Iliopsoas Bursitis?

[suzy1959]

I had a steroid injection from the Rheumy in December fro Trochanteric bursitis and, eventually, I am now able to sleep on that side without strong painkillers. The problem is that I am still having a lot of groin pain on the same side and wondering if I have other bursitis in the hip area? If so how do I get it diagnosed and treated when I am not due back to the Rheumy until April?

I have tried Bowen with no success and am currently trying Acupuncture which may help but hasn't done so yet. The acupuncturist and osteopath both notice how many of my thigh and hip muscles are in spasm at the moment but very little seems to change that. The osteopath tried to massage the whole area which just resulted in more pain and no improvement. The biggest problem is that it is all affecting my mobility so much that I can hardly walk anywhere and can't even swim at the moment- getting up off a chair is bad enough!

[HeronNS]

I had never heard of it until my physiotherapist said she wanted to try it on me - she says all the muscles along either side of my entire spinal column are very tight. So together with my low level light therapy she has been giving me what she calls dry needling. It is a cousin to acupuncture, where a needle is inserted (but quickly removed, not left in place for any time) to cause the nerves to let go of the muscles and let them relax. Occasionally I feel a really deep sensation, like a finger being pressed right through my flesh. Usually I just feel varying degrees of being pricked by a needle. I bring this up because it might be a more effective method of releasing muscle spasm than acupuncture itself. There is quite a lot of info on the internet about it.

[PMRpro Ambassador in reply to HeronNS]

Yes - I've had dry needling but more often needling with either a muscle relaxant or cortisone - it hurts like h^££ (stings/burns at the time but it goes immediately) but boy does it work well! It is a standard therapy in German-speaking regions and can often be done by your GP. I had it done by a German GP years ago and by the pain clinic anaesthesiologist here. I've mentioned it on the forums before and I know you can access it in the USA but as suzy suggests I really don't know where you could get it done in the UK.

[MollyBloom]

I had really tight muscles from ongoing tendonitis after my hip replacement. I got a referral to physio who diagnosed it and spent many sessions doing deep pressure (torture!) to loosen the muscles off before giving me exercises to do which after a just a short while really helped. The pressure manipulations and exercises made me feel sick at first but it was really worth sticking with them as it sorted out the pain and meant I could walk more than a few hundred yards again. In the meantime have you tried raising the chair even if only with cushions to ease things. The seat should be high enough to make you hips just slightly higher than your knees, but not to leave your feet dangling. I have a really comfy height adjustable swivel chair which was a saviour. Maybe referral to occupational therapy at social care for high toilet seat etc?

Hope you get some relief soon.

[suzy1959 in reply to MollyBloom]

Thank you MollyBloom, I have started putting extra cushions on chairs and not yet ready for raised toilet seats! I would love to know which Physio might have this knowledge and skill- I have tried a few already and it seems to me that this is not a common condition that Physios know about especially in the UK. Dry Needling seems to be more known about in the USA and not so much here too. The Rheumy I saw in December did not seem to know what I was talking about when I mentioned Myofascial pain and was only interested in giving me a shot in one place, so the problem has not gone away of course!

[Celtic PMRGCAuk volunteer]

Suzy, can you ring the rheumy nurses helpline at the hospital, explaining your pain, following which they may seek the rheumy's advice or even suggest bringing your next appointment forward?

[suzy1959 in reply to Celtic]

I have not been given the number or offered this service, but I guess I could just assume I can ring?

[Celtic PMRGCAuk volunteer in reply to suzy1959]

Suzy, I'll send you a personal message with contact details.

[PMRpro Ambassador]

My GP here gave the second steroid shot that cleared out what was left - the trochanteric bursitis went easily, as you say the ileopsoas was far more resistant. I think it is quite common for 2 injections to be needed. Maybe it is because it is subjected to more pressure in the joint?

Do you have a Pain Clinic locally? The University Hospital of North Durham has a pain clinic website so maybe googling your local hospitals names and pain clinic might find one?

[autrainriver]

I have been messing around with pain in the left groin off an on for a couple of years. The chiropractor thought it was the SI joint. Adjustments helped as well as massage. The last time it occurred was with the onset of PMR so that muddled the situation. In my trip to Mayo the physical medicine and rehab specialist felt it is early osteoarthritis. So if you have some buttock discomfort/pain along with the groin pain on the same side as the groin pain you can add that to the list of possibilities. He was able to make that determination from x-rays of the hips. Other than over the counter medicines as well as hot and cold packs a steroid injection is the next option. Resting the area seems to be the best help and then slowly increase activity.

[suzy1959 in reply to autrainriver]

Thank you autrainriver. I have had an x-ray already to exclude OA as a possibility. Thankfully that is not my problem.