Hip and groin pain .

[Briefencounter]

I started with left groin pain about 3 weeks ago . This sometimes goes around the outside of the hip . I saw a doctor ( not mine) and he thinks it is osteoarthritis. I have RA and OA and have had a knee replacement, same side , and a right elbow replacement.

The doctor said he thought it was osteoarthritis and gave me a sheet of exercises to do , told me to take paracetemol, 2 x 500g @ 4 times a day . And he would check up on me in 6 weeks time .

Meanwhile , I rang the RA helpline and asked for my RA appointment to be brought forward so I now have an appointment on 6 April .

The pain is pretty unrelenting so I am taking the full amount of paracetemol a day plus a 30 mg codeine tablet at night ( all prescribed ) . I try to take the paracetemol at 7 am , then the rest spread out during the day .

Following the 24 hour rule I am supposed to start again at 7am the next day . However, sometimes I wake at 6 am or 6:30 and really need to take paracetemol for pain . But I'm wondering if I would be over-dosing .

My other question is that I have been prescribed amitryptaline 10mg for pain and wondered if it was OK to take that with codeine 30mg at night .

[oldtimer2]

The best person to discuss this with is the pharmacist or doctor who has access to the full list of your medications. For example: is your codeine 30mg by itself or with paracetamol? Can you increase your codeine intake to relieve the pain at night ( I take another at around 2am!) or adjust you codeine intake so that you take more at night? We can't give medical advice here as we don't know enough about your particular circumstances or what other medication you are taking. But you should be aiming to avoid the pain becoming established - it's more difficult to tackle if you don't take regular pain relief.

[Briefencounter in reply to oldtimer2]

Thanks for replying oldtimer . My 30 mg codeine is separate from my 500 mg paracetamol. When I started my RA journey over 30 years ago I was given co-codamol 30/500 mg . I think it was a nurse who suggested I was prescribed them separately , so that I could mix and match , take them separately etc so long as I kept a careful eye on when and how I took them individually . I find codeine makes me nauseous so I just take the one at night and possibly one during the day with food if I’m feeling really sore .

I understand the maxim of not letting the pain get on top of me - which was drummed into me when I had my TKR and my TER ..

I think I’ll take your advice and add another codeine to my night time regime . There’s nothing worse than lying awake in pain . Thank you .

In normal times I take 2 paracetamol and 1 codeine before I go to sleep and that’s it as far as pain killers are concerned .

[Mmrr]

It is useful to get your rheumatologists opinion too.

Your GP saying it is OA frankly sounds a bit of a cop out to me, how would they know without investigation, particularly since you also have RA ?

My hip pain is from my degenerative inflammatory OA in my lumbar spine. Exercising makes it worse, much worse. My neurosurgeon advised against doing anything which aggravates it.

A few things help my pain:

Voltarol (diclofenac acid), rest with heat applied, lidocaine pain patches, regular change of position with gentle short spells of walking.

I hope you get some answers soon.

[Briefencounter in reply to Mmrr]

Thanks for your reply Mmr . Unfortunately , I wasn’t able to see my own doctor but I saw a young registrar . He did have a good poke around in my groin for other causes , swellings etc . He also asked me what I wanted out of the consultation . To which I replied , an X-ray and a referral to the surgeon who had done my TKR in 2009 , please . My surgeon had X-rayed my hip then , as well and said he would probably need to replace it in the not too distant future . However , I gather now , more than at any other time , protocol has to be followed and there are certain steps to cover .

I do take an anti - inflammatory , Meloxicam , so I can’t take any more . I’ve bought a wheat bag , so will try that . I’ve bought an upright walker with arm rests but my other joints are joining in the fun now .

[Deeb1764]

I have had this but lower back joined in and now right hi then crept in bladder issues. My GP has just organised an MRI of lower back etc. to just make sure nothing going on in there that we cant see.

[Neonkittie17]

My rheumy physio told me my osteo hip was causing me a lot of groin pain, both soft tissue and bone, when my RS was uncontrolled years ago. The pain disappeared once my RA was being well controlled by RA meds and was helped when I started doing hydro/pool exercises. I hope you can ask your GP to advise you ASAP for the painkiller advice.

[Briefencounter in reply to Neonkittie17]

Thanks Neonkittie . My RA has been fairly well controlled up until now . But I must admit that I’ve had some ankle and feet pain since Christmas , which has caused me to walk more awkwardly than usual . I’ve accepted that any journey with RA and OA is a matter of swings and roundabouts. Not quite sure what this episode is . 🥴

[Neonkittie17 in reply to Briefencounter]

Could it be cold weather aggravating it? My osteo joints felt worse in the really cold weather recently. I am glad your rheumy appointment has been brought forward. Hope you can cope until then. Does a micro heat pad help at all?

[Briefencounter in reply to Neonkittie17]

I don't think so . I'm one of those lucky so-and-,sos who don't feel the cold . I have tried a wheat bag with minimal effect . Just hanging on until I see my rheumy.

[Neonkittie17 in reply to Briefencounter]

I think that’s all you can do at the mo. 😑💗

[Briefencounter]

Sorry to hear that Deeb . I don’t have any bladder issues , at the moment and so far my back is OK . Hope you find an answer to your problem .

[Happy5]

All a conundrum init?I'm like you have both RA and OA the latter resulting in me having both hips replaced which sorted the pain out in these regions.

Maybe ask for an x-ray to check the painful hip?

Like you I space out my analgesics try to avoid taking as often as allowed/prescribed.

However when the pain is bad I do take analgesics in the order allowed.

As others have said check with the pharmacist about contra-indications.

Also all meds come with an info leaflet whch may be helpful?

[Briefencounter in reply to Happy5]

Sure is , blessed with both Arthurs - greedy huh?

I have asked for an x-ray but have to go through all the stages , one by one , starting with exercises .

Hoping my rheumatologist will agree to an x-ray when I see him/her beginning of April .

I'm pretty religious about reading leaflets that come with the pills - just in case there's anything new or I've forgotten something.

I'm glad new hips sorted your pain , as a new knee and new elbow sorted mine . Except for contracting infection during the elbow op - but that's another story .

[Happy5 in reply to Briefencounter]

Nasty infection post op, knocks you for six eh?

[Briefencounter in reply to Happy5]

It did ! The operation went well and I had excellent movement of the elbow joint . But the end of the scar wouldn't dry up . In the end they had me back in , opened up the replacement and washed it out .( debridement ). They then put in a picc line for antibiotic infusion . That was interesting watching them guide the line along the veins

. After that I was sent home with 6 weeks of visits from the district nurse forcing antibiotic through the line .Finally , I'm on lifetime antibiotics .

For any operation you are warned about the possibility of infection . I guess I didn't give it too much thought .

[Happy5 in reply to Briefencounter]

Interesting to read how it was dealt with but not great for you.

[Chockyuk]

Hi 👋 I have the same, but mine is in the right hip. If you asked me to extend my leg outwards (as in getting out of the car) it is painful, I kind of have to swivel around with both legs.

After having my last flare in October, my Rheumatologist ordered a nuclear bone scan, which showed an uptake around the groin and hip area. She’s now booked me in for an MRI with contrast to further see what’s happening. Meanwhile she’s also referred me to a Consultant Haematologist as my ESR is still in the 100’s, despite my RA not being active, which is all very worrying. But I have to say, my Rheumatologist has been fantastic and I’m very lucky, she is so vigilant. I have a rotator cuff too which is so painful, she straight away booked me in for a ultrasound to check it out.

Maybe your Dr should at least send you for an X-ray about your hip.

I have been taking Nurofen or Paracetamol which I don’t like to take as I’m on Mthx, and don’t want to put too much pressure on my liver. I was also given Amitriptyline for my IBS, I can’t take it though as it makes me feel hungover.

I hope you get yours sorted 👍

[Briefencounter in reply to Chockyuk]

Thanks Chockyuk . I have a Dexa scan every 6 years which shows I have both Osteoporosis and osteopaenia . Not sure how the dexa scan differs from a nuclear bone scan . However, I have an appointment with my rheumatologist on 6 April , so I hope she'll take it from there . I have been given some exercises to do which have helped as I'm not leaning so heavily on my walking aids . I get "twinges" when I move , sit up etc which make me "yelp" in pain . 😳

[Chockyuk in reply to Briefencounter]

That’s good, I’m glad they are looking into it for you, and the exercises are working 👍A nuclear bone scan is they inject you with radioactive material, then you go home for 3 hours, then back again for the scan. It’s not looking for bone density as such, more for bone abnormalities.

I’ve been waiting for my MRI since January, but my hip pain is up and down, sometimes it’s worse and I’m limping, then other times I’m walking normally? It’s all very odd, but my Rheumatologist doesn’t think it’s down to my RA.

🤷‍♀️

[Briefencounter]

Thanks for that . I guess I'll not know whether it's RA , OA or anything else until I get an x-ray. My GP did a lot of prodding to see if he could find anything else first . My pain recedes with paracetemol but livens up with the passing of time . Thanks for your explanation of a nuclear bone scan . Let's hope we both get resolutions but everything seems to take forever at the moment.