Trouble Walking on Left Leg

I recognise what you are saying, Gillian. I have been doing housework today against my better judgement and as I am right handed I find the stretching on this side results in pain and strain in my left leg and buttocks area. I think the answer is not to stretch for so long. Could hardly stand tonight for the pain. I went for a very short slow walk in the afternoon. Could hardly believe how little I could manage and how long it took. I could stride out before PMR and go for a longish walk at a good pace. Hoping tomorrow will be easier. I guess we all have to be patient but it must be harder for some than others. I don't think I am having as difficult a time as some. 

 

Constance, I'm 72 and had no problems until 2 years ago.  I did take Eilee's suggestion and try Bowen and have had 5 treatments with varying success.  On one occasion I had about 4 days after the treatment where I was able to walk fairly NORMALLY!!!!!  I recently dropped my medication faster than I should have and had a flare and I expect my made it more difficult for my Bowen treatments to work their magic. I'm upping my dose now and hoping the Bowen will be more effective.  Constance, is it possible for me to message Eileen directly to discuss this further with her?

Every time anyone writes on here a little envelope appears under their name.  Press on that and you can send a private message to anyone you wish.

Meant to add - I had the same walking difficulties and realized after a time that they were 'different' to PMR.  That is when I finally became aware that I had Osteo Arthritis.  That's why I asked the questions.  It's just possible you have a type of Arthritis.  A trip to your rheumatologist should clear this up?

You can always use the pm service - click on the little silver-grey envelope underneath people's avatars. Then you write a post that only the person it is directed at can see.

If Bowen had some effect then I'd say try more if you can afford it because there was some sign it was working. Alternatively - is there any chance of a really good massage therapist, preferably one who works on  myofascial pain syndrome? Someone in another discussion on another forum said she'd not got much help from Bowen but was able to find someone who was an osteopath I think but worked specifically on the MPS trigger points. They manifest as hard knots in muscles, in pairs, on either side of the spine in the shoulders, about rib level and in the low back. They can irritate/trap nerves and lead to referred pain - in the low back with effect that mimic sciatica. But sciatic can also cause weakness in the affected leg - and what you describe would also fit with my experiences of trochanteric bursitis. When that gets really bad it is very painful but it can also be low grade and make you feel unstable. That responds well to a cortisone injection locally - but I somehow get the impression your GP isn't going to come up with that!

They all jump on the "pred makes your muscles weak" bandwagon. I'm not convinced myself. And when it comes to muscular problems, on my own personal experiences, the last person I'd believe about them is an orthopod or rheumy. I was told there was low back wear and tear that nothing could be done about and I'd have to live with it. A physio and pain clinic specialist were horrified - it was blatantly obviously musclular in origin. Which was what I had thought originally but when a doctor says so categorically you do assume they might be right don't you? Luckily the physio and pain therapist went about it the right way! Plus a bit of Bowen - which I really must get another few sessions of...

thanks for you reply Ann.  It's truly bewildering.  I was just speaking to my brother who is a psychiatrist and asked him which physician is best trained to diagnose and treat my leg issues and he said it's your rheumy and endocrinologist whom I also see.

My suspicion would be MPS (see the response to Leonard) and possibly piriformis syndrome and trochanteric bursitis. Ask a good physio, preferably a sports physio. Bowen would also be worth a whirl. But as Constance says - I would think that!

Hi Ann,

i had what you describe and mine was piriformis syndrome. I didn't see my doctor but instead made a physio appt. and was pretty quickly diagnosed as she found the sore spot without much effort. She knows I have PMR so does her physio work with a lighter touch and with me giving her immediate feedback if it feels like too much. This may result in me needing an extra appt to resolve the problem but I had excellent results. 

Im in Canada so I don't know how your medical system works but if it was me I would get to physio and not wait around like your doctor advised.  My physio lady says its best to get it worked on sooner rather than later - easier to treat and less strain on the surrounding areas. 

thanks for your comments Mrs CJ.  I'm in Vancouver, B.C. and do have a sport physio I've seen in the past.  I spoke to him the other day and actually was going to see him yesterday but was in too much discomfort however I'll try to see him this week.  How would you describe piriformis syndrome and how it develops.  I've found most treatments with machines used on my body, and especially deep massage create even more pain and it takes awhile to settle down.  How might the treatment by a physio be different here from that of a massage therapist?  I'd be so pleased it I could get relief.

did your leg discomfort cause pain or strain on the upper inside of the thigh on our leg with each stride and make you feel like the leg couldn't support your weight fully?

The fact you feel worse before feeling better isn't always a bad thing - these treatments tend to release cytokines from concentrated trigger spots into the general circulation so you feel a if youa re having a flare of pMR until they are washed out of the system. Most complementary practitioners tell you to go for a gentle walk and drink plenty of water after a treatment for that reason and it does help.

Piriformis starts deep in the buttock, where you sit. It is nicknamed rich man syndrome - from sitting on a wallet stuffed with notes and kept in the back pocket ...

Eileen below described piriformis like I had - a pain deep in the butt but because it's such an ache it hurts to sit, walk and sleep. My physio person gently felt around the area and localized the problem and then told me what it's called. 

I don't know if a massage therapist can treat this as I didn't try that. My physio lady used her fingers to really work in that specific area.  It took several appointments for the piriformis pain to fully recede.  Nothing she did affected my PMR as she didn't do anything with enough pressure to cause me pain during her work. 

I got piriformis 2 times and for me it is caused by having my lower body in a certain position too long. The first time I was scrubbing floors and the second time I was weeding the garden - being careful to not overdo because of my PMR but not realizing that my lower body couldn't stay in one position for an extended length of time. 

My my doctor is not knowledgeable about PMR so that is why I say to just go to your physio person and see if they can diagnose you. We have enough aches without adding something else!

My pain was deep in my butt and it hurt to sit, walk, lay down. The pain radiated more to the outside of my leg and up the back of my butt than to the inside. I didn't feel that I couldn't support my weight but I didn't like walking more than I had to. 

Eileen

This is what happened and is still happening to me. However what it the cauuse and why does it happen?

What is the mechanism behind this condition of piriformis. This is how this myalgia started with me. It felt/feels as though I am sitting on rocks , both knees, ankles throb and feel as if I have ropes tieed arond ankles as they are so stiff and tight. I have the signs and symptoms of plantar faciitis as well.

What is the treatment for piriformis?

Wouldn't deep fascio massage aggravate the inflammation in the muscles?

Is it best to use heat pads/packs or ice packs?

What meds can be used t treat this? Do any foodstuffs or meds make it worse/better?

Lucy

It is basically a muscle gone into spasm for various reasons. In some people the nerve passes through the middle of the muscle group and when it is tight it can irritate the sciatic nerve, at a low level it is more weakness, when it gets worse it can cause pain too. The muscles in our backs do a wonderful job of keeping us upright - a position we were never designed to adopt. They cope with all sorts of things we throw at them - like leaning forwards to use the vacuum cleaner, sweep, lifting, doing gardening, all sorts of things that put enormous strains on the muscles. Eventually they give up the unequal struggle and go into spasm to protect themselves. Sometimes it isn't just the piriformis - it causes quite localised pain, but it sounds as if your lower back in general may be in trouble. 

Deep fasio massage will almost certainly make you feel worse before you feel better - because it will release cytokines from what are called trigger points in the larger muscle groups - a massage therapist would feel them as hard knots of muscle fibres and they are spots of concentrated cytokines, inflammatory substances, the same as are shed every morning in the body when you have PMR and cause the inflammation that leads to the pain and stiffness. Massage releases them into the circulation - so yes, you would feel worse in the short term.  But in the longer term it won't increase the inflammation in the muscles - the pred dose you take will manage that. If you expect that and can cope with it then massage would help. Another option is to get a doctor to give steroid injections into or around these trigger points - that means finding one who understands the problem, not an easy task. Quite a few people have found Bowen therapy will help with this process, it doesn't work for everyone and doesn't cure the PMR, nothing can do that - it can just help with what I call these "add-ons". I've had the benefit of all of them - I like all of the options and have had the luck to have them available to me at various times. You have to find what works best for you - and what is realistic. If you can't find a doctor who'll give injections you can't have them. The others are complementary therapies so you can find a therapist and pay for them without a referral.

Oh - forgot about diet - you can add food that help fight inflammation - oily fish, garlic, turmeric, for example - but that can only help, it won't do it on its own. I have never found anything makes much difference myself, MrsO on the other hand always noticed if she hadn't eaten her usual 3 healping of oily fish per week. Some people have found that eliminating sugar and other refined carbs helps - they are very inflammatory substances.