What IS this? Sciatica or muscular or what??

[GlomOfNit]

I've been in a lot of pain, intermittently, for over two years now. The pain is usually in my hip, inner groin/joint between pelvis/leg, knee and sometimes front of shin and ankle (!) but it always starts or is at the same time as lower back pain. I would say I have the very strong impression that the lower back pain starts the pain in hip/groin, then knee, off.

The pain can be so severe it makes me grimace and vocalise. Painkillers don't touch it. When I'm having an attack, I find it really painful to sit, but also impossible to walk without pain. I sit with my legs extended onto a stool, it's the only way I can get at all comfortable on the sofa. Hard chairs aren't much better. Lying down is usually ok, and lying on the 'worst' side is more comfortable than on the other side, as long as my knees and ankle joints are stacked one above the other.

Pain is odd - sharp stabs, at times like someone is inserting a skewer into the side of my knee, but also dull. In terms of intensity, with childbirth being 10, it's a 7. I do at times get a classic sciatica pain, right in the center of my buttock, but not always. And the pain tends to attack the sides rather than back of my legs.

For context, I'm 50 ,in perimenopause (HRT for last 2 years), a bit overweight (5'2" and ten and a half stone), have mild scoliosis and my mother has osteoarthritis.

I say intermittently because I'll have several days - or weeks - of attacks and then it'll go away a bit. Exercise can make it worse - I hobbled around yesterday and today because of short town walks, less than 3000 steps - but can also help at times. For instance, I had a city break for 4 days last autumn where I was walking at least 15,000 steps a day and lots of stairs. I was a bit sore but it was only the day after I stopped this that it started really hurting. I also climbed Snowdown and down again a year ago and in fact the going uphill seemed to help!

I think I'm actually getting a bit of weakness in the worst leg. I feel completely compromised by this - I can't plan any walks because chances are I won't manage them, I really want to go backpacking with my son but can't imagine that at the moment. I make decisions about not doing stuff because of this. GP was very dismissive the last time I went and has decided, on 5 minutes of listening to me describe it, that I have a small muscular tear injury, which may or may not get better, which won't show up in a scan so no point in scanning, to keep mobilising and don't stop doing anything... I did see an NHS physio last year (after about 7 months wait and some cancelations) and she thought muscular, gave me some exercises which didn't work. I have more recently seen a private physio who also thinks muscular, has manipulated me and with whom I do pilates classes. The manipulations don't seem to have done anything, the pilates might help with stiffness but make it hurt worse the days after ...

I feel pretty desperate. I want to go back to GP and ask for a referral because I don't think we're at the bottom of this. I can't imagine living like this indefinitely. I'm up for trying all sorts of complimentary therapies if they work - acupuncture, CBD oil, chanting ... I just want this to stop, please!

bump?

I've had all sorts of back and leg pains.
It sounds like it could possibly be a nerve impingement. If you can afford it I would suggest going to see a different private physio.

Good luck, I know how horrible and exhausting it can be

Sounds hip related

The pain in your hip and groin sounds like pgp on pregnancy which is all pelvis related so perhaps the problem is there? I had an osteopath for awful pgp and it worked but involved a lot of groin and hip manipulation which was tremendously awkward to start with! Also lots of exercises building strength later on.

Reading your symptoms made me think of the pelvis too. I could be way off, but I was thinking about a hypertonic pelvic floor. Do you have trouble releasing your wee?

Whilst awaiting further investigation have you tried naproxen - taken with food and a ppi like omeprozole to protect the stomach.

With pain like sciatica and that originating in the spine, very strong anti inflammatory meds are often the best. I have a multitude of horrible conditions, for the pain like sciatica ( appreciate this may not be part of that), naproxen is the only thing that helps everything from lower back,ass all the issues going down leg and knee. I don't understand why they dish out drugs like codeine and other weird painkillers that don't address the inflammation but I notice they often do bizarrely.

You'd need a prescription. Long term use is hard on the stomach

Hmm sounds like a chronic pain possibly from your lower back and affecting the muscles too. Probably needs to be managed with gentle exercises rather than cured.
Ask for an X ray which should happen quickly and should rule in or out any hip osteoarthritis etc. Then if you possibly can get a private mri or push your GP for an mri to get to the bottom of it.
A minor muscular tear would not last this long or be as variable.

I had something similar for 2 years.

I went to see a private physio therapist in the end.

To fix me, he had me lay face down on the physio bed. Told me to hang on tight to the top of the bed , and then he grabbed my ankles pulled my legs really hard. First one and then the other.

this basically lined up all the cogs in my spine which must have been slightly out of line.

After the first appointment, my pain was much less.

After the second appointment, I walked out of his office standing straight and the pain was gone.

I was so annoyed with myself for not going sooner.

It may or may not work for you OP, maybe worth asking.

Hope you get to the bottom of it

I've been to a chiropractor I've had good experience with them really sorting out my pain and problems with pelvis and sciatica and also doing online free 10 min pilates videos on YouTube for Stretches etc helps

thanks everyone who commented! Sorry, I did the classic thing of posting then forgetting about it!

I did see another private physio today and she thinks that my scoliosis and chronic 'mechanical lower back issues' are inflaming a nerve or two, so has told me to spend the week trying to get on top of the pain with Solpadeine and some very gentle exercises, and heat, and then next week we'll try some more exercises and manipulations. I have to say I hurt even more now she's prodded me around, but I'm getting used to that after a physio session.

Could be hip arthritis. Did you have an x-ray?

I don't suppose you have any eye issues too?

Are you thinking of the possibility of ankylosing spondylitis? I have this and a world of issues but it does affect my eyes.
Lower back pain and sciatica, usually quite severe, are presenting symptoms. A STIR MRI of the spine is the only way to know for sure if it's an inflammatory arthritis problem. It does tend to be quite severe presentation wise.

This sounds more mechanical, which is good!

I have similar pain and finally got told a couple of years back by a physio that it was my SI joint and something to do with my facet joints.

When things are starting to get bad I wear a special belt to keep my SI joint in place. This is obviously not a good look (!) so I don't wear the belt out, but will wear it as much as possible at home, in bed and in the car. The belt really keeps the pain at bay.

Doing the physio exercises to strengthen things over the years has made the episodes of pain less frequent (although I was sceptical at first), I have tried to think of them as part of my longer term pain relief strategy. But, I realise that is not helpful in the short time when you are faced with pain. Ultimately, I don't feel any healthcare professional has ever really resolved the problem and all I'm ever given is a band-aid approach.

Also, I have taken so much ibuprofen over the years to deal with the pain that my stomach is now shot to pieces and I can no longer take it. So keep an eye on that!

Good luck. It is hard to explain to people how awful and all-consuming sciatica-like pain is, so I feel for you.

@GlomOfNit A physio without proper medical examinations first might not be the best idea. I mean, physios are great and you may end up at one anyway, but until you see an orthopedist and get some scans, there’s just no way of knowing if you have a condition that, for example, needs six solid weeks of rest to improve and then it will get a bit better and then physio, or one that is permanent and you need to learn different physio exercises to manage it, and possibly have other treatments.

I wouldn’t presume to diagnose you as it sounds like it could be one of many things. With that said, yes, absolutely you need to go back to your GP and tell him it’s been two years of pain and it’s time to see a specialist and get some bloody scans! If you have arthritis and a physio is prodding you about without knowing, that could just add to your pain. Likewise, you could have an injection to help with a bulging disc that would help tremendously with the pain. But you MUST see an orthopedist and get some scans so someone knows what the hell is happening inside you.

I’m just so sorry you’ve been waiting two years already. It must feel endless. I understand your GP was dismissive and the NHS is on its knees, but GPs need to be questioned sometimes ESPECIALLY when your pain continues, and you so deserve care regardless of the NHS’ condition, so very, very best of luck!

PS Is your name a reference to Going Postal by Sir Terry Pratchett? I loved that book, and the miniseries!

I was thinking of hereditary (OP's mum has issues) connective tissue disorders that cause scoliosis as well as early arthritis due to poor cartilage.