Reply to WWYD, Hip, Glute, Low Back, & Groin Edition

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[quote=Anonymous]My apologies this is so long.

I'm 52 and was very active (walked 6 miles a day, took weight training & pilates classes, and lifted free weights) until March, 2023 when I had a recurrence of an issue from 2 years before that was resolved with PT. Exercise has been my go-to to reduce anxiety, so I'm having a terrible time. I've been in therapy since June and my Zoloft dosage has been increased.

My symptoms started as R hip tightness; hip pain when walking, running, going up the steps; as well as glute, SI, low back, and groin pain. The pain was transient and not consistent. I had been doing my PT exercises a couple of times a week since 2021, but I couldn't resolve the symptoms, so I self-referred to PT, which I did from April through early June. It seemed PT was working, but then the pain and tightness returned.

I saw a sports medicine dr. who ordered an MRI, which showed a small labral tear and tendinopathy in my glute. Dr. did a diagnostic injection, which didn't help the pain. She said that meant the labral tear is not likely to be the pain source and sent me back to PT, but at a different place with an emphasis on eccentric exercises. I started that in late June and again, it seemed like PT was working and the hip issue seemed resolved, but then the glute and hip started hurting again, although not as bad as it was in the very beginning. PT was encouraging me to do modified weight training after a few weeks, which I did. Celebrex didn't help much, but heat and compression have been helpful.

Dr. and PT then thought it was my low back. I saw a spine specialist who did an MRI, which showed some mild stenosis at L4-L5 and some other minor issues not inconsistent with my age. PT started work on my low back and I also started seeing a chiropractor who hasn't helped much, if at all.

Pain continued. Saw 2 other recommended orthos. One said he thinks it's a tight pelvic floor and prescribed gabapentin to take before bed, which has helped and pelvic floor PT. I started pelvic floor PT yesterday. I've stopped doing stretches that may further tighten the pelvic floor, as well as kegels and have started stretches that are supposed to loosen the pelvic floor. I'm also doing about 10 minutes of lower body pilates a day. This has all also seemed to help.

Other ortho said he didn't see where he could do any kind of cortisone injection (I didn't ask for one), but ordered a nuclear medicine bone scan to see where there may be inflammation to treat. I haven't had that test yet.

Discussed back MRI results with spine specialist who recommended a cortisone injection for the stenosis.

All medical professionals agree nothing major has shown up on the MRIs.

I'm going on 8 months of this issue and can't do more than walk 1 very slow mile a day on flat ground. I'm no longer lifting any kind of weight.

I intend to continue the pelvic floor PT, but will it hurt me to get the cortisone shot? Does anyone know if the bone scan might be useful? Any words of advice? I'm losing my mind.

Thank you!!!
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