It was 3:20 in the morning when my leg jolted me awake, zinging with pain. It ran down my shin and across the top of my foot. The leg then gave a spastic jerk, bending at the knee and rapidly pulling up toward my chest. Then it slowly lowered, but the pain continued for several more minutes. Repositioning my legs combined with mentally trying to relax finally ended the episode, but this was the worst multiple sclerosis (MS) leg issue I can remember, and I’ve been having them for many years.
I thought I had this problem licked. I had, long ago, switched my treatment from the muscle-relaxant baclofen, then to Gabapentin, used for restless leg syndrome, and finally to Meloxicam, an anti-arthritis medication suggested by my primary care physician. But the pain still lurks at night, striking seemingly arbitrarily. The shooting pain usually strikes my left leg but sometimes it attacks the right. Once in a while, it targets both.
I’ve had minor left hip pain for many months, centering on a spot that feels like a lump under the skin or a bruise about the size of a quarter, and sometimes it radiates down through my hip and down the leg. It seems to follow the path of the sciatic nerve. So, maybe it’s nerve pain. But sometimes the pain seems more muscular, and sometimes I even wonder if it’s in the bone.
Getting up from a chair after sitting for an hour has triggered this zing and it will, briefly, become nearly impossible to stand or walk. When this happened a several weeks ago I took 200mg of Gabapentin, which I’d returned to using, plus an Advil, and I got into bed. But I could find no painless position and there no easing of the pain, which ran from the left hip into the thigh, for hours. I wondered if I’d broken my hip. Finally, after about three hours, I was able to fall asleep. Four hours later I awoke with the acute pain gone; just my usual Level 1-2 chronic hip pain remained.
What’s your diagnosis?
Is this due to my MS? Is it sciatica? Do I, at age 76, need a hip replacement?
My pain seems to be exactly what is described as sciatica on the Cleveland Clinic’s website.
“Most people describe sciatica pain as burning or like an electric shock. This pain also often shoots or radiates down the leg on the affected side. Pain commonly happens with coughing, sneezing, bending or lifting your legs upward when lying on your back.”
The website lists more than half a dozen possible causes, including herniated or degenerative discs, spinal stenosis, and osteoarthritis. Although I wouldn’t consider any of these direct MS symptoms, it seems likely that my MS-related gait could be a major contributor to several of those. (I might also be spending too much time sitting in a chair writing columns like this, my wife reminds me.)
The Cleveland Clinic folks also mention that having insufficient core muscle strength can play a role. Abdominal muscles help anchor the back muscles. If they’re weak, low back pain can result. I used to do resistance exercises regularly plus swimming. But, for various reasons, I haven’t exercised in months or done my regular swimming and pool walking.
So, maybe I’ve answered my own question about why my hips hurt. Although I usually caution people about self-diagnosing (the dangerous Dr. Internet), before I schedule an x-ray, MRI, or physical exam I’m going to try a few things: Back to the gym for resistance exercises, concentrating on my core. Back to the pool, for swimming and walking. And my watch has taken over from my wife to remind me, each hour, to get up out of my chair and walk around (which I just did.)
I also just changed the pillow on my bed and, guess what. Although minor pain remains, the really bad zings that I’ve been having seem to have gone away. I hope I’m not jinxing things by writing about it.
(A version of this post first appeared on the Rare Disease Advisor website.)
