Severe pain in right hip in the morning

[Elmadon]

I’ve had pmr since March 2022. Started on 15 mg and got down to 8mg. But then had a flare up . Up and down now as can’t get below 7mg. At present on 10mg . I have terrible pain every morning In right hip and wonder can pmr be only on one side? GP says no and is coming from my back. I have spinal spondulosis which he says is causing the pain. But pain goes away by late morning so just wondering if anyone else has this with pmr. Would appreciate any suggestions. Thank you.

[DorsetLady PMRGCAuk volunteer]

It’s unusual to be one side if it’s PMR as such, but never say never, at it might be the start of a flare.. however it could be a variety of things…. Bursitis, tendonitis, or how you are sleeping.

Have you had X-ray? Do ordinary painkillers or specific exercises for hip help?

As it goes away late morning - presumably a couple of hours after taking your Pred that may indicate it is actually PMR.

Think you need to do a bit of a trial and work it out for yourself…. so maybe try a following advice in link re a flare and see if that helps…. If it doesn’t, you can return to current dose and then maybe a week or painkillers and gauge if any improvement. Obviously don’t do both at same time. Then you can tell GP if either have helped.

healthunlocked.com/pmrgcauk...

[Elmadon in reply to DorsetLady]

Had xray . Spinal spondulosis dignosed. GP says that is causing pain. Painkillers dont help even tramadol. Can’t tolerate any morphine based. Eg codeine et al. So painful am cannot do exercises. Only thing that helps is heat pad till pain eases and I can get moving.

[DorsetLady PMRGCAuk volunteer in reply to Elmadon]

Maybe try the ‘treating a flare’ advice in the link then and see if that makes any difference…

Has a cortisone injection into hip been suggested/tried?

nhs.uk/medicines/hydrocorti....

[Elmadon in reply to DorsetLady]

No. But not keen on that.

[PMRpro Ambassador in reply to Elmadon]

If it could be bursitis, the injection doesn't have to be into the joint - and often oral pred will take the edge off. I think your GP is being a bit blinkered.

[Elmadon in reply to PMRpro]

he has ruled out bursitis. I also saw a nirse practitioner previously and he also ruled out bursitis. Both v

Convinced it is coming from my back. Ie spondulosis

[PMRpro Ambassador in reply to Elmadon]

I have that sort of problem - it DOESN'T cause that sort of pain!!! But who knows!!!!

[Elmadon in reply to PMRpro]

This is why I’m on here to try and find a solution. Ive had this pain for months now. It did suddenly disappear for about 3 weeks then came back worse than ever. What specialist do i need to see if i was to go privately?

[DorsetLady PMRGCAuk volunteer in reply to Elmadon]

Why not? If it gives relief…,and you won’t know unless you try.,

[AliDeJ in reply to Elmadon]

I have spondylolisthesis, spondylosis and spinal stenosis. I had cortisol injections in the lumbar spine and caudal injections last November to help with my back pain and walking. I was sedated, actually unconscious, and the procedure was guided by ultrasound. Wonderful relief! I felt 20 years younger. I hope you can find a solution. One discovery I have made is not to sleep on my bad side. Wishing you well.

[marionofnorwich]

I have had life long one sided back pain which is mainly soft tissue but sometimes that pulls my pelvis out of alignment. I go to an osteopath which generally sorts me out. Ultra sound also helps

[GOandBuddy]

Dear Elmadon.

I am sorry that you are having trouble. I have pmr & gca, and like you reducing steroids, now down to 8mg. Some weeks ago I hurt my back, I saw a local Osteopath. Attended about 8 weeks, still suffering, I saw muscular skeletal person at GP surgery, as it is never possible to get a GP appmt. I have tired Reiki, and I am trying Yin Yoga and finding it really does help. I am also trying to sleep on my back with a pillow under my Knees. This helps. If I sleep on my side, come morning I can hardly get out of bed. When I do, I have to start the day doing the humping and hollowing spine exercises and hobbling around for hours until I get going. I wish you well and hope you are pain free soon. It does seem that you are really going through it.

I see that you have some great advice in your replies to date.

[Missus835]

I have PMR and on Pred since Jan. 2022. However, my back muscles and consequently, stomach and diaphragm muscles have been in spasm for going on 5 months. This due to vertebral and also small spinal fractures. The only meds that relieve this pain are extra strength paracetamol and extra strength ibuprofen together in a cocktail. I also have tried paracetamol with codeine, which takes the edge off but also constipates. Married to my heating pad. The Pred takes care of any PMR-related pain. I have been mostly in bed during this time. Yesterday began my physio therapy. Small slow exercises at first. Today I am in much pain, but I have to get moving. Waiting for morning meds to kick in. I do want to try dry needling of the muscle trigger points, but this is the hospital clinic and is government funded, so would have to go privately. Hope you find your solution. All the best...

[MiniSpec]

I've had similar pain when being too low on Pred. I found that the only solutions for me were to try to stretch my muscles by doing bursitis exercises, and also changing the way I sleep. I can no longer sleep on my side because of the hip pain, so instead I sleep in the recovery position.

It means that my weight isn't directly on the lower hip, but is supported by my lower abdomen and front of thigh. So now I take up more room in the bed because the upper leg is always bent forward, much to my wife's dismay!

[cranberryt]

You could try splitting your dose with half at bedtime to see if it gets you through the night.

[sidra1968]

Foe what it's worth, my pain is mostly on one side (hip and flank and neck)..seems to "attack" my weak spots from past surgeries, etc. Everyone is different, the docs seem to forget that sometimes.

[Creas]

The pain doesn't have to be symmetrical to be PMR. Mine began with left shoulder/upper arm pain (I play tennis with my right arm so there's a potential trigger for something asymmetric; perhaps the left arm is underdeveloped so got the PMR first) then some months later I got it in the right arm as well.

[PMRCanada]

During the 3 weeks you had no pain, were you less active. Did you have any pre-existing hip issues prior to PMR?

I know as I lower my pred dose, the familiar OA pain in my knees is returning. I experienced similar knee pain at the very start of my PMR journey and was diagnosed with OA and on waitlist for a replacement. Injections really helped providing 10 weeks of relief each time.

I do hope you get some relief soon and settle on a dose that works for you.

[Elmadon in reply to PMRCanada]

No pre-existing problems before getting PMR.

[Flinders61]

I would seek advice of physiotherapist, feel they may have something to offer & if it’s structural then remedial exercises will help.