19 year old with osteoarthristis in hip

Why isn't hip replacement an option?

I have OA and have had finger joint replacements, unfortunately not on the NHS

I 

I am sorry that your daughter is suffering so much pain and restricted mobility at such a young age. I have had arthritis since the age of 11 so can understand the problems this can bring thou mine was in the knee. 

I would suggest getting a second opinion from a hospital consultant first otherwise you could be going round in circles. 

This does not sound right at all to me. If you go on Google, and type in "top hip surgeons daily mail"  it will bring up a list of the top 10 voted by their colleagues. Choose one of these and call them for a private appointment. It will cost you about £250.   I presume you daughter has had an mri. Hospitals will give you a disc with the MRI results on to take with you if you ask - normally charge £10. 

Then go see one of these surgeons - who are al top guys in the UK - for an honest opinion.  If it varies a long way from that of your GP, then change GP or ask the surgeon to write to the GP to get you referred onwards.   What you ack here is a proper diagnosis. An MRI will enable a top surgeon to see what the hip/lower back issue is.   

I'd sort out the hip issue first and then worry about the Celiac issues.  Wilst you will have to pay circa £250 to £300 for the above, then you will be able to see a top guy within 2-3 weeks and then be able to sort out a plan depending on what they say.   Make sure you take MRI scan with you. Has your daughter had full blood tests - if so take the results of these too - the GP will be able to provide them for you. These are important as they will tell the consultant whether there is any infalmmation / lack of Vit D etc.  Tae as much with you as possible and tell them you are taking e.g. MRI - normally they ask you to turn up 30mins prior so the hospital can load it so the guy can see it with you there and then.  If you have no MRI, then ak the GP to refer you for one ASAP and argue for it. (They otherwise cost about £300).  You need an MRI so you can see the nerves and soft tissues - maybe she has a pinched nerve? Who knows? But it does not seem at least to me, they have got to the bottom of what precisely is wrong. I;d get a second opinion from a top guy as then you can plan and decide what to do and take back control of situation.  Hope this helps. 

http://www.houstonmethodist.org/orthopedics/where-does-it-hurt/hip/labral-tears/

this is quite a useful document also?

Hi,

I'll do my best to share any info, resources, experience and links that might be relevant.

When you present with joint pain doctors/surgeons will look for causes. They'll take xrays and MRI scans and if something abnormal shows up they will assume that's the root of your problem and they'll attempt to correct it with surgery. However, it's known that problems like degeneration of the joints (OA), FAI and labral tears aren't always symptomatic. These problems are frequently completely benign.

It is also known that muscle imbalance will cause not only cause pain and restricted range of motion but also wear to joint, labral tears and even FAI.

It's usually (always?) impossible to say that the abnormal findings on xray/mri are the cause of the pain and not just a benign symptom of a muscle imbalance....without first correcting all muscle imbalances. Of course, this NEVER happens. Which is CRAZY because correcting muscle imbalance and exercise is known to be the best treatment even if you do have things like labrel tears, FAI or OA!! Totally illogical not to go after the treatable soft tissue problems and ruling them out before going under the knife or taking drugs.

One of the problems is that health professionals are required to use evidence based practices. This means treatments that have been researched and shown to work. Scientific research can only answer simple questions that can be answered empirically. Evidence based research is excellent for determining whether surgery is effective or if pain relief drugs work. It's close to useless for establishing the effectiveness of physical therapy because physical therapy is highly complex and requires accurate diagnosis, a well thought out and personalised treatment plan and patient compliance. It can't be reliably studied; it can't be evidence based therefore it won't be used by evidence based medicine. Nor will it be researched. Add into the equation the fact that research is expensive and tends only to happen if someone has a vested interest in funding or sponsoring it and it's not hard to see why all we're ever offered is surgery and drugs.

Just because something isn't evidence based (proven scientifically to work) doesn't mean that it won't work. There are plenty of private practitioners offering unproven treatments. In particular in the area of correcting muscle imbalance. A lot is understood and there is a great deal of knowledge about what causes these problems and how to treat them. That's the good news. The bad news is that as there is no regulation and lots of people seeing it as a way to make a fast buck it's near to impossible to find someone with the skills needed to help you. Complex muscle imbalances are HUGELY difficult to correct. It takes a great deal of time and patience.

I'll try my best to give you some clues as to what might be wrong and where to go with it. This is all based upon my own experiences and research to cure myself. I don't have any medical training so take this as suggestions for things to try rather than advice on how to proceed!

How does she describe the pain? Trigger points (cased by tight knots in overworked muscles) can cause anything from tingling, numbness, sharp pain, aching etc. For example, the psoas muscle (hip flexor that attaches to the hip joint) can cause pains very much like menstrual cramps. It will also cause pain in hip joint, down front/inner thigh. Normally there are umpteen muscles involved though - not just one.

Another source of pain is an irritated nerve. That will tend to produce more of an ache or throb - like a tooth ache. Sometimes severe and uncontrollable pain. It will normally be accompanied by tingling or numbness down part of the leg.

Getting out of pain can often be acheived quite quickly when you figure out what's wrong. But it will come back if you don't address the underlying dysfunction - and that typically takes much longer to fix. But you do at least have a fairly normal life while you're working on it.

Describe her symptoms as best you can. Not just where she has pain, but what feels tight/sore? Is movement of her hip restricted? Does she have symptoms anywhere else - shoulders, neck, upper back, lower back?

Have you noticed anything about how she stands? Is one hip hitched higher than the other? Does she tend to stand with one knee bent? One foot forward of the other? Does her hip or shoulder rotate forwards/back on one side? Is one shoulder forwards - one hand rotated inwards when she stands? Tell me anything at all you notice about her posture and gait.

All these things can provide clues. Having a clearer idea of what's wrong helps you to find the best person to help you.

For what it's worth I was told I had classic hip OA, no chance of recovery, at one point I was told I had at most a year before surgery. I heard it all. Honestly, they just make it up as they go. I'm fine now. There's every reason to hope for a good outcome for your daughter. Stay positive.

Susan

What a shame for your daughter. Its very painful. I have tried everythibg from.oestos to chiro etc. Physio didnt hell either but one thing that did was going to a lovely warm pool and swimming. I have arthiritis in my knees n back and have been swimming now for 6 weeks..4 times a week and i cant tell u the difference in the pain. I can actually bend my knees now. Its true that if u build up the muscle around the pain area it helps a lot. I also use cold sprays and a cold ice oack every hour for 15 mins then followed by a hot water bottle. The ice reduces immflamation and the hear relaxes the muscles. Its worth a try. I also take aloe vera tablets and peppermint which i bought in holland and barrett. They r really healping me with ibs. Hope this is of some help to you.

Hi, 

dont know if its worth referring this note to your guys for comment?  

http://www.sciencedirect.com/science/article/pii/S0883540309002071