A lot of people wonder if they have a similar condition to mine – a curable imbalance that’s causing all of their osteoarthritis symptoms. Many assume that their case must be different because they have OA diagnosed in so many joints.
Here’s a list of my symptoms:
- Hip pain and stiffness diagnosed as ‘classic hip OA’
I had tightness, soreness and extreme loss of hip range of motion in all directions. Soreness would vary from groin, side of hip, front of thigh, deep in the gluteal muscles. For the most part it didn’t hurt at rest and didn’t hurt during activity provided I didn’t try to move in ways my body didn’t want to move. I still managed to stay active. HOWEVER – I used self-treatment of tight knots in the muscles from day one and that helped keep things under control.
X-rays showed degenerative changes in both hips. No details were given in the report. I later had an x-ray done by a chiropractor and (for what it’s worth – I’m not sure how reliable his skills were) he said that the degenerative changes were fairly mild and worse in my non-symptomatic hip. He was more concerned about the degenerative changes in my neck and spine.
Physical examinations revealed a ‘hard end feel’ that I was told was bone hitting against bone. This was explained as being due to joint degeneration – probably cartilage loss or bone spurs. This was deemed to be a structural issue and therefore improvement in range of motion was not possible.
Occasionally I’d get a tooth ache like pain deep in my buttock. That did keep me awake at night but normally it didn’t last for more than a day or two.
- Stiff, painful neck and thoracic – unable to look behind me when driving.
This was present for the whole 8 years that I was suffering from OA. I learned to live with it and accepted it as normal. It wasn’t intense pain. But it was very restrictive.
I had one short spell of a few days where I had intense, uncontrollable neck pain that required an emergency doctor. But for the most part this was more irritation than anything.
- Severe Shoulder Impingement
My shoulders were tight and restricted long before I was diagnosed with OA. However, in 2012 – 6 years after the OA diagnoses – I developed severe shoulder pain, bone on bone impingement and virtually no pain free range of motion. It was a 10 on the pain scale when I attempted to move my shoulders – otherwise pain free. Although at night it was difficult to sleep without aggravating shoulders.
- Six months of severe chronic pain that could not be controlled by drugs
At first the pain was mostly at night. I’d be kept awake every night getting at most 2 hours before having to get up and walk about. Later I had the pain 24/7 and it became more intense. I felt it in my hip, down my thigh, my knee, my calf and sometimes my foot. In anyone of those places or all of them. It was a relentless ache that became extremely painful. Sometimes I’d spend 3 days and nights on the floor unable to sleep, move or do anything. It reached the stage where the slightest touch caused excruciating pain.
- Bunions
I developed a bunion on my big toe on left foot and little toe on right foot
- Achilles Tendonitis
- Plantar Fasciitis
- Prone to sprained ankles – I had a few over the years
- Waking up with numbness and tingling in 4th and 5th finger of both hands
- Extremely immobile – I couldn’t tie shoe laces, put on socks, pick things up from the floor. I felt as if I had a stiff rod running down one side of my spine.
- One leg felt too long – I couldn’t stand with feet side by side without bending my knee
- When lying on my back one leg remained flexed at the hip – I couldn’t lie with my leg flat on the bed
I never consulted a doctor about the other issues – I had no faith in them. I went to the doctor a couple of times when I needed pain relief drugs but mostly I managed things myself or consulted a private physiotherapist or similar. If I had gone to my GP, then based upon the diagnostic criteria for OA and the fact that I had already been diagnosed with hip OA I would have almost certainly been diagnosed with OA in many of my joints. Yet ALL of these symptoms were a direct result of my muscle imbalance and all went away when I resolved the imbalance.
I was having a discussion today with a lady who shared many of my symptoms but her most painful joints were her hot, swollen fingers. She asked me how that could be connected. My initial thought was that it was unconnected. However, upon researching trigger point involvement in fingers I discovered that:
The trouble with having pain, numbness, tingling, stiffness, burning, or swelling in your wrists, hands, fingers, and thumbs is that it will be too quickly labeled arthritis, bursitis, tendinitis, carpal tunnel syndrome, or peripheral neuropathy. Too often, say Travell and Simons, these are mistaken diagnoses.
Pain Referral
It may surprise you to learn that these abnormal sensations rarely originate in the fingers and hands but are almost always the effects of trigger points in muscles of the neck, chest, upper back, shoulders, upper arms, and forearms. This is called “referred pain.” Trigger points typically send their pain elsewhere.
The imbalance that caused all my other symptoms certainly causes tension and trigger points in the neck, chest, upper back, shoulders and arms. I suspect that this explains why I used to get numbness and tingling in my hands at night. Painful fingers could very well be a symptom of the underlying imbalance – although it’s not a symptom I experienced.
It makes perfect sense that this particular type of imbalance could also result in knee pain/wear, ankle and foot problems and back pain. I expect the exact symptoms will depend upon lifestyle and each individuals personal ‘weak spots’.
Don’t underestimate the problems that a seemingly harmless muscle imbalance can cause!
Please comment below if you have any questions relating to symptoms – for example, if you want my opinion as to whether a symptom you are having might be connected. It’s through questions that we build a clearer picture! Please help me to spread the word – I’m doing my best to help others with similar problems find a solution.
There’s already lots of self help information online and more being added regularly. I’m also working on a self-help guide that will take you step by step through establishing if you too have a muscle imbalance and how to go about resolving it – it’s proving challenging explaining everything as it’s going to need lots of diagrams and video so please bear with me!
I’m also in contact with research centers in the hope of getting some ‘official’ help with researching this further – that’s proving VERY challenging but I’ll keep at it! If anyone has relevant contacts then please send them my way!
Author: Susan Westlake
Visit my website to find out more about how I cured my hip osteoarthritis. Find out if you can achieve the same through corrective exercises. If you want to be informed of updates please sign up for my mailing list.
I have degerative disease of the cervical spine with multi level disc bulges and herniation exit foraminifera narrowing and spinal canal stenosis worse at c5 c6.I have extreme pains on my neck and lower back to the bag of my leg and foot.I also have extreme fatigue and brethlessness expecially when I’m lying down.I don’t want to go for sugery but I need help for my pains and feeling weak and sick all the time
Hi,
Firstly I thank you for putting time and effort into something you truly believe in. It’s a great resource.
When reading your story, a lot of the things you mentioned, I have experienced.
I was told only 2 months ago I have signs of wear and tear in both hips and SI joints. Diagnosis based on mri scan.
My pain has never been that bad being honest but I am a competitive runner and I have always felt a little hampered in my gait.
At present, I am running about 25 miles a week, yoga twice a week and 1 class of spinning.
I have all the gear, foam roller, theracane, trigger point book etc etc Also I go to physical therapist once a month or so. He tries everything I believe but after a while my pains come back even though I feel like I am doing the best I can.
I have accepted the diagnosis, but somewhat reluctantly!! At 38 I am still young, and if I am to be honest I feel that imbalances could be causing a lot of my problems.
Just not sure where to start with trigger points, how long to spend on them plus will trigger point therapy alone get me back to being injury free.
Any tips, even a page in the book ? would be great.
Currently have pain in my low back, but more towards side of the hip bone or si joint. Physio mostly tells me it’s my psoas/iliacus but just wondering why it’s always this and how to stop this imbalance,
Thanks in advance for any advice
Clive
Hi Clive,
Chances are you have something similar to me going on.
It’s hard to explain without writing screeds (I am still working hard on the book but it’s taking forever!). In short, think of your body as a bundle of bones controlled by muscles. The muscles determine how the bones sit in relation to each other – so muscles determine posture and movement. It’s all finely controlled by the brain/nervous system.
When everything is functioning well your normal resting/standing position will be perfectly balanced. Mechanically, everything is working as it should – efficiently – all muscles are in the optimum position to exert force without being strained and joints move in a smoothed and balanced way.
Our bodies are ‘designed’ to adapt to what we do most. This is important for survival in ever changing environments. It helped us to survive and evolve, but nowadays it can be a double edged sword. For example, if we do lots of weight lifting we’ll get stronger. If we do lots of stretching we become more flexible. The downside is that our bodies can become ‘over-specialised’ in ways that harm us. For example, too much sitting; too much one sided activity – too much repetition of a movement at work or during sport.
The end results is that our nervous system permanently adjusts the resting position of our muscles to make us better at what we do most. So for example, our posture may change to a typical ‘desk job posture’. Some muscles are overly lengthened, some overly shortened – the forces acting on our joints have changed and our joints now move in an abnormal way. Joints may start to wear abnormally. The skeleton is no longer lined up normally so the attachment points for the muscles has moved. They can no longer work the way they were ‘designed’ to work. This can lead to a muscle lacking the mechanical advantage it needs to do it’s job so other muscles try and take over. This prevents them from doing their job. It also pulls the skeleton further out of alignment making the whole situation worse.
No one knows for sure what trigger points are. But think of them as tight knots or bands in the muscles due to them being overworked and strained. Normally because of the scenario described above. It’s known that massage can ‘release’ trigger points. But if normal structure isn’t restored they’ll probably come back.
So, regular trigger point massage can help alleviate symptoms. **IF** your structure is out of alignment BECAUSE of a trigger point then massage can cure your problem. But in practice it is going to be extremely rare to find a case where one trigger point is the root cause. Typically you’ll need to reset the tension in muscles throughout the body and re-learn correct movement patterns and posture to put things right permanently. AND THAT’S THE TRICKY THING!
Desk jobs etc tend to cause front to back of body imbalances. So shoulders forwards, lower abs lengthened, low back tightened. Chances are that you’ve got both side to side and rotational imbalance. It will almost always ripple through the whole body, but it’s helpful to look at what your pelvis (or more specifically, sacrum) is doing as that will reliably predict what is happening throughout your body.
I suspect that your sacrum (at rest) is rotating and tilting. This will cause (or may be the result of) a cascade of tight, lengthened, weak, overactive muscles throughout your body. Your physio will have identified some of the dysfunctional muscles but half of the problem is that your body is now incapable of moving correctly. Corrective exercises assume that you’ll use a certain muscle to move a certain way – dysfunctional people use the wrong muscles to move so the exercises don’t work.
They key is to find out what your sacrum is doing. That’s the starting point. I could tell you how to do that yourself, but as you’re seeing a physio ask him? He might say it’s not relevant, but I think he’d be very wrong. You want to know what way your sacrum is twisting and tilting at rest.
You may have noticed for yourself that your pelvis seems to rotate back on one side? That one leg feels longer than the other or that your pelvis is hitched up on one side? This would also give clues.
This would be your starting point. From position of sacrum we can reliably figure out what’s happening in all joints/muscles. Then it’s just a case of slowly but surely coaxing your body back into correct alignment. When that’s achieved (which can take a long time), chances are you’ll have no further symptoms or wear. In my experience and from looking at what research is available I think normally the actual joint wear is a bit of a red herring. It’s the soft tissue that’s complaining about being strained and overworked.
Just one more thing to keep in mind. Your body works by kind of pivoting around a central point. So if you have problems in one place then guaranteed you have mirror image problems elsewhere. So you can’t have overly tight muscles at the front of your body without having overly lengthened muscles at the back; if your pelvis is rotated back on the right then guaranteed it’s rotating forwards on the left; if it’s tilting to the left then guaranteed it’s hitched up on the right. It’s no use just going after the tight, painful bit (e.g. your psoas). You have to look at the whole body to find out WHY that psoas is tight. No point just trying to stretch or massage out the pain – find the source of the problem.
See what your physio says and get back to me. I’ll do my best to help – I think (hope) the book will make everything crystal clear – I’m working SO hard to make it easy to understand. But it’s still a while before that’s ready. Happy to help out vie email or here till then.
Thanks a lot for the response. Yes most of problems seems to be down to the pelvis been in a torsioned state on right side. Not anterior or posterior tilt but actually twisted. Now I don’t know why this happens, I suppose that’s a problem. Regarding work and sitting – I have used a standup desk for 4 years now as previously was having back trouble but the minute I switched, the back improved. I actually find it hard to sit for too long as i find I have to keep moving to get comfortable.
Anyway appreciate your message and would be interested to get your book when it is out.
Thanks again
You’ll find a link to my mailing list further up the page. Sign up for that and I’ll let you know when the book is ready. It’s taking me longer than I expected I’m afraid. I’m in contact with lots of people with this problem and from their questions I’m realising I need to go into much more depth than I originally intended.
This past month I’ve had so many people getting in touch for help and advice on getting started tackling this that I’m spending more time on emails – always repeating the same thing. So I’m planning on getting a blog post up today or tomorrow covering that info to save me repeating myself.
So check back in a day or two and hopefully there will be a little more info to help you until the book is ready.
Susan
thanks again Susan
Hi Clive,
Was just checking something and found your story on web page ……
Though its tough to say anything accurately without doing assessments for your body to find exact muscular imbalance but still after going though what you said, it seems that due to Running and spinning and lack of stretching of those muscle groups you are experiencing this muscular imbalance.
As per my experience it seems that you have TFL dominance over your Glutes Medius muscle and hamstring and Adductor muscle mainly Magnus and Glut complex over Lumbar Multifidus which is causing stiffness and lower back pain. you might also having Anterior tilted pelvic if i am not wrong ?
You need a good hands on loosening on stiff area like TFL, Hamstring, Adductors and Glutes, Vastus laterialis and Great Activation drills for those muscles which are inhibited and week like Glutes medius and VMOs.
In the end it is our habits and posture which creates all the trouble/muscular imbalances..
please try and apply and hopefully you will feel better after first attempt only.
Best Regards
Gaurav
Rehab Trainer
I have had two bouts of difficult to manage muscular soft tissue ailments and yes I can say that osteophytic changes was mentioned in my Xrays and other tests. My problem this time is that although I may have indeed had some level of muscle imbalance in the hip areas after ceasing work which required loads of walking, I followed that change of lifestyle up quite nicely with a bad fall, landing on my butt. It took 3 months for the whole range of symptoms to appear including damage to both ulnar nerves and the accompanying 4th-5th fingers on both hands went numb. I had the stiff neck, lower back and shoulders, intractable constant pain made worse when I tried to do anything physical. The council physios have been next to useless with zero hands on therapy and I am being guided by the actions of 2 past physios (exceptions to the norm) who were angels in disguise and treated soft tissue problems as a priority. In both cases it took months of concerted effort which included massaging the areas concerned, and in the case of my neck which had a constant crick in it, I finally got relief from the obvious imbalance and instability following 2 treatments of acupuncture for “scar tissue from a previous vehicular accident” it was said. So after months of not being able to lift my arms above my head, suddenly it all came good and I got the strength back.
For the first 9 months of my current injury I was getting 15 second pelvic spasms that almost would take my breath away. If i bent down to pick something up off the floor, my left leg would give and I would just have to keep going until my left knee touched ground. Severe overcompensating and tightening appeared to be twisting my pelvis and one hip appears fatter and higher than the other due to the soft tissue inflammation or build up and tension. At least 3 nights a week I suffered from restless leg syndrome.
I get bad knees that feel really tight and hurt walking down stairs or sometimes up as well. I even feel unexplained pain in my right foot. My middle back gets so tight that when I first lie on the ground it almost take my breath away. If I walk for more than an hour, especially in the heat of the day, I get home and the second I relax in a chair I can feel my muscles hurting. I can’t sit in a chair too long as my left leg will start going numb, if I try and run I get a numb dragging pain along from Left to right hip across my lower back & butt, almost like a constant ache. I am told my gluts have stopped firing???? But before my fall I had a chinese masseur tell me that my “bum was atrophying??” If I stand still for too long I feel stiff and sore as well. I am severely out of condition due to my immobile state during the first six months of my injury. It was easier to sleep on my couch and ball up with a blanket during the day to save money on heating bills that winter, so I went from 86kg to 98kg and am now 105kg. I also have depression and feel exhausted very easily. Before my last injury I was quite physically active and was able to pick up furniture items on a trolley using public transport and lug it home across town, a process that would take from 8-10 hours at times and felt like a complete workout. Now I avoid all lifting and fast or jerky movements, as my injury has been unforgiving and once set off can give me at least 2-3 days of pain each time. If I try to be social and go out for 2 or 3 days in a row, it is not unusual for me then to be forced to lay on my bed for another 3 or 4 in sheer exhaustion. All that muscle tightness and tension causes me to have migraines and when I get them they make me feel really tired for up to 3 days before one hits. I do believe that “good” rounded physios are like hens teeth these days and if I am unable to find one who can properly address what my body is doing, I fear my recovery will take at least another year or two. Private physios are more hands on in my experience in general, but the one I would have used is now retired.
It feels to me that most of my problem is muscle imbalance. So many areas are so tight they regularly hurt, which includes the arms. A week ago I managed to pull a chest muscle as well, just to make things absolutely “perfect.” During the worst of the spasm pain I never had to take painkillers, simply because as long as I avoided any more movement, the spasms would stop after about 15 seconds, so I feel very lucky compared to some.
Was diagnosed with OA about 15 years ago when finger joints started gnarling and aching. Received cortisone shots in them which were painful and, in time, ineffective. Now 71 years old and in the past year have had OA diagnosis of shoulders with arthroscopic on one which was ineffective due “to amount of bone on bone and degenerative joints”. Was told I would probably need both shoulders replaced within a year or two. Cortisone injections have helped for about 2 months. 2 months ago I developed very intense lower back, hip and knee pain. Been to Physiatrist who has injected spine and sacroiliac. Pain is a 8-9 as I am unable to walk. sit, stand, lay without intractable pain. Seeing a physical therapist who thinks my hip is as much muscular as degenerative joint. MRIs, CT scans. xrays indicate OE. Had EMG today with some neuropathy diagnose. Difficult to know what type of dr to consult with. Have second opinion appts set up with rheumatologist, neurosurgeon, etc. No one to “spearhead” this process. Curious why so many joints affected in such short period of time and if a systemic or immune system disorder.
Hi Nancy,
It sounds as if you’re having a tough time of it!
As you can see from my story I too had problems ripple through my joints – hip, shoulders, feet, neck. I forgot to mention here that I had a few episodes of crippling back pain where I was unable to get out of bed or even move due to immobilizing, crippling pain. Mine was all due to muscle imbalance. To try and explain in very simple terms I’d developed twisting in my pelvis. A combination of tight and weak,lazy muscles was causing my skeleton to be pulled out of normal alignment. This resulted in abnormal joint wear in joints all over my body along with pain and lost range of motion.
In my case I was able to rectify the muscle imbalance and all symptoms disappeared. Xrays had shown degenerative changes in many joints in my body. Yet when I got the muscle imbalances corrected it was apparent that those degenerative changes were asymptomatic.
You are lucky that you have a physical therapist that is able to identify this in your hips. If you have imbalance in your hips then I guarantee your whole body is out of alignment. If you want to mention my case to him then tell him that I had a twist in my pelvis that was the root cause of all of my problems. It was what osteopaths would recognize as a right on right sacral torsion. The pain was a combination of trigger point/myofascial pain and nerve pain due nerves being either compressed by tight muscles (femoral nerve) or stretched (sciatic nerve) by the tilting/twisting of my sacrum. I am happy to share info with him if it can help get you some relief.
It’s possible some of your pain is due to irritated nerves. I had good results getting that under control with trycyclic antidepressants. Although they’re labelled antidepressants they’re also very good at getting irritated and painful nerves to settle down. They take a while to work but they can be highly effective. Your physical therapist might be the best person to chat this possibility over with as he’ll have a better understanding than your doc of how nerves might be involved. If he thinks nerves might be involved he can explain to your doc and make sure you get the right treatment.
My other source of pain was trigger points – lots of them. Trigger points are tight knots in the muscles that can cause intense pain that can refer to joints and all over your body. They are treated through massage – including self massage.
Your physical therapist will also understand about shoulder impingement and how correct alignment of shoulders can put this right. With hips out of alignment so too will shoulders be. Now I know you say you have bad degenerative changes in shoulders but it is possible that with correct shoulder alignment that it’s possible to accommodate bone spurs etc. I had bone on bone impingement yet my shoulders are now fine – to the point where I can do handstands and pullups!
The big difference between us is I was fit and strong when I started having symptoms and I nipped things in the bud sooner. I managed to stay active and for the most part keep pain under control. Things never got as bad as with you. I’m a good bit younger than you. But it still sounds to me as if it’s worth talking some of the points I mention here over with your physio as he may be best placed to help you. It’s guaranteed that many of your symptoms are coming from soft tissue causes so it’s possible that the physio can at least help you resolve some of the pain.
If I can share any more info about my case that might perhaps help then please don’t hesitate to ask. I know the desperate feeling when you’re in pain and no one can do anything to help! But there’s always hope.
Susan
oh my lord – this is me to a tee! if you can help me I will be forever in your debt. where do I sign up?
Hi Nancy,
Drop me a line via the contact form on this website. If you answer a few questions about your own condition I’ll be able to give you a good idea as to whether my approach is likely to help you.
Alternatively, just keep following the blog and website as I’ll be adding new info regularly. I’ve got lots of material but it’s just finding the time to get it all online!
Susan