What Causes Persistent Pain In Both The Hamstrings When Standing?

Posted on Mon, 25 Apr 2016

Question: For almost a year, I have pain in both hamstrings. It is normally only first thing in the morning and only when I stand. Sitting or laying is no problem. Light stretching helps some of the time and sometimes it makes it worse. It normally disappears at some point if I remain active ranging from 30 minutes to a couple hours. Is it neural or physical and what can I do that might remedy the problem or at least relieve it?

Answered by Dr. Aashish Raghu (1 hour later)

Brief Answer:
Slip disc, knee arthritis, fatigue, dehydration, overuse

Detailed Answer:
Hi there.

Thanks for the query.

Do you have pain in the knees while squatting?

Have you done any recent unaccustomed activity like sprinting?

Tightness of the hamstrings with pain can be found in a number of conditions. Most commonly, a recent unaccustomed activity like jogging, running without adequate warm up time. Other causes include slip disc, arthritis of the knees with cysts, dehydration and fatigue.

If there is slip disc, you can have radiating pain from the lower back to the lower limbs with tingling or numbness. Knee arthritis would make it difficult to squat or climb stairs without bringing about pain in the knees.

It would be best to apply hot packs to the painful regions. Keep both the limbs elevated to about 30 degrees from the bed level. Eat plenty of fresh fruits and green leafy vegetables and high protein diet. Keep well hydrated. You can apply Volini spray for pain relief. You can take Tablet Diclofenac and Thicolchicoside combination twice a day for 5 days after meals and Tablet Ranitidine 150mg twice a day for 5 days before meals. This will help in muscle relaxation.

Do get an Xray of the knees if you have knee arthritis or of the lumbosacral spine if you have back pain and upload for my reference.

I hope I have answered your query.

I will be available to answer your follow up queries.

Regards,

Dr. Aashish Raghu

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Aashish Raghu (46 minutes later)

Thank you for the response. I have no knee or back pain with squatting or any activities. I am in excellent health otherwise and quite active. The pain does not interfere with normal activities once it subsides. The pain does return if I sit or stand for several hours at a time. 90% of the pain is right in the middle of both hamstrings and 10% near the top of the hamstring where it attaches to the hip.
I play golf and am friends with a local chiropractor. He ordered an xray and felt it was a slight disc bulge at the L5 that was touching a sciatic nerve root. Even I know you cannot determine a disc bulge from an xray. He tried some of the normal adjustments and decompression machine. It helped slightly but did not stop the pain first thing in the morning. Again the pain is only when I stand and normally only first thing in the morning.
Do any of the medications above require a prescription? If there are some exercises for stretches that would help, I am willing to pursue those as well. If it is a disc bulge or slip disc, does it go away on its own or a way to resolve it without surgery?
Thank you.
Dr. XXXXXXX Corder

Answered by Dr. Aashish Raghu (5 hours later)

Brief Answer:
Back extension exercise Medicine require prescription slip disc conservati

Detailed Answer:
Thank you for your reply.

The medication does require a prescription.

There are many exercises for lower back stretching which you can find online or after consulting a Physiotherapist. These exercises include straight leg raising exercise, prone straight leg raising, stretches on a step etc.

Slip disc can be part of the degenerative changes that occur to the spine as of ages. It may not go away but can be controlled to reduce its progression from compressing the neural structures further and thus offering relief. As I have mentioned earlier, perform those exercises and follow the precautions for best relief. Surgery is indicated only in severe slip disc compressing the nerves dangerously enough to cause weakness.

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Aashish Raghu (12 hours later)

Tried the straight leg raise and the pain is in hamstrings not lower back. Would an MRI give definitive information on this? The new open MRI machines are giving really good images of the pelvis spine and hamstrings. As active as I am I do not want this to progress and interfere with normal activities such as golf. Would strengthening my hamstrings help or tighten them and make it worse?

Answered by Dr. Aashish Raghu (40 minutes later)

Brief Answer:
MRI good for detecting slip disc. Hamstring stretch needed to help relax

Detailed Answer:
Due to sudden unaccustomed activity, your hamstrings are in spasm.

They need to be stretched to relax.

Hot fomentation and exercises will help.

MRI will show you issues involved in your spine if present. It would be best to try the regime I mentioned for 10 days and if you do not find relief, you could consider an MRI.

Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Aashish Raghu (22 minutes later)

I tried a heating pad on my hamstrings yesterday after your advice while elevating my legs. After only 15 minutes the discomfort was completely gone. Amazing really, the affect that it had. So, based on the information I have given you, do you believe my problem is more physical (hamstrings) or nerve related. If it were nerve related it does not seem to me the pain would go away with activity each day.

Answered by Dr. Aashish Raghu (15 hours later)

Brief Answer:
More of a local muscle problem. Do daily soaks and gradually stretching

Detailed Answer:
That's good news that the treatment is working.

This could be a local muscle issue. Continue this treatment for 10 days and if you are symptomless hence, you may not get the MRI done. Drink plenty of fresh Lemonade and water daily to restore Electrolyte balance.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Aashish Raghu (31 hours later)

The word spasm seems accurate to describe the pain. It has cramped as well.

I intend to follow your prescribed plan for a couple weeks. The heat and stretching has already helped. If this does not yield a long term fix, can you refer me for an MRI so my insurance pays for it? The XXXXXXX Radiology which is less than a mile from my house has the new open MRI which is yielding good images of the pelvic, spine and hamstrings.

How many Alleve can I take? It helps when pain is a bit stubborn in going away. I notice the prescription strength is as much as 1000 mg. Thanks

Answered by Dr. Aashish Raghu (21 hours later)

Brief Answer:
Alleve 500mg twice daily only 5 days. Not possible to find out Insurance MR

Detailed Answer:
Hi there.

Don't take Alleve more than 5 days. It could cause side effects such as kidney failure or peptic ulcers.

You don't really need to get the MRI because it appears like localised spasm which would not yield anything significant in the MRI. However if you wish to get one you may do so. I doubt I will be able to find you MRI Centres around your region which accept insurance as such information is not easily available to us.

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Deepak