[Thomas the Rhymer]

(04-06-2014 05:50 PM)Prophylaxis Wrote:  

(04-06-2014 08:54 AM)Thomas the Rhymer Wrote:  

I'm struggling a lot lately with left lower back pain and right hip pain with spasm. It seems to be triggered off by driving and is relieved by standing or lying flat on the floor. Carrying a bag on my right shoulder makes it worse, while carrying a bag on my left shoulder improves it.

When the spasm is at its worst, I struggle to properly walk - my muscles are so stiff that I struggle to initiate flexion. Once flexion is underway, then I'm okay, but I have to do this weird drop-foot gait whenever the spasm is bad - I have to swing the right leg forward. Generally though, the spasm is not that bad but it these days it often affects my running - if I try to run, it's either extremely painful/stiff or if the stiffness is not too bad, I feel sometimes like I'm going to tip over to the right (the side of affected hip).

I suspect that I'm mainly having spasm of the right piriformis, and that the left iliopsoas has to then compensate for it and then also goes into a spasm.

Applying a hot water bottle on my right glutes or over my right hip flank relieves the pain/spasm. Anti-inflammatories help the pain but not the spasm, so I generally have to take a mild muscle relaxant with it. The problem is that these solutions only fix the problem temporarily and then the spasm recurs.

I've been having this problem for a few years but it used to just be a few days every month, but now for the past 2 months I have more painful days than pain-free days.

I was thinking of going for xrays and a sonar to properly identify the inflamed areas but before I do that I thought I'd get your opinion on the matter.

Hey Thomas,

Sorry to hear man. If I'm not mistaken, you're in the medical profession - great that you can easily get your hands on some meds to help with the pain.

Certainly sounds like you are compensating with trunk lateral flexion in your gait, very common with poor hip muscle functioning.

Where specifically is the right hip pain? (lateral/anterior/superior/medial hip joint?)

Did the back pain occur first? - If so any mechanism or injury or just insidious onset?

Which of these movements brings on either hip or back pain? (which one?)



There is no tingling or leg pain radiating down either leg?

Have you tried any stretches that relieved the back pain? - e.g. repeated extensions?

It feels like it's posterior, radiating into deep gluteal area (piriformis?). But sometimes I get pain radiating down the iliotibial tract.

I do not suspect any nerve impingement coming from the lower back.

The back pain did not occur first.

Rotation makes the pain worse, to the point where, sometimes, trying to rotate feels makes it feel like lightning bolt has just struck my right glutes. The one time the pain was manageable but then I tried to turn for something and for the rest of the day I was limping because of the pain.

The following stretch relieves the hip pain when I am in the stretch... But the moment I release the stretch, the pain is worse than before.


The following stretch really soothes the lower back but it seems to worsen the right hip:


Since stretching only seems to make the pain worse, I've stopped doing stretching for now.

I'm not sure if this is useful, but I've noticed lately my right hip abduction is weaker than my left hip abduction. If I lie on my side and I abduct my legs, I can generally put a rep or two extra with my left leg. Since I'm right handed, I find this odd.

One important thing I forgot to mention is that the pain appears to be most commonly triggered off by driving and by prolonged sitting. I used to get it on both sides until I switched to driving an automatic car, now it's only the accelerator pedal leg that still gets pain.