Uncovering the answer to a case of chronic hip pain

My husband suffered with hip and low back pain for about four months. It started right about the same time he was prescribed a new blood pressure medication. He didn’t think much of the pain at first because he was recovering from a groin injury, the result of a close encounter with a hockey puck while playing the game.

But the pain grew in intensity over the following weeks. He’s a bit of a tough guy and sometimes it takes some sleuthing to figure out what’s bothering him. As with most tough guys, Jamie tends to forge on with his normal level of activity even if something is wrong. I think that’s called denial. But he’d started applying ice packs to his lower back and hips each morning and night so I knew he was really suffering. I’d encouraged him to see our primary care physician, which he did for an overdue physical exam.

He came home that day, thrilled that he’d received such a good health report for a 58-year-old.

I asked him, “Did you tell Dr. S. about your hip pain?”

Jamie looked away.

“I guess so. It wasn’t so bad when I was in the doctor’s office.”

We’ve been married for 27 years. His reaction didn’t surprise me, but I was concerned about what was causing him such pain, concerned about his fatigue, the change in his mood, the wincing.

“Did you discuss the possibility of an MRI with the doctor?”

“No.”

“Why not?” Now I was annoyed.

“I don’t know. He didn’t bring it up.”

I sighed. I’m a health care advocate and have written two books on patient advocacy. You’d think my husband would have gotten wind of some of the information I’d been touting for all these years. I emailed our doctor and explained that Jamie might not have revealed the extent of his pain in the office visit.

Our doctor convinced my husband to see an orthopedist. After the appointment, Jamie acted cagey, tight lipped about what the doctor had said. He muttered something about inflammation and bursa.

“Bursitis?” I asked. “Is that what you

“I don’t know. I don’t want to talk about it. I have to get an MRI.” And he pulled out his phone and started texting. “We’re short a goalie for tonight’s game. I have to find someone to fill in for him or we won’t get to play.”

I wanted to shout, “What? You’re going to play hockey when you’re in this kind of pain?” But I didn’t say anything because I knew the answer. Jamie was scared that something was seriously wrong with this hip, worried that like a good friend of his, he might end up needing a hip replacement. That would put an end to hockey and skiing, sports he truly loves.

After the MRI, Jamie put off a follow-up appointment with the orthopedist to hear the results.

However, last weekend something interesting transpired. I had lunch with a good friend of mine and mentioned Jamie’s problem. I said to her, “I’ve never seen him in this kind of pain.”

She said, “Do you remember when John had hip pain? He stopped the statin he was taking and hasn’t had pain since.”

The light bulb blinked in my brain. I blurted out, “Jamie’s on a new blood pressure medication.” Could blood pressure medications have similar side effects as statins?

I raced home to find Jamie again on ice packs. Seated next to him, my computer in my lap, I researched his blood pressure medication. The side effects were fatigue, dizziness, muscle cramps, and more. I stumbled upon patient reviews and read them aloud to Jamie. “Muscle and joint pain, extreme fatigue, mood changes and dizziness.”

I had his attention then. “Yes, yes. I’ve been dizzy.” He hadn’t told me that.

My eyes on my computer, I said, “All these patients are reporting extreme fatigue, leg cramps …”

Excited now, Jamie said, “I had leg cramps when I took Lucy (our daughter) skiing. I thought it was because I hadn’t skied in a while.”

He hadn’t mentioned that either. But hope spurred me on. I read more out loud. “Extreme lower back pain, hip pain.”

We turned to each other. Could it be? Jamie urged me to continue. The more I read, hip and back pain popping up in most of the responses, the more he nodded his head. “I can’t believe it,” he said with more hope and enthusiasm than I’d heard in months. “Thank you,” he said, hugging me. He then confessed that he’d been dreading playing hockey every week because of the pain. “I don’t know how much longer they’ll let me stay on the league. I’m the old guy, you know.”

I understood right then just how worried he’d been, not just about the source of the pain but about growing older, losing activities that enhanced his vitality.

And then I got to thinking. How many people take new medications, have side effects, and write them off to other causes? And end up with unnecessary tests and misdiagnoses? We all lose sight of changes in our physical condition when we’re not paying attention. And who pays attention to their bodies all the time? Certainly not me, and certainly not men like Jamie.

But it is important to pay attention. If you have new symptoms, ask yourself if a new medication could be the culprit.

Jamie stopped the new blood pressure medication seven days ago. Over coffee this morning, he said with a grin, “The pain is pretty much gone.”

Martine Ehrenclou is a patient advocate.  She is the author of Critical Conditions: The Essential Hospital Guide to Get Your Loved One Out Alive and The Take-Charge Patient.

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  • Suzi Q 38

    Statins and BP medication can cause a lot of side effects.
    I agree, and stop the statin while you are at it.
    Once, the doctor thought I had asthma. It was my BP med. Once I discontinued it, and lost 20 pounds, the asthma stopped.

    As far as hockey goes, maybe he should give that one up.
    I have back and knee problems, and I suspect that playing soccer until I was 42 may have contributed to my pain.

  • DeceasedMD1

    bingo. No one can put these things together anymore in our broken HC systemd except for smart pts and their friends.

  • Marilyn Shively

    you really do have to be your own advocate and use the brain God gave you to figure things out. Your husband is a lucky man.

  • ninguem

    Martine Ehrenclou

    If you are following this, can I ask one question?

    It’s what I always ask when someone says they have “hip pain”.

    POINT to where it hurts.

    What people call their “hip”, varies significant’y. They ipoint to their sacro-iliac area sometimes, or the trochanter of the hip (laterally), to the groin area (where you find the hip joint itself.

    Fair enough, it’s generally the area where the leg connects to the trunk, but it makes a big difference in diagnosis.

    So what do YOU call the hip, with respect to your husband’s pain?

    • RenegadeRN

      Great question! Never thought about it before, but I won’t forget it.

  • Suzi Q 38

    “.. Good thing your doc was on top of things with side effects of your BP med….”

    I wish he was. At first, he told me “no way” when I questioned him about it. More months went by. I then looked it up on the package insert myself and enlarged the part in the package insert where it talked about side effects. He finally agreed.

    Like I have said before, the doctors are a lot smarter than we are, but we are more motivated to solve our own medical problems if need be.

    They can not feel what we feel. They rely on us to give them the information on why we hurt or what the problem is.
    Given that they see more than 30 patients a day, we sometimes do not get the evaluation or time that our medical condition warrants.

    If that is happening to you, you must do some of the research yourself, coupled with common sense.

    My doctor does not get annoyed when I do this. If it makes sense to him, he agrees!

    • Martine Ehrenclou

      Suzi, good for you that you did the research yourself. You’re right, doctors have the knowledge and the expertise and they are motivated to solve our medical problems but are just too overwhelmed with patient overload to go further than what they do. That’s where we come in.
      Sounds like you have a good doctor who welcomes your participation in care.
      BTW, you’re probably right about my husband playing hockey but he loves it too much to give it up just yet.

  • ninguem

    Continuing the mental exercise, then.

    Your husband tells you he has “hip pain”, and in fact you don’t know where he actually hurt.

    So, what did YOU think when he said “hip pain”? Where was the pain, in your mind, when he said his “hip” hurt?

    Then compare it to where he reports he actually hurt, see if you are both reading from the same page.

    See, how the patient can be hurting at the sacroiliac joint, and people, making assumptions, go off on a wild goose chase investigating the hip joint.

    Even more fun, if the person complaining of pain in the sacroiliac area, also happens to have osteoarthritis of the hip joint.

    The patient could conceivably get a total hip replacement, then everyone’s puzzled why the patient still hurts.

    • Martine Ehrenclou

      Hi again,
      My husband showed me where the pain was. He showed his physician where the pain was. But the pain had nothing to do with osteoarthritis of the hip joint or anything else because since he stopped the blood pressure medication, he has been pain free.

  • leslie fay

    I remember reading a story about a woman who was taking so many meds that she had to carry a tackle box around with her. Some meds were to ‘help’ the side effects for the other meds she was taking. Anyway, her daughter sent her med list to this pharmacist who specializes in assessing all the meds you take and what the issues are. Not only did he suggest reducing and changing meds but come to find out the woman’s Dr had told her she had asthma and prescribed inhalers plus some other meds because she had developed this dry cough-which just happens to be a known side effect of certain BP meds. Found a new doctor willing to try the regimen and voila’ tackle-box-be-gone.
    One of the most important skills a patient can have is to know when to trust their own instinct that something isn’t right and they need to look elsewhere. I always used to tell my patients that a doctor is really your employee(you are paying him aren’t you?) and just like when a plumber doesn’t fix your toilet correctly you find a new one. You need to have a doctor that you are comfortable with that listens to you.

    • Martine Ehrenclou

      Leslie, thanks for your great comment.
      I know several older patients who are on many medications, often, just as you describe, medications to treat side effects of other medications. So sad.
      You are so right–that one of the most important skills a patient can have is to know when to trust their instincts. Listening to the patient is an important piece to the patient-provider relationship and I couldn’t agree more that patients must be comfortable with their doctors. It’s exactly what I write about in my books.
      Your patients are lucky to have you with your approach.

  • Martine Ehrenclou

    Julia,
    Thank you for commenting. Good for you for uncovering the association of your mom’s blood pressure medication and her symptoms. You and she both must have been very relieved.

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