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Have progressively painful area on iliac crest. Unable to sleep and pains with walking. Suggestion?

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General & Family Physician
Practicing since : 2009
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Last four months progrssivly painful area on right iliac crest. Unable to sleep on right side and gets worse as I walk my usual five miles three times a week. Any suggestions? I am 75 year old female.
Posted Tue, 13 Aug 2013 in General Health
Answered by Dr. Chobufo Ditah 2 hours later

Thank you so much for this query. I am so sorry to hear about this painful area on your right iliac crest. I hope together we will identify a possible cause and propose long lasting solutions.

From the description of this pain and its aggravation by physical exercise, it most likely originates from the iliac bone and its surrounding structures. Looking at you age, it could be bone changes related with aging that make the supportive and resistant matrix fragile. Other possible causes would have been an inflammation or an infection of your bone or the tendons attached at this point.

In order to tell for real what the problem is, you will need a clinical exam and also some tests. They will be very important to do the following:
-ESR; Erythrocyte sedimentation rate to tell whether there is an ongoing inflammation or not and if yes, to what extend. It would also be used to monitor response yo treatment if abnormal.
-A full blood count that will tell us if there is an ongoing infection.
-An Xray of the iliac bones to see if there are any changes which can explain this pain.
Also, I will like to know if you have done your DEXA scans for osteoporosis screening. If yes, what were the results. Also, are you taking any calcium supplements?

Depending on the preliminary findings, we may wish to pursue further explorations if we don't get satisfying and conclusive answers.

For now, you may want to take some pain medications and use ice packs to reduce the intensity of this discomfort. You may also want to cut back on this routine exercise and get answers to this problem before returning as it actually aggravates symptoms. I will advice that you book an appointment and get this pain evaluated by your doctor and also do the above mentioned tests to have a clearer picture. Additional treatment options like local steroid injection, antibiotics, calcium supplements, physiotherapy, etc. An ideal specialist to address this problem is an orthopedic surgeon.

I hope this addresses your query fully. If there is more that you had wished I addressed please ask specific follow up questions and i will readily address them.
I wish you a speedy recovery.
Dr. Ditah, MD.
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