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Post-TKR Piriformis Syndrome - Cortisone Shot?

Joint Replacements | Last Active: Jul 7, 2024 | Replies (15)

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@emo

@christine5 is right…groin pain is often related to a hip joint issue, and the pain is referred.

But there could be many potential causes of the pain you’re describing. For example, I have front of hip pain that occurs often with low back/sacral pain. It often refers down my groin, and I have pain behind my right leg and thigh like you described—it’s more like muscle pain.

The diagnoses (yep, plural) we settled on are: hip osteoarthritis (causes by hip dysplasia)—that’s causing the front of hip and groin pain, coccydynia (tailbone) and pelvic floor tension myalgia—my pelvic floor muscles are overly tight, which is causing the pain behind mg right leg.

All the above can also cause bursitis.

Specifically, I have the most tightness in the obturator internus muscles that run from the front of the pelvis to the back, behind the leg—that’s what’s causing the pain.

Totally confusing, right? The pain didn’t get better because I had the wrong diagnosis at the beginning. Injecting one muscle with cortisone if a different root cause is prompting the pain sometimes won’t help. Or the injection can refer pain to another part of your body.

You might want to give it a few more days to see if it calms down?

I’m not sure what type of provider you’re seeing, but I got the most accurate answers from a physiatrist (physician in physical medicine and rehabilitation specialty) as opposed to an orthopedist because they look more at the big picture, and a pelvic PT—they have much more specialized training in pelvic floor, hip, and low back pain.

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Replies to "@christine5 is right…groin pain is often related to a hip joint issue, and the pain is..."

Thank you....I was told one time I had
sacroillitis and have issues with Nsaids. I think I did this lifting a heavy bag into the trash (50-70lbs?). Right now the pain I mostly in my right butt cheek but it can radiate behind the right thigh. It helps sitting on a roller and rolling it. 4th day into methylprednisone and isn't helping. The shot in my bursa close to the piriformis did help like 60% and it isn't shooting pain anymore but it does hurt at times when I move it just right. I'm seeing a sports medicine guy and I love how he uses a portable ultrasound machine to look at things. He may give me another shot this next week when I go back as it's not resolved completely.