Trochanteric bursitis and front groin pain

[811Yoga]

I was diagnosed May 2023 and have previously posted that I saw a rheumy privately and last time July 2024 he diagnosed pain as age related. I am 72. I started on 15mg pred and was reducing along with rheumy plan. Somewhere along the line I developed hip bursitis but latterly have been having difficulty with overall hip pain and on GP recommendation went from 1 to 2mg pred and yesterday went to 3mg pred as overall pain was very uncomfortable. Due to see GP next week and wonder if anyone has any useful comment. I am going to attempt to ask her to refer me to Dr Khushid at Poole. Many thanks.

[PMRpro Ambassador]

Their fixation with pain being age-related is really not helpful. Just being older should not cause pain, especially if it is pain that appears relatively suddenly. I was told my PMR pain was age-related - I was 51 at the time and at the gym or a gentle class of some sort almost every day!

Given the timescale, if you had a diagnosis of PMR in May 2023 and pred worked well then - you have reduced past the level you need to manage the PMR inflammation. PMR is NOT a 2-year journey, and half of patients need more than 18 months to get below 5mg. If that is the case - just adding 1mg will not achieve a lot. You need at least the flare protocol we talk about - adding 5mg to where you flared for up to a couple of weeks. But that may not be 1mg - when did the pain start to appear.

[811Yoga in reply to PMRpro]

Many thanks for your reply. It appeared March April time when I was on 4 mg. This week's bloods show esr 31 and cpr 37 which is up on 2 months ago.

[PMRpro Ambassador]

Having seen your other post - those blood marker results of ESR 31 and CRP 38 suggest to me that you are showing signs of inflammation - the ESR is definitely high, what is the normal range quoted by your lab? It is usually in brackets near the result.

[811Yoga in reply to PMRpro]

Esr range 1 to 35 and cpr 0 to 5. Could inflammation be due to bursitis? Just a thought.

[PMRpro Ambassador in reply to 811Yoga]

It could - but bursitis can be a part of PMR and whatever it is that is causing it - it is building up if the markers are rising.

My markers are totally unhelpful but I have had similar symptoms to you. Usually the trochanteric bursitis responds well to extracorporeal shockwave treatment but this time it has returned sooner than usual and I am also getting groin discomfort that worsens with walking. A couple of nights ago I was a bit fed up and decided to take 10mg instead of my usual 7mg - and the difference next morning had to be felt to be believed! My next rheumy appt is mid-November - I shall experiment a bit before then and discuss it with him. I had been doing pretty well on 2 weekly Actemra and 7mg but have just been in the UK with lots of driving - maybe its a flare. I shall treat it as such.

[811Yoga in reply to PMRpro]

Thank you for sharing your experience too. The stumbling block has been the rheumy who has continued saying it has gone. I am going to try the flare protocol.

[PMRpro Ambassador in reply to 811Yoga]

There is no way he can tell - and if you have one of those sort of rheumies, it is time to find a different one. DIscuss it with your GP.

[DorsetLady PMRGCAuk volunteer]

If you’ve got down 1mg in 16 months, then most on here would probably say too fast taper. Although pains may well be bursitis, I’d be inclined to think your PMR is flaring as well.. and to be honest you probably need to treat as such [your blood markers indicate something is awry] to

See this re flare protocol -

healthunlocked.com/pmrgcauk...

[811Yoga]

Thank you for that and I have looked at the flare protocol which makes good sense. I have increased the dose and will see my GP next week hopefully.

[DorsetLady PMRGCAuk volunteer in reply to 811Yoga]

Good .. as for rheumy is talking about PMR, it most certainly hasn't gone within 16 months...I do wonder where they get their knowledge from? Definitely not from the charity nor their own society, more like off the back of a cereal packet. 😲

[Nightingales]

I am sorry. I know how painful bursitis and hip pain can be. A word of caution. I had a rheumatologist who would pat me on my head and said it’s just a touch of osteoarthritis dear. It turned out to be Avascular necrosis. If it is so sinful you have difficulty walking I would push for an MRI. Very best wishes.

[811Yoga in reply to Nightingales]

Thank you for your comments. I do feel an mri would be more than useful.

[PMRpro Ambassador in reply to Nightingales]

Did he literally do that? I;d have reported him for inappropriate actions and being patronising ... Not to mention WRONG!!!!!!

[Nightingales in reply to PMRpro]

Yes, he did. It was last year and because there was so much going on with the surgery and a very poorly daughter I neglected to follow up. I should have done.

[Pixix]

I have steroid injections for my bursitis, & they help…not long term, but always give me a period where the pain is easier. My GP does it all. I didn’t really find that consultants are too interested in bursitis, osteoarthritis, hypermobility or sciatica. I have them all, & when I was diagnosed with bursitis & osteoarthritis he just gave me too booklets to read!!