Chronic pain following total hip replacement
Posted , 55 users are following.
Hi,
I'm Sue and I had both hips replaced in Feb and Sept 2011. Prior to this I had many years of pain and a great deal of difficulty with medical fields trying to determine what was causing my pain. Anyway once it was decided to replace both hips I was happy they had at last found a cause and what I thought was a solution. My first his replaced was my right and this seemed to go okay, it was a total different story with my left. I have been in excruciating back and leg pain since, I cannot walk any distance or stand for any more than five minutes. I need to use a wheelchair if I go out and crutches also, I am stuck at home all day while my family go out to work - I am frustrated and feel useless.
My pain is across my lower back and generates down my legs, my last three toes on my right foot go numb constantly. The pain is tingling, numbness, sharp, deep pulsating pain and electric shock type pain. The more I try to do the worse the pain gets. I spend most of my time with my legs raised as this helps, the pain never goes away but does ease when resting. I have painkillers and muscle relaxants but they do not really help. My hip surgeon like most of the forums I have read told me my hips are fine according to the MRI scan. He then referred me to the Spinal consultant, after nearly a year of seeing the spinal people they have now turned round and said the pain is not coming from my back and there is nothing they can do to help. I asked them what I was supposed to do and they said they had no answers!! I have attended all the physio appointments and even did a three week intensive course along with hydrotherapy - nothing has made a difference.
I lost my job due to all this pain and I am now registered disabled. I had more mobility (although painful) prior to my surgery than I do now. It was nice to read that other people are going through what I am experiencing (although I would not wish this on anyone) it somehow makes me feel better.
I have had numerous cortisone injections in the hips, nerve block of the L4/5 nothing has worked for me post surgery. I had cortisone injection prior to my surgery and guess what it helped - work that one out. I am now being referred to the Pain Clinic (again) and Rheumatology as it was noticed on one visit to the hospital that I had a butterfly like redness on my face and they queried Lupus (still waiting for those appointments - surprise, surprise).
Thank you for taking the time to read this and if anyone would like to respond I would be very grateful.
12 likes, 174 replies
Happyhopper sue87388_UK
Posted
sue87388_UK Happyhopper
Posted
cindy6649 sue87388_UK
Posted
I don't have any joint deterioration in my back so it was all caused by muscles. My husband, however, had stenosis in his back which also caused similar pain more severe like yours. It was more straightforward though and surgery to carve away the bone and "patch" the hole in the disc made his pain go away.
cindy6649 sue87388_UK
Posted
I have nerve damage to my lateral femoral cutaneous nerve that causes burning, tingling and extreme sensitivity in almost my entire thigh. That nerve is a sensory nerve that enervates the skin rather than motor nerves (sciatic and femoral) that control muscles and movement in general. You definitely sound like you have motor nerve damage but a sensory nerve may be involved too.
I also have tendonitis in my foot on my "good" leg and it has made it very difficult to walk and do exercises to heal my new left hip. I know how frustrated I've been dealing with something interfering with my recovery for 3 weeks. I can only imagine dealing with it as long as you have.
I sincerely hope the nerve block gives you some relief. Mine was just short of a miracle. I didn't have the nerve disabled afterward but I had a procedure called radio frequency ablation that burns the nerve enough to basically deaden it for about 6 months at a time. The doctors are still hoping mine will eventually heal so they don't want to do anything permanent yet.
Good luck and please keep us posted.
sue87388_UK cindy6649
Posted
cattwil sue87388_UK
Posted
Pain related to the Psoas muscle after total hip replacement. V Jasani, P Richards, C Wynn-Jones
Journal of bone joint surgery 2002
(Br) ; 84-B:991-3
I am not suggesting this is the cause of your pain but it is worth investigating if all other tests are negative. Good luck
sue87388_UK cattwil
Posted
Jodi-France cattwil
Posted
I had tendonosis (tendonities that never goes away and becomes permenent) in both legs from my hip to my knee for 3 years. The right leg, the operated leg way way worse than the left leg. My tendonosis was debilitationg. A shopping trip to the grocery store had me heading home to lay down on the sofa, yeah bad pain. I could not carry anything over 2 or 3 pounds in my right hand because that would add weight onto that leg and the tendon would hurt.
Tendonitis pain does not radiate pain that I have found. My husband also has doctors confirmed tendonosis in his shoulder. There is a particular tendon involved, like the one I have on the outer right leg, it starts at the hip and stops at the knee, so you don't get spreading pain beyone or past the knee.
You can feel the tendon, I can feel my iliopsoas muscle, I know right where it is, confirmed by my physical therapist. This type of pain is not described as radiating and tingling or numbness, but just rather straight up pain, it hurts, it's sore. I rested it and I am much much improved now.
My French physical therapist ocmes 3 times a week and basically massages my leg with massage oil. Then he manipulats it, bending it at the knee and pushing the laeg up into my chest (well not all the way but you get the idea). He supports the leg and pulls it out sideways etc. I had been resting that Psoas muscle as I knew from my previous bouts with tendonitis you need to rest it and let it heal, pushing it by exerciing it just keeps tearing the tendon and leaves scar tissue on the tendon which I have on my tendon between my hip and my knee. I mean I can really feel the sar tissue on the tendon myself, I know right where it is.
So this time when I realized I was having tendon pain, I stopped evrything and simply rested and tried not to aggravate it. My therapist last week when doing his manipulation exercizes the one pushing the knee up into my chest, caused the tendons in ront of my hip to snap. I felt it, it was two different tendons and gave me a quite clear snap, like snapping into place. It dind't hurt really but it was an odd sensation. Kind of like they were in the wrong place and now were in the right place.
What Sue describes is nothing like I have with my confirmed Psoas, iliopsoas. For Sue I go with what the others are saying as far as nerve damage. I have no issues with my back, thankfully. Typically the Psoas, iliopsoas tendonitis is desribed as groin pain. You might wnat to google iliopsoas tendonitis.
Here is a good article. obviously replace [dot]
www.ncbi.nlm.nih.gov/pmc/articles/PMC2642547/
Jodi-France cattwil
Posted
I had tendonosis (tendonities that never goes away and becomes permenent) in both legs from my hip to my knee for 3 years. The right leg, the operated leg way way worse than the left leg. My tendonosis was debilitationg. A shopping trip to the grocery store had me heading home to lay down on the sofa, yeah bad pain. I could not carry anything over 2 or 3 pounds in my right hand because that would add weight onto that leg and the tendon would hurt.
Tendonitis pain does not radiate pain that I have found. My husband also has doctors confirmed tendonosis in his shoulder. There is a particular tendon involved, like the one I have on the outer right leg, it starts at the hip and stops at the knee, so you don't get spreading pain beyone or past the knee.
You can feel the tendon, I can feel my iliopsoas muscle, I know right where it is, confirmed by my physical therapist. This type of pain is not described as radiating and tingling or numbness, but just rather straight up pain, it hurts, it's sore. I rested it and I am much much improved now.
My French physical therapist ocmes 3 times a week and basically massages my leg with massage oil. Then he manipulats it, bending it at the knee and pushing the laeg up into my chest (well not all the way but you get the idea). He supports the leg and pulls it out sideways etc. I had been resting that Psoas muscle as I knew from my previous bouts with tendonitis you need to rest it and let it heal, pushing it by exerciing it just keeps tearing the tendon and leaves scar tissue on the tendon which I have on my tendon between my hip and my knee. I mean I can really feel the sar tissue on the tendon myself, I know right where it is.
So this time when I realized I was having tendon pain, I stopped evrything and simply rested and tried not to aggravate it. My therapist last week when doing his manipulation exercizes the one pushing the knee up into my chest, caused the tendons in ront of my hip to snap. I felt it, it was two different tendons and gave me a quite clear snap, like snapping into place. It dind't hurt really but it was an odd sensation. Kind of like they were in the wrong place and now were in the right place.
What Sue describes is nothing like I have with my confirmed Psoas, iliopsoas. For Sue I go with what the others are saying as far as nerve damage. I have no issues with my back, thankfully. Typically the Psoas, iliopsoas tendonitis is desribed as groin pain. You might wnat to google iliopsoas tendonitis.
Try Googling for a detailed article
HSS J. Feb 2009; 5(1): 78–82.
PMCID: PMC2642547
Stacee sue87388_UK
Posted
I am keen to know how you are getting on and what your latest test results show.
I am 38 years old and my history is age 11 unstable SCFE left hip and right stable. Long story short I began to experience pain again aged 25 in the left side, and in my right side at about 31. Eventually after a lot of insisting there was something wrong, I got to see a surgeon who diagnosed FAI in the left side (secondary to SCFE). We knew the likelihood of it happening in right side was high as well. Bottom line, I had left hip replacement aged 36 and right hip age 38. I haven't walked without crutches since age 36, apart from in a house from room to room. My left hip continues to give me problems. It's to early to say that my right hip isn't going to be okay. At my last appointment (6 week post op check) my surgeon mentioned referring me to a rheumatologist for the first time ever, suggesting there might be something immuno deficient going on. I don't know if this is true. But all I know is that I used to be fine until I had the hip replacements. And since then I have had nothing but pain in my buttock, thigh and groin. I currently have groin pain only in my right hip. I am convinced that there is something not right with the operation. The left side was performed by another surgeon, so I don't even think it is that he wants to dismiss it because it was his work. So far I have had only x-rays and an ultrasound guided injection to the iliopsoas tendon. Even after the injection I still had the groin pain. We haven't had any further tests on the left side as we were hoping that the right side coming good would improve the left. It's not looking likely as I am now 10 weeks post surgery.
I found an interesting article about cementless stems causing thigh and groin pain which I thought I would share here as there seem to be a lot of people with various complaints of pain.
http://boneandjoint.org.uk/highwire/filestream/14830/field_highwire_article_pdf/0/507.full-text.pdf
I don't even know if I have cementless stems or not. I only know that the cup component in my left side is screwed in with 3 screws (due to shallow socket) and my right side is cemented. I would be interested to know if you have cemented/uncemented stem.
Thank you,
Stacee
cindy6649 Stacee
Posted
You're so young to have been through everything you've dealt with already. I feel for you.
I'm 45 and had FAI after a car accident almost 3 years ago. In May of 2013 I had a labral repair but it didn't repair enough damage so I had a thr in April of this year (8 weeks ago). I also have tendonitis in my iliopsoas and more recently in my tibial posterior tendon near my ankle on the opposite side. Although we assumed the ankle problem result from being on crutches for almost two years, my surgeon ordered some rheumatology tests. Much to our surprise, I tested positive for HLA-B27 and ANA. The results themselves don't confirm a disease but the are directly linked to rheumotological and auto-immune diseases like lupus, rheumatoid arthritis and other inflammatory diseases. Like you, I had none of these types of problems before my thr. I have no way of knowing if they are related at this point but I have to see a rheumatologist to find out what I can. It was my 6 week check up when my doctor mentioned it too.
I also have "stem" pain. It's uncemented and apparently I'm one of the 30% of people who get mid thigh pain caused by the end of the stem settling into the bone. My doctor said it will likely last 6 months to a year but will eventually go away. I hope he's right.
If you have tendonitis in your iliopsoas, the only thing that's really going to help is rest. I think it took about 3 weeks of not doing any exercises that irritated it and either lifting the leg with my arms to get in and out of the bed and the car or having my husband help me so I almost never used it before it got better. It flared up again a week later because I started doing too much too soon but I rested it again (it took less time the second time) and it's better now. It's pretty drastic not to use it but it really helps.
I hope things improve for you very soon but, if nothing else, you know you're not alone. 😊
sue87388_UK Stacee
Posted
I have been to the Pain Clinic and the consultant thinks my pain is related to possible damage of the nerves (which is what I have been saying all along). He has agreed to try medial branch blocks L3/4/5 for diagnosis of facetogenic lumbar back pain (these are injections done under x-ray). He thinks my leg pain is referred pain from my back but I am not convinced due to all the sensitivity. I am still waiting for this appointment to come through now, I was told there is a waiting list (surprise, surprise). I will know immediately if the injections work. If they do work I have been told they can then go in and permanently kill off the nerve root/nerves which should permanently solve my problems. I am quite excited at this prospect and have something at least to aim for as I had nothing before, everyone else had basically dismissed me and said they could do no more.
As for the Rheumatology appointment that was a joke. The consultant asked about my symptoms, read some notes then told me I had osteoarthritis and should not have been referred to him and that I do not have Lupus! No tests were done. I was basically dismissed like a naughty child. If these injections do not work I really do not know what I will do!
Both my hips are cemented and according to the hip consultant they look good. The second hip I had done (left) was pinned also - apparently to make it more stable. Hips done by different surgeons, left is the one I have most pain in. I do not have the groin pain I had before the hips were done.
Hopefully this is the year I get it all sorted out. Will keep everyone posted as to the outcome and good luck with your pain.
Stacee cindy6649
Posted
Thank you for your reply. My surgeon has never mentioned stem pain. I just have this feeling that something from the joint is causing my pain as I never had it before. I definitely would agree that I did have tendonitis (or a strain) in the iliopsoas tendon at one time (however the ultrasound showed that it was not impinged which was what I was worried about initially as I couldn't do a straight leg lift). My physio pushed me early on when I said I couldn't manage it, and I screamed in agony. And I agree with you, the only thing that healed it was rest and time. However, it was about 1 year before I could actually do it. I still have some groin pain, but am able to do a straight leg lift now. One thing I cannot do well is do the clamshell exercise. It seems that something is not working properly for some reason. I don't know if I have cemented stem or uncemented stem. I wonder...I might be in that 30%. Did you have your blood tests done by a rheumatologist or your GP then referral? Please could you let me know how you get on with rheumatologist? I look forward to hearing from you and HOPEFULLY improvement in your pain. Take care,
Stacee
cindy6649 Stacee
Posted
I had never heard of stem pain but it was in the fine print in the possible risks of surgery so it obviously happens. I'm not sure if it only happens with uncemented stems or cemented too. I've read that micro motions are the likely cause and since those only happen in uncemented stems, yours may be uncemented.
The iliopsoas can make life miserable. I still can't do straightleg lifts. Clamshlls are INCREDIBLY difficlt too.
My blood tests were done by my hip surgeon because he became suspicious when I showed up at my 6 week check up with severe pain in my right foot (my new hip is on the left side). Now he's referring me a rheumatologist for additonal tests. Apparently it takes several weeks to get an appointment so I will have to wait. However, I'm seeing a foot surgeon next week for an MRI to see if the tibial tendon is ruptured. At least I don't have to wait to deal with the foot pain.
Oh, also, don't ever let a therpist push you to the point of pain. It's unethical for them to do that because it can cause severe damage that they may not be able to correct. Not to mention the increased pain and slowed recovery for you. You know your body and what it can handle and when it's too much. No one else can or should make those decisions for you.
I will let you know when I know more about the rheumatologist. I hope things improve soon for you too.
Stacee cindy6649
Posted
cindy6649 Stacee
Posted
Thank you! I was 9 weeks post op on Thursday. My rheumatology appointment is on 7/14. Since I don't have any symptoms that I know of, they'll probably take a bunch of blood and test for lots of things. My therapist told me that she has patients who had tested positive for the HLA-B27 and ANA, like I did, but whose autoimmune diseases were dormant until triggered by trauma. I worry a little because a car accident started all of this for me. I certainly hope it hasn't awakened something else I don't want.
Until I know more, I'm going to stay positive and focus on tiny improvements every day. I'll keep you updated. You do the same.