is the pain from hip or back?

Posted by braves11 @braves11, Apr 19, 2017

Mom is 92. One kidney. 5 ft tall..113 lbs. uses walker. She has had this pain for 5 weeks. She has pain in low lumbar, into hip, down side of leg only to knee , and lifting her leg causes hip and groin pain. Coughing causes groin pain almost down to vaginal area. Not much pain at all when walking or standing. When she is in the act of sitting down, or can't find a comfortable position to stay seated, it's severe, but once she "gets over that spot", it's mild. This is not a result of falling. The act of standing up from being seated is painful. MRI of hip is normal.... MRI of lumbar shows lots of degeneration , loss of disc space, etc but nothing jumps out as a cause like herniation . CT of lumbar is ok. Had epidural of L 4-5 ... no help. Bursa injection.. no help. Now they want to do a bone scan AND bone density test.
1. Does this sound like hip or back. We have differing opinions. One ortho says back ... another says hip... therefore bone scan. But mom is concerned about taking it due to one kidney and creatinine range of 1.3 up to 1.7. ( the contrast)
2. One says rest it... the other says PT.
3. Should we push for another epidural at L 3-4???
4. They want her to take gabapentin but drowsiness is issue , esp with walker etc. Takes Ultracet.
We are at a road block not knowing what to do

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It is my understanding that sometimes an epidural steroid injection can take a while to be effective. I have spine degeneration plus a herniated disc with nerve impingement. The first epidural injection I had did not seem to do anything. I had two more and they did help in the long run.

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Oh thanks! Can I ask you--- how long did you wait in between epidurals??were you having any of the same symptoms???

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I have similar pain startling in my lower back down to my butt then down my leg to my knee. The diagnosis, for that particular pain is osteoarthritis in my sacroiliac joint. My pain does worsen when walking, standing too long, sitting too long, etc. the only bit of relief I've had came from a procedure called Radiofrequency Abalation, which was basically burning certain nerve endings, which grow back eventually. This procedure was effective for several months at a time, but it only worked on the pain that traveled down my leg. Not the other areas of pain. But, it did make a difference in my activity level. I know when my Dr. touches the last "knob" on my spine it is painful to the touch. But a MRI was done to diagnose the initial problem.

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At the age of 92, your mom probably has osteoporosis, which is why they want to do a bone scan. I think it would be a waste of money. You can bet she'll have osteoporosis. I was taking Gabapentin until recently and was so goofy on it I told my doctor I was getting off it. It didn't help my pain.

I too have pain on the right side of my back, hip, sciatic nerve, to my knee and down to my big toe. In December, 2016, I had outpatient surgery on my L5-S1 and it took all the pain in the left side away. I have a herniated and out of alignment L4 disc which is affecting my right side. The MRI shows that i will probably need surgery at some point but not yet. Today my pain is at a 7-8 on the 10 point scale. I take Tramadol 50mg 4x a day. I take Tylenol for breakthrough pain.

If I were you, I would stay away from Gabapentin as its a weird drug that has lots of side effects. She might do better on oxycontin as its for mid-level pain. If she was my mother, at her age, I would want her to be as free from pain as possible without stressing her with a bunch of tests. I hope this is helpful.

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@braves11, I just reread your post. I think the purpose of a bone scan is to determine the density of bones. There should not be 2 separate tests for this. But, I'm not a medical professional. I recommend that you ask her doctors what they would do differently after all the tests are completed. We all have a finite lifespan, and having peace and pain relief rather than becoming a pin cushion would be my preferred choice. Have you asked your mother what she wants? That might be where to start.

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@gailb

@braves11, I just reread your post. I think the purpose of a bone scan is to determine the density of bones. There should not be 2 separate tests for this. But, I'm not a medical professional. I recommend that you ask her doctors what they would do differently after all the tests are completed. We all have a finite lifespan, and having peace and pain relief rather than becoming a pin cushion would be my preferred choice. Have you asked your mother what she wants? That might be where to start.

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Let me thank you so much for the answers you gave. I agree about the bone scan and bone density test.!im calling tomorrow and asking " what are you
looking for?" and what happens next. The bone scan I am told looks for bone issues .. not. nerve. pain... mom hates to take pain meds... but I can only be here and suggest! I agree about being a pincushion ... mom has Tramadol 37.5 mg and I can't get her to take it much!! But it's her body and she's very with it! One doc says rest left hip .... one says do PT!! We are going to do pain relief and walk!!!

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@braves11, good for you! I'm 68 years old and I hope I'm going as strong as your mom when I'm 92! Walking and pain relief sounds good to me. She doesn't have to worry about becoming dependant on Tramadol or feeling goofy with it I don't think. Its the only medication I will continue taking. Good luck. Gail B

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@braves11

Oh thanks! Can I ask you--- how long did you wait in between epidurals??were you having any of the same symptoms???

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I was having pain from the lower part of my butt around to the front of my right leg...it stopped at my knee. It was so bad that I could not walk and was in a wheelchair for two months. I had the epidural S about a month apart. The epidural S plus physical therapy helped so that I was able to go to school about nine months later at the "tender" age of 63! Please wish your mom luck!

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Thanks!!! She uses a walker and got in the shower chair today to bathe and she's a little stiff. Aggravates the area.... makes me wonder if PT is going to work....Older people hate taking pain meds and she has the Ultracet... it works. IF I can get her to take it. This pain you had is similar. And it hurts her in the groin area if she coughs... and lifting her leg is really a no no

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I am 63 and by nature a couch potato. The first time, I went to PT just getting from the wheelchair to another chair was agony. However, little by little, the pain diminished. I still take Percocet (maybe twice a month down from 4 times a day). Don't necessarily rule out PT. The PT group I went to worked with lots of older people including several people in their nineties!

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