Piriformis or Bursitis? Ugh!

[dbny]

For the past week I've had awful pain in my right hip. It doesn't hurt when I skate, except for spirals. Driving is the worst, and is very painful. Sitting isn't good either, and it's hard to get to sleep at night, but I generally wake up feeling better. I asked a Russian coach I know today, who is also a masseur, and he said right away that it's a nerve, but he doesn't know the name in English. That would be the sciatic nerve, and make it piriformis. He suggested massage and heat. Any suggestions (besides seeing a doctor)?

[jenlyon60]

The sciatic nerve runs near or through the piriformis (varies by individual, from what I've read)

There are some good piriformis stretches...

Here are some links...
http://www.rice.edu/~jenky/sports/piri.html
http://www.rice.edu/~jenky/sports/piri.2.html
http://www.drbackman.com/piriformis-muscle-stretch.htm

[NickiT]

I suffer frequently with pain in my hip and butt area mainly due to piriformis syndrome, as a result of my twisted pelvis and leg length difference. For me, skating makes it worse, usually when I increase intensity, and certain movements like backward crossovers. When I have a flare-up I find stretching helps - I do all sorts of stretches that pull on the glutes. I also find ibuprofen to be helpful. However the best thing really is rest. If I take myself off the ice for a few days it nearly always clears.....until the next time.

Nicki

[Perry]

Two and a half years ago, I started having trouble with my hip. A triner at Delaware told me I had a strained flexor, and when I got home, my doctor said it was bursitis. Later, he changed this diagnosis to appofecitis. It turns out I had all of these things, but they weren't the real problem. Over a year later, after having my umpteenth MRI (this time with contrast), I woke up the next morning and couldn't walk, since they inject it into the injured tissue. When we went to Sports Medicine, the results confirmed what the doctors were beginning to suspect -- I had torn four different things in my hip (not to mention having two stress fractures and three other conditions), and needed surgery.

Just illustrates the importance of talking to your doctor and getting the right tests.

[skaternum]

Any suggestions (besides seeing a doctor)?Why is seeing a doctor not an option? Does this extend to physical therapists? No offense, but we (a bunch of people who know nothing about your body) are not really the best source for medical info! There are numerous things that it could be, and speaking from experience, if you don't find out what it is and treat it appropriately, you could be in for years of problems with nerves, muscles, joints, etc. My advice is to go to a good sports doc and see what the problem is.

[jazzpants]

DBNY: Get thee to a sports doctor ASAP!!! You might need to also get an x-ray AND an MRI to confirm things too and how best to deal with the situation. Probably would also invest in a heating pad or an ice pack to put in the sore area. (Ice for swelling. Heat to make it feel better.)

It sounds like the sciatic nerve... and if you aren't careful and push it too far (unknowingly since you haven't seen your sports doc), you risk getting getting sciatica (and those of us who HAD sciatica know that you'll likely be sidelined from skating! It's definitely no picnic!)

Go see a doctor. I want to see you skate with me at NYC!!! :D

[dbny]

To those wise souls who are insisting I see a sports doc, the problem is that I haven't found one I trust and that my insurance will pay for. I guess I better start looking though. Thanks for the encouragement to do so.

[techskater]

PLEASE go see a doctor and a PT! Cinderella on Ice was off ice for 13 weeks due to this problem and couldn't sleep, sit, lay down, or do anything but pretty much stand as it got worse and worse. She's back on the ice now, but she's still weak and is nowhere near what we know she's capable of doing! Good luck and take it easy!

[mikawendy]

Ouch, dbny, I hope you're on the mend soon.

I've had piriformis/sciatica problems in the past and had a flare-up recently because (of all things) a fall off-ice. If you're still on the lookout for a doc, maybe someone on this forum in your area could PM you to recommend someone? I'd recommend my PT (he's also flo's PT), but he'd be way too far away for you...

My fingers are crossed that you'll have a speedy recovery.

[Cinderella]

Techskater is right. See a doctor.

The reason I have to stop posting regularly here is that I didn't take care of my "little" nagging butt/leg ache, having self-diagnosed it as either sciatica or piriformis syndrome. It turned into the hellish nightmare she described, with pain levels of 10 and - literallly - an inability to sit down OR lay down for 3 weeks and an inability to sit down at all for almost 10 weeks.

If you think you've got troubles now, try standing non-stop, 24/7, for 3 weeks straight. My co-workers were calling me Mrs. Ed because I had to learn to get snatches of sleep while standing up!

My particular problem had to be diagnosed from an MRI, but once we knew what it was (spondylolisthesis - a genetic condition), therapy exercises, use of a TENS unit (electronic nerve stimulator), lots of ice packs, and judicious use of NSAIDS has brought me back to the ice. After all those weeks of intense nerve pain, my right leg was like a cooked spaghetti noodle when I returned to the ice. It's been 6 weeks since my first step and I'm STILL working hard to get back "just" to where I was before.

If you don't know what you have, you can't treat it properly. Get thee to a doctor!!!

[dbny]

Oh, Cinderella, how awful! I'm glad you are getting back to normal and know what it is and how to deal with it.

I'm going a little bit nuts with this thing. Still haven't been to a doc, just no time, but meanwhile, it seems to be getting better. I've upped the ibuprofen to 600 mg three times a day and use a heating pad in the evening while watching TV. Some mornings I wake up and it's better, other mornings it's worse. Wednesday it was bad the minute I got out of bed, but by the time I was finished with the My First Lessons class, which involved some squatting down low, and had practiced for about half an hour, it was much better. Skating actually seems to help. How weird is that?

I'm going to give the ibuprofen a week or two to see how much it helps, then see a doctor.

[Elsy2]

Wow, Cinderella, what a nightmare. I'm so glad you are recovering and can again skate. You know this condition took my daughter off the ice too. So I'm very familiar with it.

She was a good patient and did her PT strengthening exercises daily. She was released to skate as long as she could tolerate it. Unfortunately, she just couldn't take the pain of jumping. We had her back x-rayed every 3 months to check for the position of the 5th vertebre. Now that she's done growing like a weed, the situation is less precarious.

Good luck to you! I actually have not been diagnosed, but developed a similar back problem at a young age. So I do believe the genetics connection.
Skating hurts my back every session. But I can still do it thank goodness.
Hope you heal and can successfully achieve what you want on the ice! Take care!

Dbny, you take care too. I hope your case isn't serious.

[dbny]

After two weeks on 600 mg ibuprofen three times a day and three days off driving, the pain is almost entirely gone. I did have one totally pain free day, but missed a dose the next day. It's such a relief to be able to sleep on both sides again, and driving is also OK now.

I'm going to consider this a flare up of my existing problems and keep up the ibuprofen for about six weeks, then try tapering it off again. Will also try to see my family practitioner about the safety of all that medication.

[Carleenp]

I had an injury years back where I tore cartilage in the hip joint. Surgery fixed it, but I also had a muscle imbalance that took some working out. What I learned from the years it took to diagnose it and cure it was that any hip pain can be very hard to diagnose. I agree with those who said to see a doctor. I would say look for an orthopaedist who focuses on sports medicine.

In my case, it would initially come and go. I would have good weeks or even months and then bad weeks. It finally became more of good days or bad and then I finally got myself to a doctor.

I will also add that I don't think you specified where in the hip it hurts. If it is the outside hip area, that is likely bursitis or something relatively treatable. But that is worth a DR. trip because a single cortisone shot can do wonders for bursitis. If it hurts in the groin area, that is "true" hip pain in the sense that the joint might be more likely affected, and requires more immediate medical attention. I remember that from back when I was trying to figure my own problems out and many sources said that inside (groin area) pain was a "true" hip injury that should get attention more quickly that outside hip pain.

Good luck! I hope all goes well!