PMR Pain in Hip or something else

[Vawils]

Long time PMR diagnosis of 8 yrs now down to 3 mg/day. For the last several months been dealing with pretty severe nighttime pain in the hips and buttock area and beginning to wonder that something else might be going on like bursitis etc. after reading other posts by Jayveevee and PMRPro. Most nights after an hour in bed or so, the hip/buttock sharp pain intensifies such that it is painful even to turn or change position in bed. Very painful, seems to be mostly on right side but generalized in buttock area. Usually take extra strength tylenol which seems to help a bit but just getting up and moving around is helpful as well but of course limits a good night's sleep. Any suggestions on how to proceed to figure this out or how to alleviate this pain more successfully? I have considered increasing my Prednisone again but haven't yet. Appreciate any suggestions or experiences of anyone else dealing with something similar. Thanks.

[Seacat30]

Similar areas but starting painful, after a few minutes in bed, and wearing off slowly during the night. After an MRI mine has been blamed on tendonitis which has been blamed on PMR. I have been set exercises for the gluteus minimus and medius which have made some improvement.

[DorsetLady PMRGCAuk volunteer]

Osteoarthritis maybe?

This link give a few other options re hip pain-

ortho.wustl.edu/content/Pat...

[Vawils in reply to DorsetLady]

thanks for response will check out link you provided..

[PMRpro Ambassador]

Look up the exercises and stretches for piriformis syndrome (buttock) and trochanteric bursitis (hip) because from what you describe that sounds most likely. Done regularly they DO help the pain.

It may start then because the antiinflammatory effect of the pred is wearing off before the next dose is due - it does help the inflammation involved but local steroid injections are often better. Icing and stretches are the place to start though.

This is possibly the hip part of PMR - your version at least - and possibly a bit more pred might help. But I would try the other stuff first and even investigate steroid injections because for me that gives a good and long lasting result.

[Vawils in reply to PMRpro]

thanks for suggestions..definitely will try some stretching and other exercises as a start..appreciate your feedback. will talk to rheumy at next visit as well although have brought up before to no avail.

[PMRpro Ambassador in reply to Vawils]

What are these rheumies like - mine was on it like a ton of bricks as soon as I mentioned it!!!

[Vawils in reply to PMRpro]

Wish I could go to your rhemy!

[PMRpro Ambassador in reply to Vawils]

He looks about 15! But a world name in the field but no side about him at all. But the one thing that really comes over here is how important quality of life is considered.

[piglette]

An orthopaedic surgeon told me that steroids can affect the cartilage in the hip.

[pegpowell in reply to piglette]

Piglet, see my comment below.

[piglette in reply to pegpowell]

I was talking about oral steroids over a period of time not injections as PMRPro says. As Artsister says steroids can also cause Avuncular Necrosis, not something you want to happen. The NHS now say that steroid injections should be limited anyway.

[PMRpro Ambassador in reply to piglette]

Isn't it tendons that don't like too many steroid jabs in the joint?

[piglette in reply to PMRpro]

I know the NHS said they wanted to limit steroid injections to just two a year, of course that may be due to money not tendons!

[PMRpro Ambassador in reply to piglette]

Somebody has to give them too - do you think you could get more than 2 appointments in a year????

[piglette in reply to PMRpro]

You will be lucky to get one based on the NHS at the moment! I suppose some areas may allow you more.

[oscarandchloe]

For 3 or 4 years, I suffered from progressive pain across my right buttock, tried all the exercises, massage, walking, yoga stretches and thought it was piriformis. It gave me sciatica at night which I soothed with a hot water bottle. Paid to go to a top class physio who scarcely touched me after seeing me walk and sent me for hip X-ray. I had severe osteo-arthritis in the hip, all cartilage gone. One surgeon refused to do the op as I was experiencing the pain 'in the wrong place' so I've had 6 months of complete mobility loss before second opinion . Just now I'm sitting with a rather grumbly new hip (op one week ago) but NO buttock pain.

[Vawils in reply to oscarandchloe]

Glad you finally got some relief and no pain after a long struggle. I did have my hip xrayed about 3 yrs ago and they noted osteoarthritis but not severe at that time but likely has progressed. My rheumatologist has mostly ignored it. Best wishes for full recovery with new hip.

[DorsetLady PMRGCAuk volunteer in reply to Vawils]

It most certainly has progressed over time, but when you are on a high enough dose of steroids the pain is masked and you don’t realise…until you get to a low enough dose when the arthritis pain breaks through again. Rheumy would probably say, not his problem, see orthopaedic consultant!

[pegpowell]

My ortho surgeon said the steroid shot is in the muscle, not the joint, therefore not affecting the cartilage. I have had several shots in the hip for several years and it has only helped so far.

[PMRpro Ambassador in reply to pegpowell]

Think piglette also means systemic pred - longterm pred is thought to influence joint cartilage renewal.

[Artsister]

I had hip pain and my rheumatologist completely ignored my complaints. Prednisone can cause Avascular Neucrosis —- shut down the blood supply to the hip. The only cure is hip replacement. ☹️

[Noosat]

I do not have buttock pain, but do have hip/lower back pain. I do stretching exercised and also abdominal exercises, pulling in stomach musles as I pull in butock muscles. I think strengthening the abdominal muscles helps relieve strein on my back