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Suggest Treatment For Severe Hip Pain For Non-Hodgkin's Lymphoma Patient

Posted on Tue, 11 Mar 2014

Question: Hi. I am a 57 year old female with tons of medical problems. What i am hoping you can help me with is first identifying this muscle (if that is what you feel it is) that is causing the severe hip pain that has worsened over the past 6 months. I have had many years of epidurals for lower back pain... Bulging discs, degeneration, and (forget the word) where the vertebrae are slipping. A very well regarded neurosurgeon here in Louisville does not want to do surgery...yet. If I were to, from a myelogram test, I would need 3 fusions in the lower back and 3 fusions in my neck, so neither do I. However, the horrible hip pain that has recently made it difficult to walk has me in a real quandary. A masseuse said it was some deep muscle way inside the side of my left hip. I am scheduled to undergo a radial frequency ablation with my pain management doctor after 2 facet injections that were not successful at all, but apparently insurance dictates that this must be done before the RFA. I am also an 18 year small follicular non-Hodgkin's Lymphoma patient, and I undergo IVIG treatments once a month. I take three 7.5/325 percocets a day, to no real avail. Can you tell me what you would advise?

Answered by Dr. Saurabh Gupta (1 hour later)

Brief Answer: seems to be piriformis muscle causing pain. Detailed Answer: Hello, Thanks for your query. Sorry for your multiple problems. I can understand your worry and anxiety. It seems to be piriformis muscle causing the severe hip pain. It is a flat, band-like muscle located in the buttocks near the top of the hip joint. The pain is due to the piriformis muscle compressing the sciatic nerve. Pain may also be triggered while climbing stairs, applying firm pressure directly over the piriformis muscle, or sitting for long periods of time. If pain is caused by sitting or certain activities, try to avoid positions that trigger pain.Rest, ice, and heat may help relieve symptoms. Consult your physiotherapist for exercises and stretches to reduce pain. I do hope that you have found something helpful and I will be glad to answer any further query. Take care

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Saurabh Gupta (1 hour later)

Thank you Dr.Gupta! I believe you are definitely correct in your diagnosis of the piriformis muscle. So many have suggested the sciatic nerve and what you say about compressing it must be what is happening. I remembered the name of the other "condition" many doctors have said I have...spondilolysthesis. Could this have anything to do with compression as well? Do you think the RFA will be of any help at all? Do you think I may possibly have a new tumor there of non-Hodgkin's? I always suspect the nhl in everything I get! I do my IVIG today and the RFA tomorrow, so I could sure ask my oncologist, too! Thank you again for your assistance! XXXX

Follow up: Dr. Saurabh Gupta (3 minutes later)

Ohh and I meant to tell you that my pain generally happens WHEN I am walking to the point that I must stop, hobble to a place to sit for a few minutes, and then after a while I can walk a bit until the pain reaches the ole 10 again and I must stop once again.

Answered by Dr. Saurabh Gupta (13 hours later)

Brief Answer: Go for RFA. Detailed Answer: Hi XXXXXXX I am glad to know that I could address your concern. Spondylolisthesis is a condition in which a bone (vertebra) in the spine slips out of the proper position onto the bone below it. It can also cause compression of nerve roots as well. Radiofrequency ablation(RFA) disrupts nerve conduction, specifically interrupting the conduction of pain signals. In turn, this may reduce pain, and other related symptoms. Do not think too much. There not seems to be possibility of new tumor. Go for RFA. I hope the things go well. Warm regards.

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar