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New pain in hip #282606
02/10/19 10:09 PM
02/10/19 10:09 PM
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Jacruz Offline OP
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Hi,

I've had some new pain and wondering if this sounds like SpA or related to something else. My pain was in the lower back/sacrum area. Started having pain in my glutes. A few days later the pain was inside my right hip socket. This was just different than any pain I've had before in my life and quite painful. It was hard to walk. It resolved in a couple days. It seemed like my pain moved down but that may have been my own perception and the hip thing might be unrelated to the other stuff.
Has anyone experienced this type of hip pain with ankyspon and/or this pain that moves down phenomenon? Sorry if this is annoyingly detailed but I haven't seen a rheumy yet so I'm kind of obsessed with every new sensation/symptom. Patience please!

Re: New pain in hip [Re: Jacruz] #282607
02/11/19 03:07 PM
02/11/19 03:07 PM
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Miguelito Online
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I have AS. Unclear exactly (to me) why AS leads to FAI and joint replacement, but there is definitely a link.

I have had my hips replaced (HSR, which I recommend for males, at the least). In my case, not being able to place weight on a leg meant hip pain, not SI (mine are both completely fused). I also am not sure I ever really felt pain in the hip, per se. I learned that groin pain means hip pains. All those "groin strains" I had were simply arthritis in the hip. And arthritis in the hip very commonly manifests as sciatica-type pains down the outside of the leg/thigh, often down to the knee (perhaps further, but not in my case).

I have very classical AS, so am very comfortable putting my experience out there. More useful for a male, of course, as men and women have very different bodies.

Definitely consider the hip for a possible cause of your issues. It is very easy to spot arthritis (space narrowing) of the hip on an X-ray, much like spotting fusion in the SI joint. If you haven't already, or have not had done in last 1-2 years, have your hips x-rayed when you have the chance.

Mike


Last edited by Miguelito; 02/11/19 08:40 PM.

1981 - Hip/knee problems led to early, correct AS diagnosis (amazingly!).
1990's -Doctor mistakenly diagnosed me with Psoriatic Arthritis. Bad doctor!
2000's - Increasingly problematic "sciatica". Guffaw.
2011 - Diagnosed with end-stage right hip arthritis.
2012 - Right HSR.
2013 - Partially torn Achilles.
2014 - Left HSR.
2016 - Re-diagnosis of AS, Prescribed Humira. Achilles surgery followed by subsequent re-tear.
2018 (Now). Doing pretty good. Humira working, Achilles finally better.
Re: New pain in hip [Re: Jacruz] #282612
02/11/19 08:00 PM
02/11/19 08:00 PM
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RAHMBA Offline
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Prior to my AS Dx, in my early 20s, I had severe acute pain in my right hip socket that prevented me from walking for a short time. I had a surgery that was not effective. looking back, I think my pain was highly likely inflammation from AS. The hip socket still gives me minor pain every once in a while.

hope that helps,


AS, U C, Iritis, migraines. HLA-B27neg. Yoga (instructor) & spin. No meds at this time. Dx 1989. SAA member/donor since 1993. All my posts are personal opinion/feelings and do not represent the SAA. Help find a cure & support others by donating to the SAA.
Re: New pain in hip [Re: Jacruz] #282615
02/12/19 12:44 AM
02/12/19 12:44 AM
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vosadrian Offline
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Hi Guys,

I have not been diagnosed with AS, but I find this thread interesting because of my recent path.

About 4 years ago I went to a Rheumatologist with ankle, lower back and some sciatica symptoms. I was tested and found low Inflammatory markers and HLA-B27 negative, so I was clear. At the time I thought that was conclusive. The past 4 years I have been getting worse with joint pains all over my body and worsening back pain. I have treated it all as bio-mechanical issues... trying to treat about 5 things at once and ignoring another 5 that are lower priority. Recently I had a hip arthroscopy. I had FAI and labral tears in both hips and had the surgery for the more symptomatic side about 3 months ago. I thought that a bad hip could explain a lot of my issues as it is related to pelvic pain lower back pain and even some sciatica symptoms into lower extremity joints. Some 3 months later I don't feel any better. I hope the recovery continues to improve me (and I feel a bit better every week), but currently I feel worse than pre-surgery.

I ended up on this forum because I was searching for a systemic cause of joint pain. I now realise I could have AS without the HLA-B27. I think I probably have it, and I am seeing a Rheumatologist next week. If I do have it, I would be another to have the FAI/labral tear/Arthritis with AS combo.

In my case both my hips have FAI and associated labrum/cartilage damage. I am a cyclist who spends a lot of time with my knees pumping close to my chest. My first hip surgery showed my labrum was badly shredded. Curiously, I always had good ROM in my hips and never got acute pains from excessive hip flexion. I just have had constant groin pain and pelvic pain the last few years.

I suspect there was some hip damage done, and perhaps the surgery has been helpful in addressing that, but I think the general hip pain may be AS related.

Miguelito, I am interested in your HSR. It is likely (according to my hip surgeon) I will need a hip replacement within 10 years. HSR seems good, but I know of someone who had to have it revised due to the metal toxicity. I see ceramic versions are being trialed now. I hope my hips can last out until they are in common use as that would get rid of the biggest risk of that type of hip replacement. I want to maintain activity for another 20+ years, so hoping to eventually go that way.

Re: New pain in hip [Re: vosadrian] #282617
02/12/19 02:04 AM
02/12/19 02:04 AM
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Boston, MA
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Miguelito Online
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vosadrian,

You will know when you are ready for hip replacement. Most people, in hindsight, realize they should have had the surgery much sooner than they did. They never wait as long for the other hip. I don't push people to have surgery, though, for the sole reason that the first week or so after surgery sucks. I mean, just awful sucks. My aunt and late mother felt better the day after THR surgery than the day before, but a younger male with some muscle experiences lots of trauma when they roll the femur outside the body during an HSR.

That being said, a younger male (and probably any male, period) would have to be an idiot to get THR instead of HSR unless a good HSR surgeon told them that, for whatever reason, they could not have HSR. I don't say that lightly and I mean it. There is a lot of misinformation out there about HSR. I encourage all to do their own homework.

I feel bad for your friend, but who did their surgery? When last I checked (2014, when I had my second hip done) there were only six or eight guys in the world who you should go to for HSR, and that probably hasn't changed appreciably. You need to go to a volume surgeon who specializes in it. My surgeon, Dr. Thomas Gross in Columbia SC, is one of them, and comes with my unreserved recommendation. He, and others, believe that they have solved the metallosis problem by proper device angle (I forget exactly), but check out grossortho.com and the surface hippy website. Both are awesome resources.

I never, ever think about my hips. I have no restrictions. Achilles, different story.

You are likely under 40, else they would not have done the arthroscope/microfracture/cleaning up labrum triple surgery (or whatever it is exactly). From my research on that surgery combo, results are always mixed, at best, and it is never a panacea. I had one of Boston's top docs ready to do that surgery on me (my second, "better" hip) even though I was 43 because I was in such great shape, but he had me wait six months and when I went back to him that was off the table. It was like he completely forgot our earlier conversation. Still love that doctor, though.

Yes, hip arthritis is also believed to manifest as lower back pain, but I think most of that is really the SI joints. In my experience, the hallmark pains of hip arthritis are groin pain and sciatic pain down the outside of the leg. Neither of which I have had post HSR, but I still have more or less constant low back pain/stiffness.

I am HLA B27 (or whatever) positive, so am not knowledgeable about those who aren't, but as you say, that is not dispositive either way. I also was, to my knowledge, seronegative for inflammation until somewhat recently, despite having been diagnosed with AS 37 years ago and having, in my opinion, just classic (and probably bad) AS. But, and I am speculating here, I think males with AS may be seronegative more often than females.

Please feel free to disagree with any of my conjectures. I am not a doctor. I generally try to just stick with my personal experiences.


Good luck buddy!

Mike

Last edited by Miguelito; 02/12/19 02:06 AM.

1981 - Hip/knee problems led to early, correct AS diagnosis (amazingly!).
1990's -Doctor mistakenly diagnosed me with Psoriatic Arthritis. Bad doctor!
2000's - Increasingly problematic "sciatica". Guffaw.
2011 - Diagnosed with end-stage right hip arthritis.
2012 - Right HSR.
2013 - Partially torn Achilles.
2014 - Left HSR.
2016 - Re-diagnosis of AS, Prescribed Humira. Achilles surgery followed by subsequent re-tear.
2018 (Now). Doing pretty good. Humira working, Achilles finally better.
Re: New pain in hip [Re: Jacruz] #282619
02/12/19 02:38 AM
02/12/19 02:38 AM
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vosadrian Offline
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The person I know of was a professional Windsurfer locally in Australia. He was great for around 8 years afterwards and then had a sudden onset of hip pain and ended up having to do a THR. I think he is fine again now. I am sure there are installation factors that effect the possibility of toxicity. I don't think HSR is done much in Australia at the moment. I did read an article on a clinical trial on the new ceramic type. I guess it may alleviate some of the issues in cases where installation could cause toxicity.

Thanks for your well wishes. I am actually mid 40s. Prior to my surgery my imaging showed no significant arthritis and an uncomplicated labral tear it was thought I was textbook. Although 45, I am much more active than most my age, so that may have factored into it. Anyway, when he got in there, it was much worse than the imaging suggested and there is grade 3 arthritis and the labrum was shredded. He was happy with the repair though. I have really good joint movement and ROM post surgery... but I just have the nagging groin pain mostly when seated for a while at a desk. My other non surgical side feel similar. My current plan is to get reassessed for SpA, and if positive, try to treat that and see what comes of the hips. Surgeon says the other side needs the same... should delay hip replacement by around 10 years... not sure if that is worth the hassle!!

My Achilles has also been an issue. Initially it was acute after a hard couple weeks of cycling. Then it never went away despite rest/PT/injections and the other side also started. That was when I saw the Rheumatologist first up. He could not find anything wrong to explain the pain, but with no imaging evidence and HAL-B27 neg and low inflammatory markers, he sent me on my way to treat it as bio-mechanical. I now have a rather extensive list of symptoms leaning towards SpA. Will see what the Rheumatologist says now!

Re: New pain in hip [Re: Jacruz] #282621
02/12/19 03:30 AM
02/12/19 03:30 AM
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Miguelito Online
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What injection in Achilles? I hope not cortisone. I am a huge believed in cortisone for certain joints, but does nothing for hips, and is negatively indicated for Achilles. Highly negatively.


1981 - Hip/knee problems led to early, correct AS diagnosis (amazingly!).
1990's -Doctor mistakenly diagnosed me with Psoriatic Arthritis. Bad doctor!
2000's - Increasingly problematic "sciatica". Guffaw.
2011 - Diagnosed with end-stage right hip arthritis.
2012 - Right HSR.
2013 - Partially torn Achilles.
2014 - Left HSR.
2016 - Re-diagnosis of AS, Prescribed Humira. Achilles surgery followed by subsequent re-tear.
2018 (Now). Doing pretty good. Humira working, Achilles finally better.
Re: New pain in hip [Re: Jacruz] #282622
02/12/19 03:31 AM
02/12/19 03:31 AM
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Posts: 63
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Miguelito Online
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Miguelito  Online
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Labrum is always worse when they get in there.


1981 - Hip/knee problems led to early, correct AS diagnosis (amazingly!).
1990's -Doctor mistakenly diagnosed me with Psoriatic Arthritis. Bad doctor!
2000's - Increasingly problematic "sciatica". Guffaw.
2011 - Diagnosed with end-stage right hip arthritis.
2012 - Right HSR.
2013 - Partially torn Achilles.
2014 - Left HSR.
2016 - Re-diagnosis of AS, Prescribed Humira. Achilles surgery followed by subsequent re-tear.
2018 (Now). Doing pretty good. Humira working, Achilles finally better.
Re: New pain in hip [Re: Jacruz] #282623
02/12/19 03:47 AM
02/12/19 03:47 AM
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vosadrian Offline
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I have had cortisone into the tendon sheath, but not the tendon itself. It was followed by very low activity for several weeks and then heel drop program for strengthening. It never made any difference... but I had no issues due to it (and that was around 3 years ago). The heel drop protocol is often recommended as the best treatment for achilles tendonitis, but mine just gets worse. I have done it for months with no benefit unfortunately.

Re: New pain in hip [Re: Jacruz] #282646
02/15/19 11:07 PM
02/15/19 11:07 PM
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GoGirl Offline
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Jacruz,

I've experienced all of what you describe, along with other hip, upper thigh and low back pains. I tend to attribute most of it to AS since my dx, and that may be the cause of yours.

But that pain that starts in one hip or the low back, moves into a spasm in one glute and then down that leg until you can barely walk? That plagued me for decades before my other AS symptoms started, and I'm not sure it's AS-related. I think mine may have more to do with spinal alignment, maybe only exacerbated by my AS. If I ignore it, it turns into a nightmare of worsening pain and disability for a week or more, so I usually respond with frequent sets of that PT move they teach you for a disc problem - either bending backward while standing or lying on your stomach and pushing up with your arms - along with NSAIDs, moving very carefully for a few days, watching my posture, rest if I can get it, hot showers, sometimes ice, sometimes a TENS unit.

Do ask your rheumy. And don't apologize for your question. I was diagnosed 8 years ago and I still wonder whether each new pain is AS or something else, how long it will last, how bad it will get, and how I should treat it.

Good luck.


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