Question
Hi Dr. Tran,

I have a question regarding this on/off pain in my right hip. I started having joint problems when I was pregnant two years ago. I had excrutiating pain in both hips, especially if I had to get out of bed after lying down; I had to take tiny slow steps at the beginning. The doctor seemed to ignore when I told her about it. This pain was only pregnancy related.
Now, two years later, I have different hip problems.  Some of them started when I started a contemporary dance class in December. The pain is somewhere below the iliac crest and it feels like a pulled tendon. I also have pain as if on the bone itself (iliac crest), they are both mainly noticeable when I step on the right leg; so with every right step, that's when I feel the pain. Also when I press on the iliac crest or tap it, I feel as if it is slightly bruised. The pain goes away a little if I don't exercise for a while, but it also seems to be coming back around the time of my period. When I have my period, I also have a dull ache in my right leg (not sure if it is sciatic pain). I am very puzzled since this leg pain is really there only around my menstrual cycle. Could these problems be affected by hormone changes? I am noticing sometimes that my joints in general (in wrists and ankles especially) hurt before my period.
One last thing. When I lay down on a hard flat surface, my lower back seems as if some pieces are not fitting in place and as I move slightly that causes pain. When I am standing and need to pick something up for example the bending also gives me a soreness in my lower back.
I am wondering if you could help me get some info on the possible causes of my pains, which increase and decrease at times, and if joint and bone problems could be hormone sensitive. I appreciate you help.
A.

Answer
Dear Anyka,

It seems your conditions are hormonally related.  The body will produce a hormone that will allow the tendons and ligaments to become lax in order to accomodate the expansion of the hip upon delivery.  For some women, this will reverse by itself while there are those cases where the conditions linger on.  

The ligaments are the tissue that hold the joints in place and stable.  When they are laxed, the joint will naturally become weakened and any movements involving the joint areas will produce a weakness sensation and pain to the joints because there is a lack of support.  

Since your leg pain is dull and achey in nature, I would not think it would be sciatica.  Since movements aggravate your pain, this would suggest toward muscles issue.  The changed in your joints' strength and laxity due to the hormonal change may have altered the function of your muscles to the surrounding area.  The pain associate with the menstrual cycle does confirm the hormone to be the root of the problem.  It is very common for people to have hip and low back pain during their pregnancy especially in the later trimester as the body is preparing itself for labor.  

The temporary advice I can tell you is to try heat and massage to the area to see if that alleviate the pain.  The best advice I would sugges for you to visit a Chiropractor or Acupuncturist who will be able to give you a definite diagnose with appropriate management once they have examine you.  

Best Wishes,

Dr. Man Tran
www.DrManTran