Ischial bursitis

I’m sorry that happened to you…bursitis can be really painful. I’m glad you got a diagnosis. Hopefully your PT can provide you with guidance with a specific diagnosis now?

I’ve also had hip bursitis, but on the lateral side (tronchater bursitis I think it’s called?), not by my hamstrings. It might help to discuss with an orthopedist, your PT, or physiatrist, about your specific situation and what they think may have caused it. But it’s my understanding bursitis is usually caused by overuse…so it could be doing “too much, too fast,” or too soon with PT or hiking. I could totally see myself getting a flareup of bursitis with trail walking because of the uneven ground (because I am susceptible to things like this that require a lot of core/hip/pelvis stability).

In my case, I have hypermobility spectrum disorder (HSD), which causes joint instability so I need a lot of strength in my muscles to support my joints or they get fatigued easily, I lose optimal alignment…and can get bursitis easily, no matter the joint. I have had a Lot of these kinds of injuries.

Eventually, I overcame the pain by doing “active rest,” so avoiding or minimizing activities or exercises that irritated it excessively, but still doing gentle PT and physical activity. Bursitis is inflammation of the bursa caused by too much of…something, so you kind of have to find a way to reduce the irritation to get the inflammation down. Medications can help with that, but that only helps so much if you keep doing activities that ratchet up the irritation again.

I would probably say it took around 6-8 weeks for the pain to go away so much that I’d forget about it? It’s hard to say for me because I have chronic pain conditions; some of it blends together.

I still had pain and moved around, but tried not to do things that caused the pain to increased more than 2 points on the pain scale for more than 24-48 hours (per my PT).

That improved the pain over time, but I still need hip and glute strengthening to stabilize my hips and pelvis to prevent it from happening again.

I don’t get much leverage out of medications personally (because of my underlying medical conditions), and I don’t tolerate meds well, so I didn’t really take anything. I’m glad the diclofenac topical is helping you. My go-to was topical peppermint oil (I like the smell over Icy-Hot or Biofreeze) and k-tape works really well for me.

It can take a while, but it can get better, or at least that was my experience.

Wishing you all the best!

Thank you…I think I have some bursitis on the sides, too, but manageable there. We are so active, and I gave that up to just house care stuff, shopping etc and pt. Will see what doc says after mri on Monday. I think that this second round of Pt for this has made me stronger and I love that feeling back, but starting to hurt more again. Quit big meds 5 months ago-helping spine (severe scoliosis) but wasn’t really helping butt at all so I stopped.
I think pt has to drop back to more gentle, and see what happens.
Having nerve ablation for nasty scoliosis on 8/1; orthopedic doc mentioned that could possibly help with the bursitis…
Appreciate your input, was also thinking that less might be more with activity 😟
Was there anything else that you found helped?

You’re welcome. I hope all goes smoothly with the nerve ablation and scoliosis. That’s interesting, because I have scoliosis too, but it was treated with a spinal fusion when I was 11 years old.

Hmm. I wish I could think of something else insightful that helped a great deal, but in the beginning when the pain was at its worst, it was mainly minimizing things that would make it mad 😆 And eventually starting hip/glute/core strengthening with low and slow progressions.

Now that I think about it, we did realize one of the things I thought was helping, actually wasn’t: Stretching. It would feel good in the moment but end up hurting a few hours later. My PT pointed out that stretching could still be putting my legs in a position that would be compressing the bursae. Everyone is different though?

Because I have chronic pain and hypermobility, all of my new PT exercises already have to start with a small number of repetitions and then slowly increase. i.e. I’ll usually start with just 5 repetitions if something new, and if I don’t have a flare-up, the next time I add another repetition and another, until I get to the point where it’s a challenge. But that approach is very specific to my pain condition; it’s how to retrain my nervous system to tolerate new activities. It benefited me with the bursitis though because I had to take a more gentle approach, like starting with exercises where I’m lying down or doing isometrics.

But this happened in the fall and so far it hasn’t returned, as I continue with my home exercises 🤞

I hope your pain calms down sooner rather than later.

I didn’t even know I had scoliosis until I was 50, and found on my first routine chest X-ray. Doctor and I were both stunned. Have been truly active my whole life, sailing, skiing, hiking, yoga, golfing etc, with no issue until nerve damage 6 years ago. I have so much curve, I’m straight…I guess I’m lucky!
I am extremely flexible, and stretching is something that has also always felt amazing until last couple years. Is that your issue, too much flexibility?
I have stopped every thing, hiking with hubby and doggie was recently last to go. Long car rides, too.
So, thinking about what you have said, back off on intensity of pt, (was my thought too) do minimum activity until healed then start slowly. One thing you mentioned that I have never used, is kt tape. Do you think it might help heal in my area? I see a pelvic pt person, she should probably be able to show me how to apply correctly. Once healed, use it to keep things in place?
I really appreciate all of your input, every crumb of information might be the one that puts everything together!

Oh wow. I’m not really sure how they found the scoliosis; I think my pediatrician did some reason checked my spine and it’s visible if you’re looking. Maybe no one would have found it otherwise, but the curves were considered “severe,” hence the spinal fusion.

I was also very active before I started having symptoms of chronic pain. Apparently that happens a lot when people develop POTS and hypermobility spectrum disorder.

I don’t want to sound crazy, like I’m seeing this everywhere because I recently for a concerned diagnosis 😆 But since you mentioned you’re very flexible, I wonder if you might also have joint hypermobility, and if that might be a contributing factor to your pain, if you have pain in other parts of your body? Scoliosis can often occur with hypermobility. There aren’t many doctors who are experienced recognizing or diagnosing it, though they’d usually have heard of it if you asked. I find that PTs are more aware of it. A PT realized I’m hypermobile and did a Beighton test (they just evaluate how flexible your joints are by observing you try different positions). But it’s harder to diagnose the older we get because we naturally lose flexibility.

If you wanted to read more about it, the EDS society has a straightforward explanation: https://www.ehlers-danlos.com/what-is-hsd/ You can also view the international diagnostic criteria. I will not be offended if you think that’s over the top lol. It’s just that I would never have known unless someone told me about it.

But for the k-tape, sure I can share a little more. People have different theories, and you know there’s a lot online but I did a deep dive into the research a few years ago, and what they have been able to conclude is that taping helps some people with pain, but not because it’s holding anything in place—the tape is too flexible. They found that even “sham taping,” so not even placing it “correctly,” with proper tension, etc. still gave people relief.

That suggests it’s the sensation or experience of having the tape on that is somehow changing some people’s pain experience. It’s also thought that it can help with safer alignment or posture because if the tape is applied in the ideal position, it can feel weird if you’re out of that position by too much or for a long time.

In my situation, I have central sensitivity (brain becomes very reactive to new things causing increased pain signals). In my particular type, the part of my brain that maintains sensory communication with the most painful parts of my body is impaired—and that can cause more pain because my brain has too much uncertainty about what’s going on. So my PT suggested k tape because it was one way to increase sensory feedback.

Not everyone responds, but it could be worth trying if you’re really in a lot of pain? The studies show now everyone benefits, but there’s not too much risk. It cut my pain in half when I have my worst flare-ups! I wish I could use it all the time but the foundation of my treatment is to help retrain my brain so that it’s not so sensitive to pain and that would blur the lines.

The only down side is if you have sensitive skin, it can cause irritation. A pelvic PT might know how to apply it. (I love pelvic PTs btw lol) My favorite is the Kineseo brand found on Amazon. It sticks a long time and well and doesn’t irritate my skin as much.

I know, super long reply. But wishing you all the best!

Like I said before, anything might help. Type as long as your fingers will let you!
I have always been able to put my hands flat on the floor, and that’s weird, because doc said I should be 6” taller in my upper body…long legs!
Anyway, did not have this bursitis pain or hamstrings and some other pelvic areas until the first PT group I saw really got me strong and amazingly fit…except for this new pain.
I mentioned it and I was discharged that day. Hmmm
Finally was able to get into a pelvic pt, she helped with lots of things, then moved…found another one and she was also helpful with some things. I quit the big meds for spine, knee, like 5-6 months ago, and just started regular pt. They were not helping the bursitis (didn’t know what it was then) and I wasn’t going to go stronger meds.
New pt person miraculously turned out to be pelvic specialist, as well as regular pt, and is good. We fixed knee, got spine in a comfy place and building strength every where, but as we both mentioned, probably time to cut back on so much and be gentle again. She will agree.
Can’t tell you how much this helps me understand what might be going on and where to head!
Ps. Read briefly about the hyper mobility and symptoms-I had SIBO, cleaned that up 3-4 years ago, about the same time as the pain started. I wonder?
Again, thank you

You’re welcome! Yep SIBO is a thing too… The most obvious sign of hypermobility is in the joints but since it’s thought to be caused by a defect in collagen and collagen is found throughout the body, people can have other symptoms.

That’s great that you have a PT you feel comfortable with. There aren’t many pelvic specialists, and I’ve had a lot of turnover with my pelvic PTs, especially since the pandemic. If hypermobility could be a contributing factor, a PT is usually able to check it out and adjust the exercises for it. The main treatment for it is PT anyway. But I know you’re already doing a lot with your upcoming procedure too. Good luck!

Thank you again, just reread your post. Slowly-filled with great info.
Really interesting about the taping, even the sham taping. When I put a 1/2 diclofenac patch on each side, (takes a few hours for Med to penetrate) it seems to feel better almost immediately…not perfect, but somewhat better, I know that it’s not the Med yet…was starting to think I’m making things up in my brain…

Who diagnosed your central sensitivity? A neurologist? Pain management? I saw a neurologist several years ago for other nerve issues that appeared after the accident.
I am going to find that rabbit hole and try to find more info about central sensitivity.
Thanks again!

As I am reading these posts, I feel like I’m reading my life and I’m still completely undiagnosed and just putting this together myself I have spent more money on doctors and the surgeries that I’ve done nothing and this is all starting to make sense.

For what it's worth, I can relate... But having more information I feel means we can take back some agency, even though it doesn't make up for all that might have been lost by the time we got to this point.

Do you think you have central sensitization, or hypermobility (HSD/EDS)?

I just came across this blog post on WebMD if you're interested in learning more about central sensitivity (which many people with hypermobility also have): https://blogs.webmd.com/pain-management/20230731/disabling-pain-tests-may-not-tell-you-why

Apparently, the physician who wrote it has a book coming out soon about chronic pain/central sensitivity. But I checked out her website, and she has some blog posts specific to central sensitivity that could be helpful if you're wanting to learn more: https://askdrshana.com/

I didn't look too deeply into it; it might be a little thin on specific recommendations, but I'm happy to share my experience if any of it would help. Or just commiserate.

And @ch47 I'm so sorry I just realized I never replied to your post! Sometimes if I delete the notification, I lose track of it. Were you able to find anything that helped? The above sites are new to me, so might be of interest to you too.