THR 10 months and still in pain<

Hi @MyJampa
It's nice to hear from you. I'm sorry you're struggling some.
Let's ask @Josephine to weigh in on your pain location and possible cause due to your activity.
I've tagged her for you so you'll need to check back in the event she has questions.
Remember also that there is a time difference as she's in the U.K.
I hope you get it figured out and find relief soon.
A great week to you!
 
I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
 
Hi @MyJampa
I've been tied up a good bit this weekend so sorry I didn't see you've popped in!
Good to see you on the forum but yes I still had issues crop up after 5 months...but many were activity related...we should be able to do more but we do something we haven't done in a while or overdo, and blam! Some new pain pops up?
Let's wait on Jo and see what she thinks..
Guessing you've eased up on icing like I had...that still is a Good idea when you rest up in evening!
Hope all eases soon.
 
Here y'go then!

It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are

1. what approach did you have for your surgery? Anterior, posterior, lateral? You can look here to see the various types THR approaches or incisions

2. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

3. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

4. are you icing your painful area at all? If so, how often and for how long?

5. are you elevating your leg. If so how often and for how long?

6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

7. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.
 
Hi @Josephine ,

Thanks for your assessment, here are my answers;

1. Posterior, from the back side 5 months ago 2/27/18

2. My pain level
As I sit or lay down is (0-1)
Walking I get some dull aching pains (1-2) below my scar which is more painful to palpation, Also pain in my glut, assume it might be my piriformis.
New pain two weeks ago, I started to get pain while walking around the middle of my scar near the top of my femur(2-3), with an occasional sharp shooting pain (5-6) If I apply a bit of pressure on the point of pain (where I can feel a little popping sensation) I can reduce the pain.

3. I am off all pain meds.

4. If I have been walking or on my feet and feel sore. (1-3 times a week) I will apply two packs, one under the hip and one to the side for about 45 minute. I did alot of icing earlier on, started cutting back around the 3-4 month after surgery

5. If I am sore when i get home or after a walk I will lay down and elevate my leg for and hour.

6. I work at an office job and sit 8 hours, taking small breaks to do light stretch and walk to the ladies room. I do some gardening which at times I get a little carried away with weeding. I cook and wash dishes (standing in kitchen 2-3 hours/day), and do some light cleaning. Will go to the grocery store 2-3 times per week.

7. I have been using walking as my main exercise (as suggested by Bonesmart), slowly building up the number of steps I do per day, Month 3 - 5000 steps/day, Month 4 - 7000 steps/day, Month 5 - 9000 steps/day. Was doing well until two weeks ago and now I am back to 4000-6000 steps/day. Having a hard time walking a 1/2 mile at a time.

Exercises;
After having my walking setback two weeks ago I started to do a few exercises;
Standing leg raises 2 X a day, 5 to the side and 5 to the back

Pt;
Did a little PT in the 2nd month after surgery but none since then.

I am signed up to start Pool therapy the 2nd week of Aug.

Side Note:
I do feel that I was lightly floxed (a term I have learned about referring to fluoroquinolone toxicity from taking the antibiotic) I feel that I have some lasting effects from the Levaquin that I was given at 6 week mark for a UTI/kidney infection. I have feelings that I have never had before; looseness or weakness in my joints, some muscle wasting, and when I push a little too hard I get an overall feeling of exhaustion like I have just finished a huge race and it is really hard to take another step. I know that I am healing much slower than I did from my TKR in 2015. I feel fortunate that i stopped taking the med after my second pill. Reading some of the stories of others is so sad.

Thanks again
 
2. My pain level
As I sit or lay down is 0-1
Walking I get some dull aching pains 1-2 below my scar which is more painful to palpation
Also pain in my glut, assume it might be my piriformis.
New pain two weeks ago: I started to get pain while walking around the middle of my scar near the top of my femur 2-3, with an occasional sharp shooting pain 5-6.
If I apply a bit of pressure on the point of pain where I can feel a little popping sensation, I can reduce the pain.
But this is all about your hip - is that all? Nothing on the knee?



4. If I have been walking or on my feet and feel sore. (1-3 times a week) I will apply two packs, one under the hip and one to the side for about 45 minute. I did a lot of icing earlier on, started cutting back around the 3-4 month after surgery
Okay
5. If I am sore when I get home or after a walk I will lay down and elevate my leg for and hour.
Okay
6. I work at an office job and sit 8 hours, taking small breaks to do light stretch and walk to the ladies room. I do some gardening which at times I get a little carried away with weeding. I cook and wash dishes (standing in kitchen 2-3 hours/day), and do some light cleaning. Will go to the grocery store 2-3 times per week.
Okay
7. I have been using walking as my main exercise (as suggested by Bonesmart), slowly building up the number of steps I do per day
OK
Exercises;
After having my walking setback two weeks ago I started to do a few exercises;
Standing leg raises 2 X a day, 5 to the side and 5 to the back
Ok but did you not read the BIG TIP in your recovery articles?

BIG TIP: Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

I still have a decent amount of pain in my hip mainly just below my scar. When I stretch my long walk over a ½ mile I get more pain.
Where do you get this second pain?

Also let me have a photo of your scar with you pointing to the area where you get this pain.
 
I have attached a picture of my scar, I marked a purple plus sign where the new pain is. (3-4 cm in front of the scar about midway from the top or bottom). I think it might be near the top of my femur. This is the point that I hold when it gets painful, and I can feel a soft popping feeling. Do you suppose I could have bursitis?

The one positive I feel, is that the pain is not always present. It is more bothersome when active.

I have tried so hard not to push myself, and held to walking, in the library in the "Activity Progression for THR" it says you can increase walking to 30 min at 4-5 weeks if it feels good. I finally got to 30 min (= about ½ mile) around 3 months and have been trying to slowly add to that as I feel up to it.

I have made an appointment with my OS for this Friday. I so appreciate any advice you have so that I can figure out what is going up with my hip and if I should be worried.

Regarding my knee, it still has pain but has not gotten any worse, and the new pain in the hip has made me forget about the knee pain. I have had three surgeries on the knee over the years and think that I may have some fibrous tissue building around the joint.

Thanks again for your help and advice.

MJ.PNG
 
Best wishes you can make some sense of this through Josephine and your OS visit on Friday.
I'm sure you feel as though your progress is stalled. I hope you get answers soon.
Please let us know how your appt goes...
@MyJampa
 
Thanks for the photo. It showed me everything I needed to know! Your problem is ITB (ilio-tibial band) issues and most likely coupled with Trochanteric bursitis. As you can see here, the ITB goes from the hip where the trochanter is, all the way down to the knee. The bursa is approximately where the red star is. So your two pains are very much connected!

ITB and TB.JPG
 
Hi @MyJampa
At least you're getting direction as to the source of your pain.
Will be interesting to see if your OS concurs tomorrow. Please let us know.
Hopefully with some rest and effective stretches you'll be able to move beyond the pain.
Wishing you well!
 
Thank you @Josephine for connecting the dots between my two pains. and @Layla for your support and concern. It is so nice to have some directions as to what I can do to relieve the pain. I have started to do some of the stretches (being very careful with the IT band stretch) and applying the acupressure and can already feel a slight bit of relief. I think I will wait to do the foam roller until I get the pain down a bit.

I will be interested in what my OS has to say tomorrow, and am glad that I have a better understanding of what might be happening. I will report back.:flwrysmile:
 
Got back from my OS and he also thought that it was Trochanteric Bursitis. He took and x-ray just to make sure that nothing looked out of place. He was happy with how things looked.

He gave me a one time referral to go to PT to get some good stretches for someone at my stage of a posterior THR.

I feel better having a reason for the pain and a potential plan to help relieve it... Hope :) :-) (:

He offered to give me a cortisone shot, which I said I would rather do other things first, since steroids can potentially cause problems with people who have reacted negatively to fluoroquinolones.
 
@MyJampa wow, thank you, I had no idea about the cortisone-steroids / fluoroquinolone connection.. and was recently considering trying the shots to get me through a longer timeframe between THR's. I have "NO Fluoroquinolones" notices all over my wallet and ID cards but never heard this until now. You may have saved me! It's curious how many people aren't aware of the burst tendon and worse issues from those drugs. I've stopped many a friend who started on them and casually mentioned their pain in the Achilles or legs...then you ask - You weren't prescribed levaquin were you? Yep. It used to be the antibiotic of last resort and seems now they distribute it off the top like candy. Black box warnings! Know what you're ingesting. Thanks again for the heads up and best of luck with the bursitis issue and stretching!!
 
Look at all the good information that comes from sharing here.
Glad your hip looked good.
Hope you have a great weekend!
 
Last edited:
Great news your hip looks good. I'm happy your OS's diagnosis concurs with Josephine's,
or you would have been in a conundrum, lol.
Hopefully the exercises will bring you swift relief. Please keep us posted.
I hope you have a nice weekend!
@MyJampa
 
Hi @1stSurgery,
Yes, I was given Levaquin for a UTI that went to my kidney after my THR. I had some strange tingling and pain in my left arm after taking the first pill, which made me read the drug info. I ended up taking a 2nd which gave me pain and tingling in both arms. I had been walking well with a cane at that point and was set to head back to work. I ended up using a walker for my first few days back at work. I had what they might consider a mild floxing and have experienced some tendon issues, unusual fatigue, and some muscle wasting. I feel lucky compared to what some people go through. Did you get floxed?
 
@MyJampa - oh I'm so sorry that happened after THR! What a mess to have to deal with. Thank goodness you'd read about it in time. I mean you'd think they'd at least tell patients it has an FDA black box warning!

I was only lightly floxed...had a reaction with tendons, but I know many who have suffered, so I'm like the levaquin lookout guard in my circle of close people. Hubby is a runner and they tried to give it to him for sore throat and because he'd seen all the studies and heard me over the years going on about it, he declined. The doctor later admitted that he was "on the payroll" of the company as a sort of representative of the product. A girlfriend took only ONE for a recent kidney infection, before I gave her the info --and she was already in Achilles pain and is still, a month later, having unusual muscle /joint weakness. Never had muscle tendon issues before. My mom ended up with a nasty ruptured tendon in back of her calf diagnosed as levaquin reaction. My Sister's feet and ankles swelled up HUGE right after taking levaquin, and on and on. You don't have to search far. Hope you're clear of it!
 
Hi @ Layla, @Mojo333
So it has now been a month of my setback with the hip bursitis. I am very hesitant to use anti inflammatories or cortisone shots (they can cause you to be symptoms of being refloxed and I do not want to go through that again) Due to the Levaquin I took. I still Ice a number of times per day, and have been doing some rotations with Ice and Heat. I went back to using my cane last week, trying to get more relieve and take stress of the joint. My pain moved from just in front of my scar (the picture I had sent Josephine) to behind the scar a few weeks ago.

I was suppose to start pool therapy a few weeks ago, but when I went for my first session and heard jack hammers. :nah: The pool was being remodeled. Instead of pool therapy I have gotten a couple sessions of light myofacial release which felt great while it was happening, but I can't say that it truly helped. The pool opens this week and I will start pool therapy this Friday.:roseshwr:

On a hopeful positive note... - Last Friday I have a different therapist and after I told her my story she looked at me and said, I have no doubt you are in pain. Her trained eye saw that I was standing with my left hip forward, which she said could definitely cause the pains that I am experiencing by putting slack in one set of muscles while stressing another. She showed me how to pull my hip back while I am standing, and to walk with a better gait making sure that I complete the stride on that left side. She also corrected my mechanics in a couple of the yoga poses I have been going, and told me I should get on my horse and ride. She is very excited that this should make a difference for me, I am hoping to heck that it will make a difference.

I feel a little hopeful, and am wondering if you know of any other hippies that have experienced things like this.

I actually think I had some of these same issues before surgery. I had lost quite a bit of range of motion in the hip which could have made me stand and walk with the hip thrust forward for a number of years.:umm:

I am 6 months out tomorrow and am still asking myself why I did this. I am no better off then I was before surgery.

Hope you are both doing well.
 
I want to be hopeful with you.
I don't know what the issue is but it sounds like not only does your therapist See what we Cannot...she has insight into what your true passions are and want to incorporate these into your therapy.
I was suppose to start pool therapy a few weeks ago, but when I went for my first session and heard jack hammers. :nah:
Oh my stars...you really do have some kind-of luck, eh?

Please know I am still working you all the best and recovery Can take more than a year.
Best wishes and healing hugs @MyJampa !
 

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