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Pain in my right hip

I have had pain in my right hip, in the center of my right buttock for a little over 4 years now. I cannot sleep on one side and notice severe pain when driving long distances. Two days ago, the pain was so bad that I decided to go to take physiotherapy treatment from a clinic nearby( http://www.physiomed.ca/treatments/physiotherapy/ ). I know that there is something very wrong. I am hoping that it helps me. Have you gotten any relief with physiotherapy treatment? I am so worried.

  1. Thanks so much for reaching out with your question! I'm so sorry that you are in so much pain. I know that impacts every aspect of your day. I have not had the full range of services listed on the website link you provided, but I have had physical therapy and the electrical stimulation mentioned on the list. (I've also tried a number of alternative therapies such as acupuncture, chiropractic care, and massage.) Both were helpful to a degree, but did not bring the level of relief I needed. While strengthening muscles is important in supporting our joints, and the other modalities may also help with pain and overall health, I haven't heard of these practices being able to impact the immune system response, which is the cause of rheumatoid arthritis.

    Are you being treated by a rheumatologist? If so, it's advisable to discuss this treatment option with him/her. Also, make sure that s/he is aware of how much pain you are in. When I've had intense hip pain like you are having, the most helpful short-term treatment I've had is a shot of corticosteroids into the hip. It can bring down the pain and inflammation very rapidly.

    I hope that you are able to find some relief soon. I certainly understand and am familiar with the worry that accompanies acute pain. When I've experienced long lasting flares, the combination of frequent communication with my rheumatologist and additional alternative therapies has been key.

    Wishing you all the best, Tamara (Site Moderator)

    1. I am very new to this forum and I too have major pain in my hips that is so bad it radiates to my butt cheeks. Almost 8 years ago I had rapid onset joint pain & stiffness from my toes knees, hips, elbows, wrists, fingers and shoulders over a 3 day period. Totally stopped my very active life.
      For the last 6 years I have been in what I like to call "medicated remission" using a combo of Methotrexte, plaqunil and 5mg. prednisone. 5 weeks ago it all came back but stopped at my hips.I've had the predizone z pack, hip injections and haved upped the Methotrexate dosage. Still can't sleep, walk more than 20 steps or sit for longer than 15 minutes without becoming overwhelmed with pain.
      My question is; what does your Dr. give you for pain while waiting for the increased Methoate to kick in? I am in increable pain and can't go back to work.

      1. Mb8frk,
        Welcome to our forums! Thanks for taking the time to share with us. I am so sorry to hear about your radiating hip pain. I understand how frustrating it can be to have a setback when the cocktail of medicines had been working for you for the past 6 years. Did your doctor mention how long to give the new dose until it is expected to work? Have you gotten a second opinion? In addition to the feedback I hope you receive on this forum, you may also wish to post on our Visitor’s Posts section of facebook: https://www.facebook.com/RheumatoidArthritisDotNet/posts_to_page/

        In the meantime, I wanted to share some tips for managing pain that you might find helpful at this time: https://rheumatoidarthritis.net/living/managing-ra-joints-related-pain/

        Also, once you are able to get back to work, you may wish to try some of these strategies suggested by other community members like yourself 😀
        https://rheumatoidarthritis.net/living/community-thoughts-strategies-work/

        I am keeping my fingers crossed that you begin to feel some relief soon.
        We are here for you.

        Warmly,
        Jillian (Rheumatoidarthritis.net Team)

      2. Hello! In addition to Jillian's post, you may want to ask your rheumatologist if it's time to add a biologic medication to your treatment plan. This article describes the various biologic medication options currently on the market: https://rheumatoidarthritis.net/treatment/biologics-treatment-options-for-ra/. When traditional DMARDs such as Methotrexate and Plaquenil aren't enough to control RA disease activity, a biologic drug is often added (here's an article on DMARDs: https://rheumatoidarthritis.net/treatment/traditional-disease-modifying-anti-rheumatic-drugs/).

        As far as pain, rheumatologists' views on pain management vary greatly. Some doctors prescribe pain medication, while others do not. I have found that taking a muscle relaxer such as Flexeril at night can help with the pain, when I don't want to take pain medications due to the side effects. I also use Lidocaine patches, which adhere particularly well to my hips, for localized, topical pain relief. Pain management is an important conversation topic to discuss with your rheumatologist. If s/he does not want to prescribe a painkiller and/or you don't want to go that route, options such as muscle relaxers or lidocaine patches might be helpful options.

        Wishing you all the best,
        Tamara (Site Moderator)

    2. Steroid injections guided by x-ray worked wonders for my bi-lateral SI joint pain. The injections were done by a Pain Specialist MD.

      1. I have had regular pain in my joints but did not get a diagnosis of inflammatory arthritis until one day I simply could not move due to pain in my hip. I was sitting in a chair, tried to get up, and simply couldn’t move without excruciating pain. I couldn’t walk, move even a bit without incredible pain. I went to an orthopedic doctor and he diagnosed bursitis, but was very rude saying I shouldn’t be in so much pain and it shouldn’t be disabling. When I went back to my rheumatologist, he immediately reacted to help me. He put me on Plaquenil and prednisone. I had immediate relief with the prednisone, but the Plaquenil has never worked, even after 1 year later. I have tried to decrease my prednisone to 5 mg a day, but that results in me being more symptomatic and in a lot of pain. My hip and foot pain completely disrupts my sleep. As soon as I lay on my side, my hip hurts. I turn to the other side to get some relief, and within a minute, that hip begins to hurt. It is a constant battle of rotating to get relief. Once I eventually fall asleep, I often have dreams of unbearable hip pain and wake up due to the actual pain I’m experiencing. So at this point. I’m about to start on methotrexate and eventually work my way off the prednisone. Really hoping to get some relief. It’s so hard to get a good nights sleep when in pain!

        1. Hi Amyjane,

          I'm so sorry to hear you are in such intense pain! Have you ever considered getting a second opinion? If I'm understanding you correctly, you've been on Plaquenil and Prednisone for a year now, and your rheumatologist is only now adding Methotrexate? If that is the case, these are the reasons I suggest you consider getting a second opinion from another rheumatologist:

          - A year is a long time to be on Prednisone. Sometimes being on long-term corticosteroids is the only way to deal with pain and inflammation that won't respond to other treatments. However, as you're only now being prescribed methotrexate and you have not yet been on a biologic (I'll address this further down), it sounds as though your rheumatologist is very comfortable with long-term corticosteroid use rather than try other options. I recommend a second opinion to see if this is indeed the best option for you. Here is an article about steroids that lists some of the potential side effects of long-term corticosteroid use: https://rheumatoidarthritis.net/treatment/steroids/

          - Methotrexate may be very helpful for you, but I wonder why your rheumatologist waited a year to prescribe it (if I am understanding that correctly). Methotrexate is often one of the first medications prescribed.

          - Biologic drugs are the most sophisticated treatment for RA, and can be more effective than other RA treatments. Here is an overview of biologics: https://rheumatoidarthritis.net/treatment/biologics-treatment-options-for-ra/. I've been diagnosed for 17 years, and biologic drugs are necessary for me to keep my symptoms at a tolerable level for the majority of the time. I'm currently on Orencia and Plaquenil, and the Plaquenil alone would definitely not be enough.

          Perhaps your rheumatologist has recommended another medical regimen to you and you have opted to be slow to try them (there are many pros and cons to weigh, and treatment can be cost-prohibitive without insurance), in which case a second opinion may not be required. However, if you have been open to additional treatment but your rheumatologist has waited a year to recommend Methotrexate and has not discussed biologics (note that trying Methotrexate is a requirement of many insurance companies before they will cover biologics), then I do suggest you get a second opinion in order to have the best shot at getting your pain level down as soon as possible.

          Also, methotrexate can be very effective, but it can also have many side effects. Here's an article about methotrexate: https://rheumatoidarthritis.net/treatment/methotrexate/. Some people tolerate it very well, but some people have a hard time with it. For those who do have a lot of side effects from it, some people find that methotrexate injections are easier for them to tolerate than pills. Hopefully you will be in the group who tolerates it well and finds it to be effective. I only mention the other groups of people in case you do have a lot of side effects, so that you can know that a) injections might be an option and b) you wouldn't be alone in that physical response.

          Please continue to reach out any time you have an experience you want to share or questions or concerns. RA is a tough disease, but you don't have to contend with it alone.

          Wishing you all the best,
          Tamara

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