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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Hip Pain

Symptoms: 1) Pain Left side, L4,5 facet area - chronic @ pain level 5 2) Pain, left side, low buttock wrapping into thigh/hip joint - severe & generally chronic @ level 8 with occasional variation - increases with walking 3) Pain - left calf, central calf outside only, extreme pain and commensurate with buttock pain - History: 56 yr. old male with 30 yr. history of degenerative back issues generally resolved by Chiropractic. Pain described above started in Jan. 2012 - Tests & Procedures since Jan. 2012: MRI lumbar, many issues, but inconclusive. 3 wks. PT with no resolve. Med-branch block (2) in April, L4/5. Results - minimal relief for less than 2 hrs. Trans ESI #1, May 1, L4/5, followed by 5 wks. PT. Results = 70% pain dimminishment - success duration = 5 wks. followed by full return of symptoms. Myelo/CT 7/12 with results inconclusive. - Current Status: Neuro #1 consulted in March referred me to pain mgmt. for diagnostics. I consult with a new spinal neuro later this month - Pain Mgmt. Dr. referred me to his in-house associate today for 2nd opinion. That Dr. suspects the problem is the hip, but agrees back is a mess---just not the source of the severe butt/calf pain. Ordering a hip MRI. Mentioned a condition with 10 syllables that I didn t catch, but started with glute xxxxxx. MRI should confirm. Any thoughts what condition he suspects?
Thu, 14 Feb 2019
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Physical Therapist or Physiotherapist 's  Response
Hi,

Firstly, Sorry to hear about your condition. Coming to the point. As mentioned you have intervertebral disc issues and this is leading to Radiating pain. I consider this condition as Lumbar Radiculopathy.

In this condition, over a period of time, there leads to a lot of weakness in the lower limbs and that leads to other secondary symptoms. What I feel is the Physician might be looking for any Osteoarthritis of the hip but I think its better to not get into OA Hip.

Let's come to a solution which I have been trying in cases with multiple disc injury and radiating pains. I prefer you start the exercises for stabilizing the core along with strengthening the hip muscles more. You may find videos online and can perform slowly and gradually increase the repetitions.

Consider, that pain might be present while performing exercise, but if a proper prescription is followed for 3-5 months things can be better and controlled. Over a period of long time the exercise prescription needs to be re-assessed and Re-plan for best of your suitability.

Important that nerve blocks, pain killers, chiropractic, etc., are short lived in such cases with chronic history of the disc degenerate disease.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Jay Indravadan Patel,
Physical Therapist or Physiotherapist
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Suggest Treatment For Hip Pain

Hi, Firstly, Sorry to hear about your condition. Coming to the point. As mentioned you have intervertebral disc issues and this is leading to Radiating pain. I consider this condition as Lumbar Radiculopathy. In this condition, over a period of time, there leads to a lot of weakness in the lower limbs and that leads to other secondary symptoms. What I feel is the Physician might be looking for any Osteoarthritis of the hip but I think its better to not get into OA Hip. Let s come to a solution which I have been trying in cases with multiple disc injury and radiating pains. I prefer you start the exercises for stabilizing the core along with strengthening the hip muscles more. You may find videos online and can perform slowly and gradually increase the repetitions. Consider, that pain might be present while performing exercise, but if a proper prescription is followed for 3-5 months things can be better and controlled. Over a period of long time the exercise prescription needs to be re-assessed and Re-plan for best of your suitability. Important that nerve blocks, pain killers, chiropractic, etc., are short lived in such cases with chronic history of the disc degenerate disease. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist