and X-Ray determined the extent of the arthritis deterioration in my hip. That was the answer for me!

    Hopefully, you can have the correct doctor look at you to come up with a real formal diagnosis, mine is only based on my own personal experiences.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • dilaurodilauro ConnecticutPosts: 10,038
    Here is a great site dealing with Arthritis:

    You can register for this site and browse the medical information. At this point, there are no patient forums, this is more of a pure medical site
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • Well I have groin pain too. But I have been to a new physio that specializes in how the pelvis works and she could tell right away that the way I was standing was pushing my femur into an incorrect position and it was causing my groin pain. I was trying to do a pelvic tilt while I stood, walked etc. One side would tilt but not the right side. She told me to stand with my butt sticking out a bit and that has taken pressure off the femur in the joint. It is more distributed over my quads in the front. But again still a wobbly leg but lessened groin pain. I probably won't get my tear fixed, waiting for an ortho appt with the top guy in Vancouver for tears. 2 years to see him. I don't know how successful it would be. If the muscles that help keep the joint in place aren't working properly??? May just cause more problems. I do not have inflammation in the joint and very little cartilage breakdown so an injection won't help.(so says the physiatrist.). Do you take any nerve meds such as Lyrica etc? But keep your chin up if getting off the meds is important to you. It's always weighing quality of life, risks, side effects etc. Each person makes their personal choice.
  • Thank you very much for the site link! I saw that there is a transcript somewhere of a conversation with a Dr. Harrington about spondylolisthesis, but it isn't available for some reason (404 message). I reported it via the link, so hopefully it will be available soon.

    I am now having the pain down my leg and my foot is numb again, so I think it is just the ESI wearing off and it is my sciatica again.

    In related news, I called my doctor to refill my Norco since I was weaning myself too fast, getting sick, and hurting a lot. Apparently he really took me at my word when I responded to his admonitions about hydrocodone by saying I didn't want to take it any more because his nurse said she would refill it next week (way past the run-out date even taking it as slow as I have) because "If you're not going to have the surgery, you'll need to return to your family doctor". That makes sense, but my family doctor has known me for 13 years and he will give me unlimited amounts of pain meds. I don't want that either. Sigh. Maybe I will have to succumb and get a pain management team. Ugh. At least there is a good one close by, and I'm sure my doc will refer me there.
  • BlueSkiesBBlueSkies Posts: 59
    edited 07/14/2012 - 3:21 AM
    I had my family doctor refer me to the pain medicine clinic downtown, mostly because everyone on here sings the praises of those clinics and my ortho doc couldn't help. (PM me if you want names because I was really pleased with them). This doctor was a bit odd, listened more than he talked which is dangerous with me because I'm a talker. :), and then said he wants to repeat the facet joint injections even though they didn't work last time and also want to inject my hip. He agrees that much of my present pain (post-ESI) is right at the SI joint and we should try injecting it. I was really straight with him about my medicine concerns, and he didn't really say much except that my ortho doc had reduced my meds too fast and too low and my PCP was giving me too much of the short-acting ones. He said I'm taking too much Advil and that repeating the corticosteroid injections (depomedrol) every 3 months like clockwork is a bad idea (bone density). We're trying the 300 mg Tramadol ER because although I don't like Tramadol (coming off it is terrible!), it works well for my pain. Then I also have Norco for BT pain, but, as you all know, I'm trying really hard not to take it for my own reasons. This clinic does have a cognitive behavioral therapist affiliated with them, and I think I may explore that too. I'm still doing massages, meditation/relaxation, exercises, Flector and lidocaine patches, and need to get new electrodes for my TENS unit.

    I'm really happy he is exploring the hip. Thanks for the links and other information.
  • I am glad you've found someone to help you BlueSkies!
    I wish you the best of luck!
  • Just in case someone searches this issue, I wanted to tell how things turned out for me. Two days ago, my new doctor gave me a medial branch block (which he says is the same thing as a facet injection) and injected my SI joint. I am incredibly, unbelievably better. I am able to stand and walk for much longer than I could before. This was just in the nick of time since we're packing up this house to move to our new one, and even though we're hiring movers, last night I was able to stand and wrap little fragile items and pack them for well over an hour, unthinkable last week.

    When I was in the procedure room, I asked for a Sharpie, stood up, and marked the places it hurt the worst. Maybe this made the difference, I can't say, but they were able to do something right because I am so much better. The doctor did say he thinks there may be an element of piriformis syndrome, and we'll investigate that in a few weeks, but I am happy if I can just maintain my present status.

    I am not having to take any Norco at all. I am unfortunately still having to take the Tramadol 300 mg once a day because (a) I'm afraid to stop...why rock the boat when it's only been 2 days, and (b) I'll get the jibblies if I stop it all at once. Maybe when I see the doctor next, we can discuss going off that if I'm still feeling good.
  • So happy for you that you are having success with the medial branch block and SI joint injection. I was reading your thread since I have bad hip, buttock pain, and am really starting to think that it could be my SI joints. Does your doctor think that it is a combination of facet and SI joint with possible piriformis? How does everything look on your MRI (facet si joint?)

    I hope that you continue to have success. How often can you have these injections , and would the next step be rhizotomy?Please continue to let us know how you are doing.
    >:D< >:-D< : Karen
    L3-S1 herniation and bulges, stenosis, mod facet,ddd,impinged nerves,coccydinia
    discectomy/lami July 2011-unsuccessful
    adr L5-S1 Feb 2012
  • Thanks for the happy thoughts for me! I haven't had a chance to talk to my doctor in depth since the procedure, so I don't know many answers. He mentioned the piriformis while I was there on the table with my little Sharpie-marked body and he was kind of visiting with the fellow who was assisting in the procedure. After the discussion, he said, as if making a decision to proceed, that based on everything my MRI said and what we had discussed in the office prior, he was going to go ahead with the injections the way he had planned, but that we would discuss the piriformis at my next appointment (about 10 days from now).

    He had said that if this worked more than a certain percentage (maybe 75%?) for a certain period of time (maybe a couple months? I can't remember), then we would look at doing something more permanent. I assume that means some type of RFA or rhizotomy...I don't really know what those are, and I am delighted to have new things to be researching. My ortho doc had not even mentioned these potentials. I am beyond thrilled that there may be a permanent option.

    My MRI shows a very large bone spur which combines with the spondylolisthesis at 2 levels (at opposing directions, retrolisthesis and anterolisthesis) to cause severe foraminal stenosis at 2 levels. However, the doctor said it was the severe facet arthritis that was causing the greatest pain. Nobody even mentioned the SI joint in reference to an MRI, and I am hoping they will do some more thorough imaging studies since this seems to have been at least one of the culprits.

    My next appointment is a week from Wednesday, and I will be glad to update after that. Maybe something he says will be helpful to you too! Thank you again for the kind thoughts!

  • dilauro said:

    Some times it is difficult to distinguish between sciatic pain and arthritis pain in the hip.
    The biggest difference for me was that sciatica always went all the way down my leg. With my hip pain, it stayed around the buttocks and traveled just above the knee.

    Once I had my hip totally replaced, that pain went away

    I can't believe it took me 10 years of telling a dozen specialists this and finally after 4 MRI's of my lumbar spine a rumotologist suggested an MRI of my hip , all along I have had a torn hip labrum and I,m going for athroscopic surgery. Amazing doctors can't diagnose the above statement . I never would have read this though had I not started searching the word labrum. Anyway thank you kind Sir ! Spread your wisdom as there seems to be a shortage of it in the medical community.

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