Lower back right hip pain difficulty walking ... - Pain Concern

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Lower back right hip pain difficulty walking sitting driving lying down sleeping.

teddybear12
teddybear12

I have been suffering with severe lower back & right hip pain since January, the pain never goes away I'm on 15mg bupronophien patches with 400mg of slow release tramadol a day, I have physio weekly & work with a personal trainer on a rehab programme I've had an MRI scan that showed nothing that could be fixed surgically I've had an x-ray on my right hip that showed mild arthritis in my hip & as a result had a cortisone injection in my groin back in May, my life has been brought to a standstill as a result I want my life back & the pain to go away I don't see any hope of this pain ever going I don't know what to do next I can't keep going like this for the rest of my life.

37 Replies
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Hi Teddybear,

I suffer from similar problems with back/hips/legs and can sympathise completely with the pain and change of lifestyle that comes along with it - it is a very hard adjustment.

You mentioned that you were advised that nothing from the MRI displayed an option for surgery, however, did you get any information from it at all? Was this completed via hospital recommendation, GP recommendation, Orthopaedic surgeon or the Pain Clinic?

If you are yet to see a specialist orthopaedic surgeon you can ask for this via your GP or via the Pain Clinic. The Pain Clinic is a great place to be referred to as they will generally have specialist surgeons, Occupational Therapy, Physio, Anaethetist and Psychologists (for issues with life adjustment) all under the same roof and solves many issues for being passed from pillar to post. There is light at the end of a very dark tunnel which can come in the form of advice, exercise, changes in pain meds, pain management or by surgery.

If you have followed this path already you are always entitled to second opinions. My advice is ask as many questions as possible at every meeting with a proffesional.... use this time.... take a list of things you wish to know and educate yourself on any options - time between appointments can be very long unfortunately.

I look forward to your response and hope you find your answers.... you are not alone on here and I am sure many others will add suggestions.

Take care.

Thank you for your response my MRI showed a slight bulge in my L4 & 5 disc but as mentioned nothing that can be fixed surgically & I didn't find this out until I got to my pain management consultant as my 1st consultant said there was nothing more he could do so discharged me to pain management. All my treatment to date is being done privately my intisl referral came from my physio to my Dr who then referred me to my consultant for my back, he was the one that sent me for my MRI scan gave me no information from my results other than telling me nothing needing fixing with surgery he sent me for a test on my leg that involved electrodes that tested the response down my leg at my S1 nerve this showed & proved nothing at which point he discharged me to pain management. This consultant was excellent he sent me for the x-ray on my hip that showed the slight arthritis in my hip & arranged for the cortisone injection in my groin a few weeks after this procedure when I went for a follow up appointment he thought this had helped sufficiently for him to suggest I went to see a personal trainer yo improve my muscle strength in my hip & lower back. I had a follow up appointment arranged for a month later by which time I had been for weekly one to one sessions with my personal trainer & my consultant on my follow up appointment said there was no further need for medical intervention as this was working & getting positive results.

I have been steadily getting better improving & my walking / pain getting easier the problem is that I keep having flare up's that put me back I have had to have my pain meds increased on a few ocassions it's bad again at the moment & everything is back to being very difficult.

Teddy, have you had your sacroiliac area checked out, scanned, xrayed etc? This is often overlooked and can cause a heap of problems. Those many tiny muscles and ligaments around there can become very highly sensitised.

Hi yes this is what my physio & personal trainer believe is what causing my pain they both work on this area from a physio & excerise perspective.

I had my usual physio session on Wed my back & hip were bad straight leg lift nearly impossible my leg is like a dead weight, so he had a look at my back & asked me to face the wall & lift each leg my left leg (good leg) my pelvis does what it is suppose to rolls & goes down but my right leg (bad leg) my pelvis raises which means my sacroiliac joint has popped out again this keeps happening. He treated my back particularly my sacroiliac joint & once he had finished straight leg raise was easier & my knee lift on my right leg the pelvis lowered & rolled as it should. Is there any reason why my sacroiliac joint keeps coming out of line & causing me all this pain?? I think it has slipped again as both indicators are back to being very painful again. I have bought a sacroiliac belt just waiting on its arrival, my physio wants me to go back to pain management to have this joint injected directly is this my best long term answer??

I am going through the same thing it sounds like. I'll be doing fine for a good while and then I'll have a flare. The last flare was even worse than this one. I wasn't able to move hardly at all and my husband had to help me do everything. Were you ever able to figure out what it was? I need some advice on what to so. I am only 24 years old. I have had so much trouble with pain.

brifi
brifi in reply to sanctifydgrl

i know this was over a year ago that you posted but I'm a fit 26 year old woman who has recently become completely immobilized by lower back pain into my right leg. Can you tell you what you found out happened to you? I'm on day four of not being able to even stand and being in constant pain. Please help.

I have the same problem I'm in constant pain in my lower back n right hip I've been hospital n nothing was done apart from giving me painkillers

Hidden
Hidden in reply to teddybear12

If you have bulging discs that is a precurser for surgery. The pain doctors charge outrageous prices that eventually will send you back to the surgeon for surgery! Sorry

Hidden
Hidden

Hello BOB here

Your doctor seems to be dealing with your problem, possibly He may feel that you are not in the need of a pain clinic appointment as you seem to have covered and began a treatment plan.

You are having treatments with physio and visiting a personal trainer so they must feel that exercise and manipulation are the way forward. Your doctor also has provided you with analgesics to cut your pain

One problem you may have here is posture, also I think you must be now a senior patient.

When we get older the joints in the hip and spine become more of a problem have you been involved in an accident.??.

One way to go with this is have words with the physio about posture and look at the way you are sitting and walking.

If you are walking or sitting you will be possible over compensating and putting stress and the lower back and hip.

this will cause more problems on other joints, so a savage circle sets up and this puts stress on joints in different parts of the body.

Remember you only need heroic treatment if all other treatments fail and your doctor seems to have this covered, Carry on with what you are doing now and discus with the doctor your way forward as He is in partnership with you and He/She will keep you right.

Always look for a more simple way of looking after your problem if you have only slight arthritis I would be happy with that and treat as above, I am not a GP so you will need to take this as suggestions

All the best

BOB

teddybear12
teddybear12 in reply to Hidden

Hi Bob thanks for the response I have been down pain management my consultant was the one who referred me to my personal trainer as he feels this is my best fix process I'm not a senior I'm 41 up until being signed off my Dr I worked full time at a desk job, yes I do have a limb on my right side that does effect my posture & the way I walk. I keep having flare up's that I am told to expect things seem to be getting better & easier when I take a few steps back & end up with severe pain again & all my other symptoms exasperated.

Hidden
Hidden

Hello teddybear

BOB here.

When people come onto this site if asked to give support and encouragement,we wrongly assume the persons age.

So you are still 41 years young,sadly now I am 63 and been in chronic pain now for near on thirty years.

You do not need to be a slave to your condition.

One of the main problems people have can be treated by bettering their posture and replacing lounge furniture etc.

Now I hope you get plenty of support with your condition and if and when you need support you know where to come to

All the very best

BOB

Hidden
Hidden

Odd mix of drugs... generally it isn't a good practice to mix weak opiates (eg. Tramadol) with strong opiates (eg. Buprenorphine), although far from unknown.

Extra problem here though, because Buprenorphine acts a bit oddly compared to other opiates in that it has an action that inhibits other opiates! For that reason in some countries it is used to get people off other opiates.

Almost all Doctors, unfortunately don't seem to have the slightest clue as far as this is concerned, (no shock there!) and don't realise it's not a very effective thing to do, mix BuTrans with other opiates.

There is a lot of information on this if you are up to the technical side of it, it's all about it's inhibition of CYP2D6 and CYP3A4 if you want to Google!

I personally found that it did not work at all well with Oxynorm (another strong opiate), and I was getting nowhere, even had withdrawal symptoms until I got that replaced with Temgesic for breakthrough pain - Temgesic is the oral tablet version of Buprenorphine, taken by letting it melt under the tongue.

As a result even though I have spinal arthritis as well as a dislocated and arthritic hip I can generally much fo the time "get by" on just 15mcg/hr of patches, with relatively few Temgesic tablets for breakthrough pain, which is really not a huge amount at all compared to some opiates I have previously taken, I was using about three times the equivalent dose of Fentanyl for example - in effect 15mcg/hr is hardly more than the equivalent max. dose of Tramadol!

I don't expect anything like total pain control, though, it's NOT going to happen, my optimal is getting enough pain relief to enable me to get moderate sleep, and get around in my own restricted way - I get ill, very quickly when I can't sleep.

Sadly exercise, even when I was not nearly as bad as I am now never did a single thing for improving pain - I did quite a lot in the past, and yes it helped mobility a little, but only ever creates MORE pain for me, often quite a great deal more - something well known, the jury is really out as far as this is concerned, as some people are helped with exercise, and some do not... the only way you know is by trying it. You still have to do some though, or your mobility soon suffers, an ultimately weight gain and other illness tends to follow on!

Hi there, you have had some very good advice especially from Stampede. You say you are under a Private Pain Clinic. I was too and then went to an NHS one where they had more choice and variety of healthcare professionals and I found them much better. This may be worth considering as you are on a strange mix of meds. Have you tried the paracetamol, ibuprofen, codeine root first? Different types of analgesia work on different types of pain so may be worth researching yourself and going to them with suggestions. Morphine based meds can cause extra muscle pain (ironic!) and not many health professionals know this. For me it felt like, the pain you would get from doing 2 hours in the gym the day before but never eased. Have you had a sudden increase in your meds which may cause the worsening of your symptoms? Have you overdone it recently which has caused your flare up? It may be your body telling you to rest. I know life means this is not always possible but for chronic pain sufferers it is important to recognise and act on this as sadly our lives are far from normal! Pain is very frustrating and restrictive and it does take a while to learn about your pain and how to make the best of it, coming on here and talking is a great start so good luck and keep in touch.

Sharelle that was one of the best bit of advice I've heard as I know that lowly old paracetemol can work fine and yes you must listen to your own body , but people with pain will in the end, learn these lessons, for themselves, as pain is a great teacher...but about ibuprofen and paracetemol watch your stomach by taking that blistery-pack one????

A visit to a sports physio may give you more options. They use a variety of manipulation techniques, massage etc and understand pain, its routes and how to minimise it.

I have lumbar disc problems, fractured pelvis and compensation pain, with a load of triggers thrown in. I see a sports physio every couple of months for top ups and have a battery of exercises to do each day. This with meditation, distraction and pacing means I can live a fairly normal life. Some things need more planning, but day to day is built on rotations of therapies I do myself.

As you say the pain won't go away as its arthritis, but you can reduce it without using meds. Keep moving, try pilates, there are specialst groups for those with conditions which are gentler and don't progress as quickly through the levels. Hydrotherapy is a great way to exercise non-weightbearing and half an hour in the pool is the equivalent of 1 1/2 hours in the gym, so should be treated with great respect.

Meditation will take you to another place and when you return, your brain will be free to concentrate on what matters, not the ifs and buts.

The main thing to remember is that recovery, or increased well being, fitness etc is a very long and slow progress. There may be remissions when your body refuses to co-operate. Always think about the longterm rather than each day. Plot it on a chart so you can see improvement - things like walking 5 mins pain free, then 10, then 15 etc.

We are yet to have a pain killer that is suitable for chronic pain, and if you try some of the above, you may not need as many

It is all trial and error as to what works for each person, everyone is different. If you did alot of sports in your younger years, your body will respond quicker to exercises, manipulation etc because it remembers.

Even sitting on an exercise bike on the easiest setting and doing 2 mins at a time will help build up stamina and muscle. The hardest bit is setting aside 2 mi ns every couple of hours to do this, but if you persevere, you can increase steadily.

Check with your physio before you do anything else as it may interfere with their long term plans for you.

Everyone above seems to have covered the medical side and physio side of your illness at the moment very well. However you really seem to be struggling with frustration and depression commonly felt by most people dealing with chronic pain. I wonder if you have been offered any counseling or cbt courses that may help you deal with things with a more positive attitude.

The last 24 hours I have felt like I really can not bear to face another minute in the level of pain I am in, I have had little sleep and my brain cloud has descended, the difference is I know it will pass and that for today and maybe tomorrow I will have to limit my activities and not be to hard on myself. I also had a good moan and some popping candy to make me smile.

I really hope that things get easier for you and that you get some relief from your pain.

nutty

I feel I am a bit late to the party as most previous responders have covered the majority of issues quite well.

One persion has mentioned meditation and to that you need to add mindfulness. There is also Alexander Technique which is quite helpful.

Starting to live with the problems of chronic pain requires a lot of adjustment and handling of the bereavement issues. You have a major loss in your life. The loss of your health and the ability to do what you like when you like. The next loss in the system is the weeding out of people who were fun when healthy, but drag you down now that you are in ill health.

Meditation helps in quieting the mind and helps develop new skills with which to enjoy the simple pleasures of life. Simple pleasures are a joy which one has missed when in engaing in all the activities that good health has allowed one to engage in.

Mindfulness gives you the tools to notice what is happening in front of you. Little things now matter. It is the little things that can make the difference between minor pain and major pain.

Alexander Technique helps you notice how muscle usage can cause pain and helps modify muscle usage so that the way you your muscles will cause less pain.

Of course there is McTimony Chiropractic which I have found also helps

Hope this helps

You asked about reasons for your unstable SI joint. I wonder, do you any hyper flexibility of your joints? Also known as double-jointed. The SI joint is a beggar for this. It is possible to have this joint fused via a surgical procedure but I don't know anything about success/appropriateness of this in your, or anyone else's case.

I don't believe I am double jointed well I'm not anywhere else at least.

Hi Teddybear12,

My partner is going through the same thing, exactly!

We went to see a sports physician who seemed to think the whole thing could be fixed by stretching/increased flexibility as it could be an SI joint problem. feel like we are hitting our heads against a brick wall without really getting anywhere. He is going for the MRA but we are not expecting much from it. If you have any success with anything, please let me know. He is in his early 30s and we are really struggling with this.

Cheers

Hi crazy-skier I have recently been back in with the consultants after a bad flair up that wasn't settling down, my pain management consultant was contacted on my behalf by my GP & personal trainer due to the amount of pain I was in, he called me a few days later & advised me that I needed to go & see a hip specialist. I arranged an appointment & saw him 2 weeks ago. He had a look at my x-ray examined my hip & its range of movement observed how I deal & handle my leg & said without a shadow of a doubt my problem was my hip, its quite severe & I have been told than other than leaving it as it is my only option is a hip replacement which at this point I am not ready to put myself through need to get my head round what I've been told & even though I have always suspected that my hip was my main cause of my pain having it confirmed is a whole different thing in my head anyway. I won't pretend that the pain doesn't get to me at times & have me in tears but I'm not ready either to put myself through surgery & everything that comes with.

frame1
frame1 in reply to teddybear12

Hi teddy,

Frame here. Thanks for posting. Just read your entry of two months ago and thought I had written it and forgot, wouldn't be the 1st time as my memory is shocking, hee hee.

You describe my pain so well. I've just improved after a major flare up which kept me off work for four months but couldn't see pain consultant only a phone call from nurse (who is great) as consultant said it was JUST a typical flare up! Trouble is after ten years of managing have been signed off physio, pain clinic etc but keep adjusting meds up &down depending on severity of pain. This continuous cycle gets me down, sometimes dangerously so and feel can't go on but it does eventually get better. You sound like emotionally you are struggling with acceptance like me and miss being your old self. So if you need to talk I'm here, you can send a personal message anytime.

Has your pain or mood improved. I do hope so. Do you manage to work or get out and about? Try to keep in touch with people as I know this helps me but when you need company the most this is when it's hardest to get out and do things. I have managed to be a bit more open with a couple of friends and this has helped them understand but I am trying not to be too needy or expect them to meet me at short notice and realise people without pain like to plan ahead which we can't do.

I have just realised that as registered disabled and with higher mobility allowance and lower attendance allowance I qualify for some discounts e.g. Council sports centre give free swimming/leisure access and you can get a cea card for free access to most cinemas. If you haven't got these passes you should apply. As I have only part time work I had given up socialising when physically fit due do lack of funds so this is a big help. Do you know of any others I could use? Just waiting for leisure card to come through and then going swimming. Have already found local pools with easy access as I can't climb out using ladders and need proper steps, too embarrassed to use hoist as I look as if I have nothing wrong with me and always worry what others think. I hope to find a local aquafit class to meet new people too as at moment being middle aged I don't fit into the eldearly or young mum groups.

Hope things improve for you. Try to remember you are not alone and everyone on this site hAs a bit more understanding than joe public. I hope you find something to keep you busy and distract you from even a little bit of your pain.

Best wishes

Frame

teddybear12
teddybear12 in reply to frame1

Thank you for the reply & your concern, no I'm not working at the moment have been signed off by my Dr all year & at this point he won't let me back until I have seen occupational health through work still awaiting this appointmen, when I do work I'm full time I have kept in touch with work I go in at least every 4 weeks as I prefer to go in so no one sees it aa strange when I do go back aa they wouldn't have seen me for so long.

In relation to your concerns about my mental state 99% of the time the pain doesn't get to me I think my Dr is quite impressed as to how well I'm coping with the permanent pain. Don't get me wrong there are bad days when I loose it pain is bad crying but I have a great man at my side that will do anything for me he looks after me takes me out when he's home from work, I also am blessed with a great set of friends that will either come pick me up & we go do the girlie lunch catch up & steady wander, as I drive I also go out to meet my friends I'm not by any token locking myself away as I feel as you said this is often the worse thing you can do. I have a personal trainer that I see on a 1-1 basis once a week that has a programme that I work on that is juat adjusted to accommodate how bad my hip is as I do have quite severe flare ups just coming out of another so back on the up thank goodness.

I do not claim any form of benefits linked to disability as this is not a road I'm going down so am unable to advise on anything you may be entitled to but have missed sorry. I too don't fit into the old or younger group for this condition to effect but I try to keep going as best I can, I have a pain management consultant that I can arrange an appointment for if I need it but he has since referred me onto the hip specialist that has now officially diagnosed my pain coming from my hip which is what we have always suspected was just a shock to have it as an official diagnosis.

Hi teddy

Glad you are in good spirits. It's a shame you have been off work for so long but very sensible to keep in touch in person. As you now have an official diagnosis I hope it helps in your treatment plan. Which part of the country are you in? Only ask as in Scotland our pain management consultants appear to be in short supply and very difficult to see. I'm really impressed that you push yourself with a personal trainer. Do you think this helps minimise flare ups and can you still exercise even when your hip is really bad? Good news that you are on an up just now. Hope it lasts for a while.

Good luck

Frame

Hi nice to hear back from you, I live in England Sheffield to be exact, the fact that I now have an official diagnosis with a long term treatment plan does give me an explaination as to my pain but does not make it any easier. I'm lucky enough to be able to have private treatment so my pain management consultant will call me & if necessary get an appointment quickly this is the guy that referred me to my personal trainer & hip specialist. In relation to your question about my personal trainer yes I think it has helped a lot & he tailors my programme to how bad my hip is if I'm going through a flare up we go back more to my stretches & ball work we've put the cross trainer back in recently too only on the easiest setting but he says this is good for my hip as its low impact but gets it working & warmed up in the right way. I would recommend that if you are able to track down a personal trainer that will work with you on a rehabilitation programme & your finance's will allow you to do it that you do as even though I'm not as good as I have been I'm definitely a lot better than I was 5 months ago when I 1st started going to see him, he tells me off for overdoing it as this is what triggers my flare ups mainly. Well I think I had better get myself to bed as I'm at the gym in the morning but I'm not sleeping very well at the moment with the pain but that's all part of what I'm going through right now.

Sarah

Sorry, I came into this late in the game; but what was the final diagnosis ?? I have similar problem and wondering where to start.

I had the same hip pain for any years. I went to my GP who sen me to ortho. He told me it was bursitis and gave me cortisone shots in both hips. After that, I had charlie horses in my groin all the way to my toes for 4 days. I wonder if it was really muscle lock and the shots made it more affected. To this day, the charlie horses were never explained. but was diagnosed with PSA a few months later. Since starting the proper drugs for that, my hip pain has subsided for the most part.

God pain I know the feeling I'm starting with low back pain stiffness hips and legs I'm slowly losing ability to walk I've had upper back pain and stiffness for yrs now it feels like it's spreading down my body and I want to cut my feet off they hurt so bad. I can't sleep most of the time if I do it's only on my right side if I lay on left or back my god the pain!

Hello I know I'm 2 years late but yes I too would love to know what your diagnosis was. I'm a 24 year old female that has increasingly painful issues across my lower back that go in to my left hip and down my leg. I can't sleep a full night, sit, stand, or anything for a long period of time. People always ask why I snap or I'm angry and it's just this pain. I'm a typically happy person and it sucks with activities like pool that I used to play with my bf because I can't bend and then straighten.... it's constant....and I cant stand it any longer. I've had xrays and mris and seen a neurologist and was told they saw nothing but there has to be something causing this.

I have. Been having the same pain and I know the pain is horrendous.over the year I have had 3 inj of cortisoneand I have been taking

Oramorph.i had an operation on the 10 of Sept I have the clips out on sat Bursites .dr said when he went in my hip was very bad. He removed the bursa as it was very infected .So here's hoping !,I do have osteoatherites and osteoporosis all over my body .

I have found the op. quite painful at first but my pain in the back and hip have now gone very lot of bruising but this will go as long as the pain is gone.. I hope this helps good luck I am a 77 year old lady.

I had almost identical issues to you. I ended up having to use crutches and became depressed. The constant pain and my inability to manage daily tasks without making the pain worse.

MRI and X-rays showed early onset arthritis just like you. I was referred to a 'young hip specialist' and had injections and weekly Physio.

Several years later, once my life was seriously impacted due to inability to work and reliance on buprenorphine patch, tramadol, pregabalin and antidepressants, the specialist decided to do an arthroscopy.

A BONE SPUR which was deep in the hip socket, unable to be seen on MRI had been tearing my ligaments to shreds for years along with bone on bone grinding doing damage.

Following the arthroscopy I have been almost pain free. I suspect that it needs doing again soon as I can feel the pain creeping back but please, ask the question of your specialist. That operation gave me my life back, if only for a limited time.

My hip started to bother me about a week ago and is progressively worsening. I am limping around and have trouble driving because when in a sitting position my right leg is like a dead stump. I literally have to lift it with my hands to move it over to the brake which obviously isn't safe to be driving like that. It seems to be better in the beginning of the day and progressively gets worse as the day gets later. It's the exact same thing as described except for the lower back pain, I don't have that but everything else. Right hip pain with difficulty walking sitting driving and lying down to sleep. Of course now I can't even see a doctor unless I go to emergency because it's a long weekend. But after reading all these posts I feel even more discouraged because it doesn't sound like there's much hope.....

I also have been diagnosed with a bulging disc and have suffered with sciatic pain in the past though this does not feel the same or in the same area.

I know exactly how you are feeling , I am 36 and have gone through exactly what you have, I'm in a wheel chair due to server pain and muscle cramps I get when I try and walk. I have been pushed from pillar to post !!

I'm a year on and have my first psysio appointment tomorrow , the pain clinic soon oh and now mental health services.

I literally feel so alone, like no one understands the pain, it's driving me crazy, nothing I do is right oh and the guilt is horrendous.

How much pain do you need to be in before somebody takes you seriously x

I hope things get better for you soon

And how long have been poorly x

Hi Katie and everyone, I am exactly where you are. I'm 47.

Went from very active yogi, biking, dancing, tai chi, running, hiking, walking, etc, to wheelchair. Started with nightly Charlie Horses in calves 5 months ago, moved to right leg pain, to total cramping. Can't even walk with crutches, etc, because leg just seizes up with cramps. It's in my hip now too. Just on the right. When I walk it is super super slow and painful and I have to carry my leg. Cause? No clue. All tests normal.

MRI is mild. Mild disc bulge, mild spinal stenosis, but over all, a "very healthy beautiful spine!" Went to neurosurgery consult today and they say what everyone else says...too mild to do anything. Sure, I can take neurotin (no thanks) or get an injection, but they have no clue why I can't walk. Recently saw an Osteopath in France who was certain it was my tailbone and hips and to give it time. I have tried so many things. I go to Mayo end of Sept. All of the many docs and chiros and PTS, etc, reassure me that of course I will walk again. I'd give anything for that. At this point. Anything.

This is hugely depressing and very hard. I have a ten year old boy who keeps asking when I'll get my legs back. My mind often forgets my body can't go and I keep tripping on my numb leg when I forget and try to walk normally. Every night I dream of freedom in my body again... running, skipping, walking fast . Work is hard. Can't drive. Relationship is stressed. And I see there is some great info here, lots of wisdom and the body wants to heal and it will.

Please continue to share and I will do the same.

Does anyone know the result? I had sponylolithesis (grade4) of the L4/L5 almost 20 years ago. Many of the described symptoms are similar. The treatment - spinal fusion. It worked, but now the pain is returning in a different area. 🤔

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