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Chronic Leg Pain in the Hamstring Area (Myofascial Pain Syndrome?)

Age - 30
Sex - M
Height - 5'5''
Weight - 160
Duration of complaint - 1 year and 7 months
Location (Geographic and on body) - Right Leg Hamstring Area, Rear side between the buttocks and knee.
Any existing relevant medical issues (if any) - None
Current medications (if any) - Advil (3 pills every night)
Include a photo if relevant (skin condition for example) - Area of pain: http://images.medicinenet.com/images/illustrations/hamstring_muscles.jpg

Around March 2014, I was doing my usual runs and then I felt a muscle snap in my right hamstring leg. There was severe pain in that area and it hurt terribly. I applied the RICE method to abate the pain but after about 2 weeks with no decrease in the pain I went to see a doctor.

I had an X-ray test that didn't show any bone fractures. The doctor didn't seem to care, he looked like he was in a rush, and just said I should rest it out; He gave me some anti inflammatory medications that I still use. After about another 2 weeks, I went back to see the doctor again for a follow-up; he gave the same diagnosis and of course more pills.

I cannot sit on a chair for more than 2 minutes, the pain becomes excruciating and feels like another muscle is about to pull. My right leg has to be stretched out all the way for the pain to subside a little. If I am docile for too long, the pain becomes more intense. Following a light run or fast walk, the pain seems to fade for a little bit (an hour or less) but it comes back.

I cannot drive in my car for more than 15 minutes as it becomes unbearably painful.

I am no longer with my previous employer and lost my healthcare insurance. I am self-employed and cannot afford to frivolously go to the hospital as I used to. I informally spoke with another doctor and he thinks I have Myofascial Pain Syndrome and says I need a trigger point injection to alleviate the pain.

My questions: Is it possible to get this treatment in a walk-in clinic and frugally pay out of pocket? Is there another diagnosis for my pain? What other treatment is available?

Thank you.
3 Responses
547368 tn?1440541785
Hello Lilmase,

Welcome to our Pain Management Forum. I'm sorry to hear about your undiagnosed Chronic Pain. Many of us have been there. It took me years to find the right DX (diagnosis). Thank you for providing a good picture into your symptoms. It's helpful.

Myofascial pain syndrome (MPS) is just a fancy way to describe muscle pain. It refers to pain and inflammation in the body's soft tissues. Often "bumps" or "lumps" can be felt in the affected area. These areas are very tender to touch. Obviously not everyone has those bumps - I do - but I do not have MPS.

You're right that one of the TX (treatment) of MPS is NSAID(s) non-steroidal anti-inflammatories.  The dose you are taking is pretty small and not frequent enough to be as effective as NSAIDs need to be when one has inflammation. Discuss your dose and frequency with your Pharmacist. They are a great source - and are free. Physical Therapy, Heat, Ultrasound and Massage Therapy is often ordered also for MPS. Trigger Point injections are in the arsenal of treatments - but remember they are TXs. Some ppl find the injections effective for short periods of time while others find they bring little to no relief.  These injections are not a cure - they are only part of an overall treatment regime.  First my friend in pain - you need a DX. If you have MPS you'll require good care - with repeat consults and TX.

I'm sorry that you do not have medical insurance. Today everyone should be able to afford some type of plan. If you haven't checked into ObamaCare I encourage you to do so.  I am not saying that I support the institution or continuation of ObamaCare. I'm not making a political statement. I just hate to see anyone without medical insurance and I truly encourage you to find a plan. We can't afford to be without insurance. We never know when a medical emergency can occur - like myself when I was hit by a loaded dump truck. Had I not had medical insurance I would have lost everything, my home and business. Remember also that with many conditions if they are left untreated they'll become worse or even untreatable. Please don't put off protecting yourself, your business and family (if you have family). Okay, enough of that - back to your question.

Before a medical provider is going to treat you, you'll first need to a DX (diagnosis). I highly doubt that with one appointment you'll find a medical provider that will accept your self DX  and give you Trigger Point injections. (Even though your DX may be correct.) When they r/o (ruled out) MPS with me - one of the things that they did do was Trigger Point injections. A medical provider may do the same with you. It's my guess they will want to do additional diagnostic testing. MPS is often a DX of exclusion - meaning you r/o other possibilities before you give that DX.  

Do you have a free Clinic or County Clinic in your area - or even a within an hour or so? If these clinics are not free  than they are usually on a sliding scale pay plan. These  clinics should be able to at least begin the initial work in the DX process - sometimes they do all the care and treatment.

I hope you'll keep in touch. I'll look forward to hearing from you again - and soon. If you have additional questions - or I wasn't clear on something please feel free to ask for clarification.  I wish you the very best - and hope something I have said will be of help. Best of luck.

Take Care,
~Tuck
1 Comments
Hello Tuckamore,

Thanks for your heart warm response.

I will visit the pharmacist first thing tomorrow and ask recommendations on the dosage. I am severely frightened at overdosing on pain killers; I have being using them constantly for the past year to help heal my leg.

One of the main reasons I am soliciting help from online doctors is to get a more accurate diagnosis and possibly visit a  hospital to request the treatment rather than trial and error which I cannot afford.

I have not looked into the community clinics around my area but I will definitely try those. When I had insurance, I paid (out of pocket ) about $500 to get medical care for my leg. Currently, I cannot afford insurance and I am in an awkward situation; I make too much money to qualify for any benefits from the ACA (Obamacare) but with my expenses, its simply impossible to pay for insurance.

The cold hard truth might be a frequent visit to a clinic to get the treatment I need which will probably keep me in debt longer.
547368 tn?1440541785
Thank you for your reply to my response. So often 'never know if our responses were even read - as ppl do not reply. It can be disheartening - so again thank you.

It's a sad truth that ObamaCare still allows ppl like yourself to slip through the cracks due to financial restrictions. It is far from the end-all, be-all it that was promised. Ppl are still often forced to chose between paying for insurance or food or housing.

I don't know much about the medical pay help available in TX, maybe other members from your state will offer suggestions. I know that in some states you can obtain a state voucher for a medical problem. That voucher pays for a one-time consult for a current medical issue. If the MD than deems it necessary to do diagnostic testing you're able to return to the source of the voucher and they will often pay for the recommended testing. You may want to look into that possibility. I'd first look for that county or free clinic. It's obvious to me that you need someone in your state to assist you in finding medical coverage (or assistance) that you can afford - it's out there - you just have to know where to look.

There are no on-line physicians on this site. It's my understanding that many of the on-line physicians do so as a supplement to their income. Most of the on-line medical help sites are not affiliated with a hospital or a clinic. These physicians rarely if ever make an actual DX on-line, unless it's for an obvious cold, sprain or flu like SX. If anyone knows different I hope they will enlighten me. If your DX was an easy, one the physicians you have consulted in the past would have caught it. I hate to sound pessimistic - but I really think that's a fact.

I understand your concern on over-dosing on NSAIDs. I'm not certain what you are taking - somewhere I thought I read IB - but as I reread I see you are taking a prescription NSAID. My suggestion remains the same - talk to your pharmacist and see what recommendations he/she can suggest. They may also offer suggestions as to local free or county medical clinics. Talking ti medical professionals in your area can be helpful. They know what's going on in the area - or even the state. Even contacting your county social services for suggestions may be helpful.  Often one person (medical) can lead you to another - and that's my hope for you.


I'll be very interested in hearing more from you. I wish I had a better answer for you. Again, good luck my friend in pain. I'll watch for your updates.

Take Care,
~Tuck


1 Comments
Hello Tuck,
I went to visit a pharmacy and they recommended I take aleve instead of advil but with less dosage. I currently take 2 every 12 hours (as opposed to 4 every 12 hours with advil). Just after 1 day, I felt the difference; it subsided from a level 10 to level 6. The other NSAID I took prior to advil was prescribed by my doctor (around July 2014) and I honestly cannot remember the name.

I will hold out on visiting the clinic for another week to await more results from the aleve medication.

Thanks again for your help.
547368 tn?1440541785
So happy to hear from you again.

I am very glad that Aleve is effective in reducing your pain. Aleve is a brand name, it's generic name is Naproxen. It is a non-selective COX inhibitor and a nonsteroidal anti-inflammatory drug (NSAID).

Be aware that it is often ordered along side a proton-pump inhibitor (PPI) in order to reduce the risk of GI distress including stomach ulceration. It is considered less corrosive than Ibuprofen or Aspirin. PPIs are medications like Prilosec. Again your pharmacist can help you with this if needed.

I know ppl that do have great results with Naproxen - unfortunately I am not in that group. If this does the trick for you - awesome!

Please keep in touch. I'll be interested to hear more from you. I hope you'll be active in our community.

Happy 2016!
~Tuck
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