Hip me out
January 25, 2007 11:52 AM   Subscribe

I'm 30 with bursitis in my left hip joint. Should I get an MRI as prescribed?

I think I sustained the injury running in September. I've been to physical therapy once a week since October, I tried a cortisone shot which I am reluctant to try again. The problem hasn't gone away and I have not been able to run since, which is my goal.
Now the doctor wants an MRI so "we can rule out whether there is any other issue"
With insurance, this will cost me about $200 so I am a bit hesitant to do it.
I know that bursitis is oftenm just a nagging thing and it's not like I can't live with it. Part of me is just inclined to think that I should give up running again as a goal and just live with it and hope it goes away, since I've been frustrated by the lack of success these other treatments (therapy, cortisone) have given.
Should I go ahead and do it?

Also does anyone have any experience they can offer me on how long it took you to cure this problem and how did you do it?
posted by chickaboo to Sports, Hobbies, & Recreation (26 answers total) 2 users marked this as a favorite
Do what the doctor says. If you feel iffy about it, get a second opinion. Don't make this decision on your own.
posted by Ironmouth at 11:54 AM on January 25, 2007

I have no experience with bursitis, but I have advice anyway: seek alternative consultation with a chiropractor. The problem in your hip could be caused by an underlying alingment problem. I had a hip problem which was never diagnosed but caused me a lot of pian. I sought alternative help when the doctors wanted to "go fishing" with an ultrasound. I saw a chiroprator who pointed out that my pelvis was aligned such that a lot more of my weight was being caried by one leg than the other. They fixed the problem for good over the course of three months, with 3 adjustments per week. And, to dispell the common chiropractor myth: once it was fixed I *didn't* have to go back ever again. It was much more expensive than an MRI, b/c insurance didn't cover all of it, but worth every penny.
posted by Eringatang at 12:11 PM on January 25, 2007

I've had multiple MRIs, which made a big difference in diagnosing the problems with my back, and I eventually needed surgery (successful).

$200 is nothing compared to being able to use your leg. Just think how much money you'll be out when you collapse on the sidewalk or your kitchen floor and then have to be taken to the hospital in an ambulance, and maybe miss weeks of work while you're laid up.
posted by bingo at 12:11 PM on January 25, 2007

Most runners I know, if you offered them $200 to give up running for good, or even just one year, would just laugh. So why let that amount keep you from it?

You are lucky enough to have insurance-- not taking advantage of it when an MRI could solve your problems is incredibly foolish and short-sighted. While you're hoping it will go away, you may wind up sustaining more permanent damage, costing you more in the long run.

Hips are not something you mess around with. You may be relying on that joint to move properly for another 50 years.

And yes, if you feel iffy about it, get a second opinion as Ironmouth says. Even if it costs extra.
posted by hermitosis at 12:11 PM on January 25, 2007

I successfully cured my suspected bursitis with a ten day course of ibuprofen at max OTC dose. ymmv.
posted by thirteenkiller at 12:14 PM on January 25, 2007

Go for the MRI. Yeah, it may 'only' be bursitis. Or it may not. There is really only one way to find out (well, there's exploratory surgery, but that's kind of overkill at this point, and carries its own set of problems). Bursitis often goes away when the source of irritation is removed, but if staying off the joint as much as possible and the cortisone shot and the PT didn't 'heal' it, there may be something in the joint annoying the bursa sac. FWIW, it took nine months for the bursitis in my shoulder to 'go away', so six months for a weight bearing joint isn't that bad, imo. And yes, after six months, the doc sent me for an MRI just to make sure there was nothing physically wrong with the joint.
posted by jlkr at 12:36 PM on January 25, 2007

I was diagnosed with bursitis in my early 20's (I'm now 37). I went the cortisone route and it sucked. Go for the MRI, just to be safe and rule anything else out. Then look into alternative therapies: accupuncture, homeopathy, message, etc. Those things helped me tremendously and still do. I still have the occasional flare up, but nothing like the incapacitating pain I had in the beginning. Good luck!
posted by kelzabel at 12:51 PM on January 25, 2007

How, exactly, did you injure your hip? At, or around the time of the injury, were you taking Prednisone for anything? I say do the MRI immediately and rule out Avascular necrosis.
posted by bkeene12 at 1:12 PM on January 25, 2007

hi thanks for all the great thoughts

There was no one moment Keene. I had two bad runs day on consecutive days and the pain never stopped after that. the best guess is, I tried to increase my distance in Aug and Sept going from 2 miles 4 days a week to 3 or 4 miles 4 days a week. They think maybe I didn't have the core strength for it. Though I still don't understand why I would be so markedly weaker on that side after the two runs.

Have also had some IT band issues so I don't think it's a joint problem.

I also had a bike accident 2 years ago and had a contusion on that hip. But I had felt fine in the intervening period so no one seems to think it's related.
posted by chickaboo at 1:22 PM on January 25, 2007

My philosophy - you've got one body, it comes with no guarentee and no warranty. It heals very poorly (usually just scarring over previously-functional tissue), and as it deteriates, it takes your quality of life with it. And then your life itself.

So when it comes to budgeting, anything health-related gets a blank cheque, and so I don't worry about the cost. It's only money. I'll figure out how to make cuts elsewhere later.

Get the MRI. You're too young to be risking future mobility.
posted by -harlequin- at 2:05 PM on January 25, 2007 [1 favorite]

I encourage you to get a second opinion. I got hip bursitis when I was 27. I'm 46 now and it's just as bad as it ever was. It comes and goes. Whatever you do, don't sleep on the injured side, don't ride a bike EVER, take lots of ibuprofin and, best of all: ICE. Ice really works well. This is such an easy condition to diagnose, I don't see why this doctor wants to send you off to an MRI. Perhaps you can say it's too expensive for you and he can offer another option. An x-ray and a blood test would show if you have arthritis, wouldn't it? Please don't waste your time on homeopathy or acupuncture. Both have been thoroughly debunked in the medical literature.
posted by Lockjaw at 2:06 PM on January 25, 2007

You're a step ahead of me . . . I've been living with pain in my left hip for too long and I did stop running. I recently started weight training and it seems to be helping my hip. I noticed that my left side is much weaker than my right. I don't know why this is, but it is. Maybe one leg is longer than the other? Maybe I favor one for some reason (due to other injuries?) I think it's worth strengthening the weaker side and getting an MRI.

I guess like everybody says, it's better to know and get it taken care of before it gets worse. Also, if you never get it checked (my shoulder) it seems like it goes away, but it doesn't quite - it gets messed up again.

I'd also be curious to know what kind of remedies are available -- both through standard western medicine and other (esp. eastern) treatments.
posted by nnk at 2:07 PM on January 25, 2007

Definitely get the MRI. For $200 you can put all the worry and speculation behind you and get on with your life. You will feel a lot better in knowing what you are dealing with. Sounds like you might of just worn out a bit early- over did it while too young.
posted by bkeene12 at 2:13 PM on January 25, 2007

Ok lockjaw now you're scarin' me.
I have been doing stationary bike 2x a week for my cardio - are you saying that's bad for it?

I agree ice helps a lot. My favorite trick (besides rolling a tennis ball over it) is to freeze water in a styrofoam cup and then rub that on there, tearing the styrofoam away as the ice melts. The styrofoam protects your hands and it' s amuch more intense icing than you get with a bag of peas etc.

Ok I am leaning toward the MRI. I guess I am being cheap.
posted by chickaboo at 2:19 PM on January 25, 2007

I buggered my right hip with repeated episodes of wildly uninhibited stoned barefoot spaz dancing (stupidly high-impact; sometimes my kidneys would bleed a bit at the end of the night, too). I lived with stiffness and pain for about four years. Then I bought a second-hand inversion table, and used it maybe once or twice a week for a few months. Every time I hung upside down in that thing, I could feel my hip totally loving it. It doesn't hurt at all any more.
posted by flabdablet at 3:49 PM on January 25, 2007

I had bursitis in my left shoulder in my 20s.

One cortisone shot cured it right up. There are complications possible with cortisone, but it really worked for me. It does involve a big needle going right into the sore spot, but after 2 years of not being able to raise my arm above my head, it was a chance I was willing to take.

Be careful taking high doses of nsaids though, especially for long periods. My sister had a friend who had to have some of her intestines removed because of advil abuse.
posted by vronsky at 4:36 PM on January 25, 2007

Sounds kind of like what is bothering me. A chiropractor and physical therapy have helped somewhat. Try these stretches.
posted by Frank Grimes at 4:58 PM on January 25, 2007

Oh and a bike seemed to aggravate (and probably caused) mine.
posted by Frank Grimes at 4:59 PM on January 25, 2007

Ok I am leaning toward the MRI. I guess I am being cheap.

Dude. You're young, yet you have a chronic injury that's not responding to first line treatments. The implication (though you don't say it directly) is that after a great deal of this, you've gotten, at best, nothing. At worst, the problem is now worse.

This is *exactly* when you start second level diagnosis. It could be bursitis, caused by impingment, until that impingment is gone, it'll never heal. It could be Avascular Necrosis. It could be referred pain from a spinal problem. It could be a hip knocked out of whack because of a knee problem. It could be gnomes mining for coffee gems, though I'll admit that's *really* unlikely.

However, it's probably not simple bursitis, because the simple treatments haven't done you squat. Get thee to another doc, if you wish, but personally, I'd be wiggling into the magnet.
posted by eriko at 8:27 PM on January 25, 2007

The MRI costs several thousand dollars, so $200 is a bargain.

You don't need an MRI for bursitis. It won't help make bursitis better.

But avascular necrosis of the femoral head, osteosarcoma, microfracture - all these things can be diagnosed easily and early with an MRI. Before they're diagnosed, though, they can be (and often are) misdiagnosed.

As bursitis.

Your body, your money, your decision. If I were advising you, which I'm not, I'd probably suggest going to get it.
posted by ikkyu2 at 8:58 PM on January 25, 2007

I think you should get the MRI. It's cheap compared to a lifetime of pain.

If they still can't find the problem after that, ask about blood tests, especially if others in your family have joint pain, or if you have ever had iritis/uveitis or other eye infections. I am about your age, and I have recurrent iritis and pain in my hips due to a genetic disease related to the HLA-B27 gene. It took me about five years of doctors and "why the hell does my hip still hurt, I hurt it dancing years ago" before my doctor spotted the gene in a blood test! I don't want to scare you, but please check out the blood tests for HLA-B27 if your doctors are still stumped after the MRI.

As for things that help with hip bursitis, try heat and ice, Advil, stretching, and prone lying (lie still on the floor on your back for 15 minutes or so). Acupuncture has helped me very much (and it HAS NOT been thoroughly debunked; there's plenty of evidence that acupuncture can work as part of a treatment regime for chronic pain.) Marijuana may also help with the pain. Avoid chiropracty -- it doesn't help anything, and depending on what's causing your pain, it might make things worse. You might try massage, though, if you can get it at the physical therapist. Massage always makes me feel better for a couple of days.

I'm not a doctor, just somebody living with hip pain, so please seek professional medical advice. Contact me at the email in my profile if you need more details about any of this. Anyway, I wish you luck, hope this helps!
posted by vorfeed at 9:15 PM on January 25, 2007

Well, if you make some very rough assumptions with the probabilities, you can reach this decision on your own.

Is it reasonable that there's, say, a 5% chance that there is something really wrong with you that could be fixed by surgery or medication that will cost you, say, $1000?

Would you pay $20,200 to choose "mobile and healthy" over "suffering from a debilitating injury that would be a lot better if we had caught it sooner"?

I would.
posted by Kwantsar at 10:35 PM on January 25, 2007

About a year after a femur fracture with surgery and a rod to repair it I developed a bursa in the left hip. Plenty of pain and occasional swelling that made it look like I had an orange in my back pocket. 100% cured by surgery to remove the bursa. No "alternative" medicine for me, no semi-doctors, no quackery. Now I have full mobility, can bike and swim without problems.

Hope that whichever course you follow you'll end up well and healthy.
posted by X4ster at 11:35 PM on January 25, 2007

Thanks to bi-lateral Avascular Necrosis, I had both hip joints replaced back in 1994. But I hurt, more and more, from the end of 1992 until I eventually had the surgeries in 1994. Prior to 1992, I was physically very active, and travelled internationally on business regularly. By January of 1994, the 11 steps from my bed to my bathroom at home was a long and painful journey. While on that long, downhill slide, I saw lots of doctors, including board certified neurologists who thought I had problems with my lower vertebrae, and treated it with steriod injections and a variant of TENS. I saw orthopedic specialists, who stretched my back, and sent me off to physical therapy. I lost weight, and did prescribed exercise routines, including lots and lots of ab crunches and leg lifts, while week by week, I was able to walk less and less. Eventually, I was referred to an orthopedic surgeon, by which time, even I could see in my xrays and MRIs that my femur heads were grinding through my pelvis. It shouldn't have got that far, but it did, under $18,000 worth of medical supervision, paid for by BCBS.

By that time, I need both ball and socket replacements in both hips. Not fun, and it basically took me another 6 months in 1994 to get over the surgery and learn to walk again, and finally, get back to work. I think about my artificial joints every day, and had to have the left one revised in 1999, when it broke while I was walking.

Have the MRI. If the MRI isn't diagnostic, pursue additional tests, until you find out why you are hurting. Don't treat yourself based on assumptions. Don't live by taking pain killers and keeping a stiff upper lip. Don't watch your world shrink, and think there isn't anything that can be done about it, or that it will get better on its own, if you tough it out. You're in pain for a reason, and someone, somewhere can tell you why, and what can be done about it.
posted by paulsc at 2:35 AM on January 26, 2007

wow you all are so inspiring.

Ok I'm going to go and gladly.

I didn't even realize how many people have been there (and worse) so that alone makes me feel much better.

If nothing else this has given me a lot of good ideas for where to go next if the MRI doesn't figure it out.
posted by chickaboo at 7:11 AM on January 26, 2007

Ok did it - now just waiting to go to the doctor. Just with an untrained eye I can definitely see a difference on the two sides, my boyfriend and I think there is more bone showing on the left. Still waiting for the results.
posted by chickaboo at 12:18 PM on February 1, 2007

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