Weakened hip flexor muscles

[Marcy47]

After moving to Scotland last year, I asked for referral to a Rheumatologist as I had been having pain in left hip on standing and walking.Was told they didn't deal with PMR left that to Drs. After an X ray of pelvis and hips I was told nothing wrong with hip joint, but my pelvis was tilted and lower spine bent. I was sent to Physio who said it was weak leg and hip muscles caused by the Prednisolone. She saw me a few times and gave me exercises to do, some of which I find very difficult at I can't put my full weight on my left leg. I am going to try acupuncture next week to see if that helps, the pain on rising is agony. I am the main carer for my hubby, who has Parkinsons and urinary incontinence, and we also have an elderly cat who likes to wake me too early with his howling. I am taking Paracetamol but am loathe to try anything stronger. Has anyone else got this problem, have you found anything that helps?

[SnazzyD]

I had all sorts of issues due to weak pelvic and low abdo muscles from time on Pred and the lifestyle that my disease caused. Is your Physio perhaps starting at a low point that isn’t low enough or appropriate for someone who has had your issues? I went to a pelvic specialist physio and my exercises were not weight bearing until I got stronger, but on the floor or bed. I also went to an osteopath to sort out the wonkiness so that my exercises didn’t hurt so much because of parts being hammered when they shouldn’t be. If weak muscles is your problem, I don’t think acupuncture will bypass the need to strengthen them.

[Marcy47 in reply to SnazzyD]

Hi SnazzyD,Thank you for your reply. I was hoping acupuncture would help to relieve the pain, she is an NHS doctor who specialises in musculoskeletal issues so we shall see what she advises.

I also have the number of a chiropractor locally, I had a problem with my sacroiliac joint before PMR struck and wondered if that was the problem . Watch this space.

[SnazzyD in reply to Marcy47]

In my experience it’s usually a complicated mix of gait, minor injuries along the way like small falls or trips, posture, surgery, weakening from lack of use, particularly the small muscles that give stability. One can get rid of pain for a bit but it’ll come back due to the underlying problem. My sacroiliac joint has been a weak point for years and I kept getting it ‘fixed’. I dread to think how much it has cost me over the decades. This was ok for a time but then I became very weak due to GCA and getting older, I could no longer hold it (badly) together. A podiatrist saw my gait was not good, evidenced by subtle changes in my right foot, a sign that genetic chickens were coming home to roost. They also spotted my weak pelvic muscles. So my approach is get it ‘fixed’ and then try to help maintain the area. For me, doing the same movements every day in the same direction put me back to square one. I have to consciously, daily put my body through stretches and full ranges of movement in all directions. I’ve been back in the ‘garage’ recently after Covid caused me to stop this for a month and I’m getting payback in my right SI area.

[PMRpro Ambassador]

Has anyone looked for trochanteric bursitis? It could be underlying your pain and paracetamol will not achieve much - you need some antiinflammatory effect for that such as ibuprofen or Naproxen but neither are good longterm.

I have a combination of sacroiliac joint inflammation and trochanteric bursitis. Pred doesn't help much except at a much higher dose, paracetamol does zilch! Ibiprofen does - the pain clinic doctor here had a fit at even the idea of a single dose a day long term. So my terrific rheumy took it in hand and a week or so ago did an ultrasound guided steroid injection into the sacroiliac joint - a miracle! I have less pain first thing without pain relief than I could ever achieve WITH pain relief before. The hip bursitis is still there but better and I have an appointment for extracorporeal shock wave therapy for that in a few weeks. I could barely manage into the village before - 1500 steps maybe, Yesterday and today I have accumulated well over 9000 steps and am not in pain.

[KASHMIRI1]

I have exactly the problem you are describing and on the same side. I have seen physios who gave me exercises that eventually helped. Then things got problematic at home and it came roaring back. I had an MRI on 4th December and hopefully get the results next Tuesday. I am hoping something shows up and I can get some help. The pain is extreme. I have managed to get cocodomol 30/500 which helps without it I would really struggle. I see an acupuncturist which I think helps but doesnt get rid of it completely

[KASHMIRI1]

Just another quick thought the doctors think its a lower back problem and transferred pain, and the physios think its possibly bursittus.

[Marcy47 in reply to KASHMIRI1]

Sorry to hear you have the same pain as me. If I get any help with it in the next few weeks I will let you know. Good luck 🤞😊

[KASHMIRI1 in reply to Marcy47]

Good luck to you as well.

[pegpowell]

Years ago I found I could only walk a short distance before pain in the left hip which eventually was relieved by steroid shots as described by PMRpro. A year ago that hip was replaced because of arthritis and the pain only appears at night when sleeping on that side.

[GrandmaPirate]

You do not mention the dosage of prednisolone, which I presume was prescribed for PMR. PMR itself can cause hip problems and the hip problems should disappear when your prednisolone dosage is high enough. My hip, knee and shoulder pain caused by PMR, disappeared very quickly when I started on 20 mg pred/day. In 2 years I was able to tapering down to 1 mg/day for more than a year now. I am very active walking the dog, pilates, indoor rowing at 76 years old. I hope you can find a rheumatologist, well aware of PMR and it's treatment to figure out if you suffer from PMR and whether prednisolone is the right medication for you.

[Marcy47 in reply to GrandmaPirate]

I was diagnosed with PMR in 2015 and put on 20mg Prednisolone which took away the aching muscles in my hips and thighs. I have been tapering down slowly ever since, suffering a few flares and having to increase again. I cannot seem to get below 7.5mg without getting pain again. But this pain I think is something different, it us only on the left side, and affects the groin, the back , and the front of the leg, feels like a trapped nerve somewhere, and is extremely painful.I am seeing the Dr again on Wed. Going to get appt with a Chiropractor ASAP. Can't cope with this much longer.

[PMRpro Ambassador in reply to Marcy47]

It could be this

mayoclinic.org/diseases-con...

but greater trochanteric pain syndrome, formerly known as trochanteric bursitis, is also a possibility though it tends to be more to the side rather than the front of the thigh.

[Marcy47 in reply to PMRpro]

Meralgia Paresthetica sounds exactly what I have. I did fall on my left knee in 2022, maybe that was the start of it, my sister noticed I was walking with a limp last year.I will mention it to the Dr on Wednesday, many thanks PMRpro. 😊

[GrandmaPirate]

I had also groin pain at the left , that prevented me from walking. I have monthly osteopathy and she worked with her hands very deep at that side. Over time I got rid of that pain and walking the dog became a pleasure again.