Hip Arthroscopy 3 months post op

[KnightHawk]

Hi everyone,
Had FAI and labral repair surgery on July, 21 2020. Have had a long history of hip/hamstring/flute/lower back pain. Was really hoping the surgery was going to improve my pain when I sit down dramatically. It did help with some of the actual hip pain(3 month post op went well doc said it looks good) and walking feels more natural now, if you guessed there was a "but" coming you're spot on. The pain I feel while sitting on hard surfaces is still severe to the point where I am unable to do without severe pain at least the rest of the day. Been doing pt this whole time and everything I was supposed to do. Now it feels like my muscles are thickening up quite a bit and have numbness in my legs, some doctors think piriformis, some think low back, some think problem in the brain with upper neurons. I do have tightness in my piriformis and low back/glute/hammstring area, it also feels like a thicker muscle as well (not sure how else to explain that).

Also on the hip that was operated ony, still dealing with nerve sensitivity issues and pain, was wondering how long anyone else had to deal with that? Any advice on what to do about spasticity in my muscles and severe pain while sitting down? I've tried ice/heat, foam rollers, cushions, stretching, all different kinds of medications. Not sure what direction to go now

 

[Jaycey]

@KnightHawk good to see you posting here - Welcome!

Have you had a followup with your surgeon since your op? What do they say about this pain when sitting?

And have you seen anyone about the lumbar pain? Does the illustration in this article look like the area where you have pain?

Regarding the nerve sensitivity and pain in your hip - this recovery can take up to 12 months or longer. How long did you ice the area? Ice for 45-60 minutes several times per day.

Another option is a TENs machine. I have chronic spinal pain and a few sessions with my TENs usually settles spasms.

A good physio who specialises in spinal issues might also help. I had very bad piriformis pain post LTHR. My physio did deep muscle massage to ease the tightness. I hurts like the dickens when they start but muscles ease off very quickly.

I'll leave our recovery guidelines for you. They refer to THR recovery but your recovery will be very similar.

Hip Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:

rest​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

3. Do what you want to do BUT

a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​

b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of this BoneSmart philosophy for sensible post op therapy
5. Here is a week-by-week guide for Activity progression for THRs
6. Access these pages on the website

Oral And Intravenous Pain Medications​

Wound Closure​

Pain management and the pain chart
Healing: how long does it take?
Chart representation of THR recovery

Dislocation risk and 90 degree rule
Energy drain for THRs
Pain and swelling control: elevation is the key
Post op blues is a reality - be prepared for it
Myth busting: on getting addicted to pain meds
Sleep deprivation is pretty much inevitable - but what causes it?

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.

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

 

[KnightHawk]

Hi Jacey! Thanks for your response. I will attempt to answer all of your questions.

I did have followup with surgeon and he referred me to Dr. Pascual in St Louis for ischial bursitis and hamstring issues as well. Some doctors I've been to see are convinced it is piriformis so I have another appointment with a doctor who specializes in piriformis syndrome. Also they are doing another lumbar MRI, last one I had showed some minor bulging goin on but nothing worth having surgery on. I also have an EMG scheduled as well. I also have had sitting pain before the surgery as well and has been a long term problem.

I have a TENS unit as well I use sometimes but it doesn't seem to help me a lot. I have a physical therapist but he doesn't do deep massage for me (even though I've inquired about myofascial release and dry needling) I have done some research on different types of tests that can help diagnose nerve problems that uses MRI and certain dyes to see the sciatic nerve. There is a place in Kansas city that has one but not here where I live. I feel so uncertain about how to determine which problem is the most important in my sit pain. Si joint, piriformis/glute muscle, hamstring, or even muscles in my lower back or disc's. I need to have some degree of certainty before deciding on a major surgery like piriformis surgery or hamstring surgery.

 

[Jaycey]

I had spinal decompression due to a trapped sciatic nerve. A good spinal specialist can diagnose sciatic problems from an MRI. As this is an on-going problem I would get as many opinions on the actual diagnosis as possible.

When are you having the lumbar MRI?

 

[KnightHawk]

The MRI is this Thursday.

 

[KnightHawk]

Here is my last mri last year

CONUS MEDULLARIS: Normal in position and appearance.
Conus ends at the level of L1-L2.
LUMBAR VERTEBRAL BODIES: No compression fracture or subluxation.
Normal marrow signal.

DISK SPACES: Disc desiccation is seen at the level of L4-L5 and L5-S1.


T12-L1: No stenosis.

L1-L2: No stenosis.

L2-L3: No stenosis.

L3-L4: No stenosis.

L4-L5: Mild spinal canal stenosis secondary to broad based disc
bulge, and ligamentum flavum hypertrophy. mild narrowing of the
foramina. No root compression.

L5-S1: Mild spinal canal stenosis secondary to broad based disc bulge
with central protrusion.Slight narrowing of the foramina with no
definite S1 root compression.
Root compression in the lateral recesses of S2 nerve root is not
excluded

PARASPINOUS SOFT TISSUES: Normal.


IMPRESSION:
1. Disc bulges at the level of L4-L5 with mild spinal canal stenosis.

2. Diffuse disc bulge at the level of L5-S1 with central protrusion.
Nerve root compression in the lateral recesses of S2 nerve roots.

3. Progression is seen compared to the previous examination at the
two levels.

 

[KnightHawk]

Mri got pushed back to later this week

 

[Softtail]

Sounds like you are going thru a lot Knighthawk. I had a laminectomy for compressed nerve this past January, and was not sure how successful it was untill getting both hips replaced due to them radiating pain into my back. Jury is still out ,and my back doctor says I may not fully know till a year from my last hip replacement. I do know at this point I am miles ahead of the back pain I experienced pre hip surgery so hoping all is good now. The back can cause some horrible pain so if the latest mri shows any real compression you should definitely get two opinions from back doctors as to what you may be able to do about it.