As some of you may know, I’ve endured spinal compression for over 20 years due to a car accident in 2000. The pain was manageable until last year, marking the beginning of a relentless journey to find answers as to why my condition worsened so significantly. Since February 2023, I've met with two orthopedic specialists, a sports medicine doctor, a neurologist, two pain management clinics, three physical therapists, and an acupuncturist for seven treatments. Despite multiple X-rays, an MRI with contrast, and an extensive nerve conduction study (EMG), the only finding was the known spinal compression.
A Series of Failed Treatments
In January of this year, my pain management doctor administered an epidural injection between my L5 (fifth lumbar vertebra) and S1 (first sacral vertebra). It didn’t help. Severe groin pain led to a double SI (sacroiliac) joint injection in April, which also failed.
The Psoas Hypothesis and Acupuncture
Around my third or fourth acupuncture session, the practitioner identified the psoas muscle as a potential pain source. Despite focused treatments, relief was short-lived (only about an hour), so I eventually stopped acupuncture after seven sessions (she kindly dismissed me, since it wasn't giving me longer-term relief).
Exploring New Avenues and Making New Discoveries
I informed my pain management doctor about the psoas hypothesis, but since their office doesn’t perform muscle injections, I was referred to a larger hospital system for a psoas injection under ultrasound guidance. The doctor added that if this didn’t work, he would order a CT scan of my lower back and an MRI of my hip.
In June, I met with the doctor who could perform the psoas injection. Instead of jumping straight to the procedure, he took the time to listen to my story and conducted a thorough physical examination. His findings led him to believe the issue was with my hip, not the psoas. He suggested X-rays of my right hip, which showed a possible discrepancy in hip width, warranting an MRI arthrogram with contrast for a detailed look at the joints and soft tissue.
Another Failed Injection in an Ongoing Pain Cycle
Understanding my pain and the urgency of getting some relief, he offered a hip joint injection that day despite usually avoiding injections without a confirmed source of pain. I agreed and received the injection. He assured me his office would schedule the MRI and insisted I follow up immediately after the MRI to develop a long-term treatment plan.
Unfortunately, the shot did not help relieve my pain — third failed injection.
Reflecting on my medical history, I recalled that a few years ago, an interventional radiologist identified congestion in the veins on the left side of my pelvis. At that time, gabapentin (300 mg/day) was prescribed, which effectively managed my pain for a year. Given the severity of my current pain, I asked if gabapentin could provide temporary relief again. Fortunately, the doctor agreed. As of now, it has not helped, but I am hopeful it will, over time.
The Search for Answers Continues
In mid-July, I underwent an MRI arthrogram of my right hip with contrast (that was also painful), which revealed a small tear in the anterior superior labrum. After enduring pain for 18 months, I was eager to explore my options, which, from my research, seem to include physical therapy, injections (which haven’t been successful for me), and surgery.
Seeking Clarity: A Doctor's Perspective
Last week, I met with my doctor. Armed with several questions, I asked when the tear might have started, whether the psoas muscle was ruled out as a potential cause, and how this tear might affect my pre-existing spinal compression. I also questioned why a previous injection provided no relief and whether there were other pain management options. Additionally, I asked how I could improve without physical therapy and if I should continue my current exercises, such as clamshells and side planks.
The doctor was surprised the hip joint injection offered no relief and explained that, unlike a bone fracture, it’s difficult to pinpoint when the tear occurred. After performing a few hip tests, the doctor suggested the tear might not be the primary source of my pain, indicating there could be another issue with the joints.
Moving Forward: More Diagnostic Options
From here, my options include consulting with a hip specialist or surgeon, trying a psoas injection for diagnostic purposes (if nothing else), or starting physical therapy. The doctor advised me to avoid exercises that cause pain as well as activities like jumping and running. After the appointment, I met with their physical therapist, who assessed my condition and provided me with some exercises to try at home.
Unfortunately, there is nothing else they can do to help with the pain. He suggested using a lidocaine patch on the hip, as most over-the-counter meds do not work for joint pain.
The Pain Loop: A Continuous Struggle
The process has been exhausting and debilitating, especially for someone like me who has always been physically active. The pain loop is real. For those unfamiliar, the pain loop refers to a cycle where chronic pain leads to heightened stress and anxiety, which in turn can amplify the pain. It’s a vicious cycle that is difficult to break. My pain loop affects not just me but also my husband, who sees me suffer through it every day.
Living With Pain, Advocating for Myself, and Finding Hope
As I continue this journey, I realize the possibility exists that I may have to live the rest of my life in constant pain. It’s a reality I find difficult to accept, and I’m trying to navigate through it with as much hope and resilience as possible.
Reflecting on all I’ve been through, I realize how vital it is to advocate for oneself in the medical system. It's been a challenging road filled with frustration and setbacks, but I remain hopeful that the right treatment is out there. I've spent $4,500 and 18 months on my pain, and while the answers have been elusive, I’m not ready to give up. My journey has taught me resilience, the importance of asking the right questions, and the value of persistence.
I ask you, what would you do if you were in my shoes?
