Life destroying hip pain for 7 months

I have deep continuous pain just beneath my left iliac crest in the glute med and also deep pain at the left Piriformis, my lower back is also stiff. This pain has been constant and life altering since March when it came on during a yoga sessions where the teacher put me into an exaggerated twist position. Aggravated even more by seemingly any activity, this was originally diagnosed as tendinopathy, then a nerve issue but it carries the characteristics of neither. There is a deep aching pain, not an electrical pain. The pain does not shoot down my leg, the area doesn’t tolerate gradual loading. The pain is only relieved somewhat after lying down in bed all night but then as soon as I’m up on my feet again the pain builds and builds throughout the day and is worst in the evening. It can be positional to the extent that side planks with the left side lower are particularly aggravating. Shockwave therapy which I had in May hasn’t improved the pain, neither have 100s of hours of light physio exercises over 7 months- clam shells, bridges, monster walks, planks. I have tried regular deep tissue massage, had over 20 physio sessions, there is no relief. The only window I had was for 2 weeks in August following 5 steroid injections into the glutes, now the pain is back to its original levels. Formerly captain of the netball team, a marathon runner, cyclist, now pretty much housebound, I would really appreciate if anyone could help with diagnosis or suggestions so I can get my life back. I am a 34 year old woman, healthy weight. I have history of ACL surgery on my left knee 4 years ago using hamstring tendon (so my left hamstring is pretty weak), I had stress fractures in both left and right tibia 3 years ago and I had ITB problems left side last year.

Hi Kristyfoster,

Bad to hear the pain has not improved your regardless the physio, injections and all those treatments.

The fact that muscle-targeted treatments have not improved your problem should direct focus on other structures such as the sacroiliac joint (SIJ) and low back. Aggravation of symptoms when loading while improving when unloading would support this theory. Mechanical and manual tests to analyse these structures may help undertand the source of pain and help your pain.

I suppose, however, that your physio has already thought about it

Let us know if your pain gets better

Thanks so much for the reply!

I have changed physio very recently (this week), my new physio is concentrating on lower back, has started acupuncture and is considering reformer Pilates. The previous physio could not get past this being a hip tendinosis, and after a long time with no improvement, I decided it was time for a change. I’m also now booked in for radio frequency ablation in November, it’s a temporary measure but I’m at the “I’ll try anything” stage.

Thanks for the advice, my consultant has confirmed no sacroiliac joint dysfunction but the last MRI I had was back in March, I’m not sure when it might be time for another one but no desire to rescan me just yet.