THR Back pain

[LoyalD]

I sympathize with the back pain you are having post-op; mine was shin and ankle pain. I attribute the "new pain locations" to relearning how to walk, and I learned that here on Bonesmart.

 

[Me2]

I had back pain before my first hip surgery. My back felt pretty good right after surgery, then some new issues cropped up as my body adjusted to new hip. Those sorted themselves out. I kept what I found out from here were SI joint issues, had an injection for that which in combinations with some exercises has that under control. I am so hoping the last remaining back pain is totally related to right hip and will be part of the magic cure in just 15 sleeps!

@Jaycey - I'm impressed - so happy you are doing well!

 

[Carriemay60]

@mattyb Hi Matty & welcome! I have had some fairly significant back pain following my hip surgery. My hip replacement was due to a fall so I did not have the same issues as most of prior to your THR but I did have surgery twice for slipped discs 12 & 14 years ago. Once you have back trouble, it does seem to be a weak point. For example, if I get the flu the body aches are far worse in my back than the rest of my body. My OS agreed it is a weak point for me and suggested walking a bit (not to excess) to help and to watch that my gait was even and heel to toe. Sure enough it helps. Obviously, we walk quite slow in recovery which doesn't help your back - think about how your back used to feel after doing a couple hours of the "mall saunter" as I call it. Elevating my legs so the small of my back is flat on the bed also helps a good deal. I hope you find some relief soon!

 

[Jaycey]

@mattyb if you can't tolerate chiro treaatments try an osteopath. I had several treatment for my back and it really helped. Ice also helped. Hope things are easing!

 

[pepperpots]

Thanks so much everyone. You are all fabulous. Good luck with the recoveries!

 

[Josephine]

I'm going to ask you some questions and 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 compare this with the bone-on-bone pain you had before surgery!

)

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

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

5. what kind of PT/exercises are you doing? How much and how often? (and detailed details would be appreciated, please! Reps, sets and session and all that)

Note:
If you're not familiar with this, it goes like so:
1 lift of a 500kg bell bar = 1 rep or repetition.
Doing 5 reps and then a brief rest = 1 set of 5.
And doing 5 sets and finishing = a session.

 

[Nannyannie]

Welcome @mattyb This is the place to get help and good advice, I don't know how I would have managed without the Bonesmarties! Josephine will help you, but don't forget that you are still in the early stages of recovery - still healing internally and your whole lower spine/pelvis area will be adjusting to the new alignment. I hope you have plenty of pain meds (and are not afraid to take them) and are RESTING. Us women find that hard!
Best wishes
Anne

 

[Newhipneeded]

I am 17days post op and I still get tired easily, so don't worry, hopefully it will pass. Wishing you a speedy recovery


I had THR on 15 September 2014. Had to have a bone graft due to protrusion into the pelvic bone. Also found out I have "soft bones" and therefore have small fractures on my femur due to operation.

 

[pepperpots]

Hi Josephine

thanks for replying

Answers to questions

1. OS did not tell me the approach but it looke to be like posterolateral. OS was convinced I would need a bove graft until he did the op. and was able do do the op without a graft.

2. The pain I am experiencing in my lower back and on the lower left side opposite the operated is leg is about 6 when walking and about 4 when sitting. It was awful before op but seemed to have disappeared for first 10 days or so following op.

3. I take 1 Diclofenac daily, 4 Paracetomol (2x2) and 1 dihydrocodeine 30mg. I also wear a 12 microgram Matrifen patch which I have been using for 18 months. It was reduced from a 25Microgram one before the op to help pain control after the op. Also 1 syringe of Klexane daily for 35 days

4. I honestly believe that I am not doing that much and maybe not as much as I should be doing. I do about 3-4 5 minute bursts of tidying and light housework every day e.g wash bathroom sink and toilet etc/ I also have a 5 minute walk outside twice a day but the back pain stops me doing more.

5. Exercises
Heel slides 1 set of 10-15 heelslides 3 times a day
Pulling knee up in bed 1 set of 10 3 times a day
Ankle pumps 1 set of 20 3 times a day
Pushing knee into bed 1 set of 10-15 3 times a day/

These were the exercises given to me by physio in hospital in Glasgow. There is no follow up physio and check up is not until Dec 17th. Am looking for domiciliary physio as I write.

Many, many thanks for your help with this.

 

[NuMe2014]

I had RTHR on Sept 8,2014. I too have been experiencing the fatigue, but have been listening to my body and resting when tired.


Sent from my iPhone using BoneSmart Forum

 

[MarkK]

As everyone has said, you need to rest to heal. But you asked: "...is it still ok at this stage to be taking pain meds?" I think this is about how much you are taking and how much pain you are in. Because some pain killers will make you very tired.

When I was about 10-15 days out from surgery, I was taking 2 oxycodone's, one in the morning, one in the afternoon. I did not like the sleepy feeling in the morning, and the pain was not bad, so I stopped the morning dosage. I showered, ate breakfast, did my PT, read various stuff, had lunch, then took one pill, slept for 2-3 hours in the afternoon. That one pill sufficed. It was enough to deal with the pain, and I stopped it soon after.

Many people need the painkillers for some time. Others don't.

Mark

 

[Josephine]

The pain I am experiencing in my lower back and on the lower left side opposite the operated is leg is about 6 when walking and about 4 when sitting. It was awful before op but seemed to have disappeared for first 10 days or so following op.

Okay, let me ask you something else
Can you tell me the exact site of your pain using this chart?
Please note the instructions in the smaller image

3. I take 1 diclofenac daily, 4 paracetamol (2x2) and 1 dihydrocodeine 30mg. I also wear a 12 microgram Matrifen patch which I have been using for 18 months. It was reduced from a 25Microgram one before the op to help pain control after the op. Also 1 syringe of Klexane daily for 35 days

Klexane is enoxparin, a blood thinner. Not an analgesic.
Can you tell me the times you take the other meds?

4. I honestly believe that I am not doing that much and maybe not as much as I should be doing. I do about 3-4 5 minute bursts of tidying and light housework every day e.g wash bathroom sink and toilet etc/ I also have a 5 minute walk outside twice a day but the back pain stops me doing more.

Yah think? I disagree. Did you read the articles left for you in the second post of this thread? You are 3 weeks out and I suspect you have been doing this much since what ... week one? First three weeks you should be doing almost nothing but rest, ice and take your pain meds! Read the article on Activity Progression. In fact, go back and read ALL the articles! (again if you already have! )

Exercises
Heel slides 1 set 10-15 3 times a day
Pulling knee up in bed 1 set of 10 3 times a day
Pushing knee into bed 1 set of 10-15 3 times a day
These are all knee exercises and unnecessary for a hip. I think you may have been given the wrong exercise sheet!

Ankle pumps 1 set of 20 3 times a day - these are just circulation/anti-clot exercises and you can stop them after about the 4th week

These were the exercises given to me by physio in hospital in Glasgow. There is no follow up physio and check up is not until Dec 17th. Am looking for domiciliary physio as I write.

I wouldn't worry about getting a physio because you really don't need one. Hips actually don't need much 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.

 

[Jaycey]

Heel slides 1 set 10-15 3 times a day
Pulling knee up in bed 1 set of 10 3 times a day
Pushing knee into bed 1 set of 10-15 3 times a day
These are all knee exercises and unnecessary for a hip. I think you may have been given the wrong exercise sheet!

I was given the same sheet @Josephine . Unfortunately I think this is very common.

@mattyb please follow Jo's advice. I am 5 days out and only walking. It's amazing how fast things settle if you give them a chance. All this sliding, pushing and pulling only aggravates traumatised muscles and soft tissue. Try this route - I think you will be very happy.

 

[pepperpots]

Hi

Unfortunately I did not receive any sheets re exercises from hospital but these were the ones given to me by the physio in hospital when they were getting me up after op.

I take my meds at approximately 11-11.30 am in the morning and then about 4-5pm in the afternoon and sometimes, if I feel the need, I will take another set of painkillers at approx 10.30 pm before bed.

The back pain is worst in AL2B and AL3B. Today I went out for a shory while and the pain was horrendous in my back, just as bad as before the op. I really don't want to moan but I can't help thinking that this is it now and this is what it will be for the rest of my life. I wasn't in the best shape before the op. as the combination of the meds and the pain had worn me down and I was contsntly exhausted but I was planning all kinds of wonderful things for after the op. as I could do so little beforehand and I wanted to do so much more with my children who are really young but I really can't see that happening.

Sorry if it sounds like a moan, am really grateful for any help.

 

[Hoppy Nanny]

So sorry you are having this bad pain now...can hear your despair and I feel for you......but, I'm sure this is not how things will remain. You've had back pain before & you know it can be aggravated by walking differently & I'm sure your body is adjusting from the THR. Could you take more painkillers ? Just for a few days....until the back settles down.
I've had knee pain since my THR and have felt quite down some days as I thought I would be pain free and I've not got toddlers to deal with @mattyb. Hang on in there....thinking of you. Chrissie x


Sent from my iPad using BoneSmart Forum

 

[Josephine]

So your pain is about here then?

In November 2011 I suddenly developed burning back pain across my lower back which became worse over time and eventually dwarfed the pain in the hip. It became too difficult to stand for longer than 2-3 seconds.

So what investigations and/or treatment have you had for your back? Is this what you were prescribed the Matrifen patches for?

I take my meds at approximately 11-11.30 am in the morning and then about 4-5pm in the afternoon and sometimes, if I feel the need, I will take another set of painkillers at approx 10.30 pm before bed.

I suggest you have a chat with your GP and make some changes in your medication. In my experience, the best meds for a hip replacement are either codeine or Tramadol and reconsider using the patches but all to be disc.

You also need to be on a more structured routine of meds like this: codeine 30mg + 2 paracetamol at 8am, 12md, 4pm, 8pm and at 12md 60mg codeine which should cover you through to the morning.

 

[pepperpots]

Hi
Yes that is where the pain is now. Before the op it was also there but often the burning pain spread across the bottom of my back and even round the front of my body at times. My GP reckoned it was all to do with the stress that my musculo skeletal system was under as a consequence of the severe OA and the way I walked hence the Matrifen patch. He reckoned the op would cure it. The OS I saw asked a Spinal OS to look at me who exaqmined me, took XRays which seemed ok and he also thought it was hip related.

I have had a spinal MRI a few years ago as I also have NF2 but I suppose they were only looking for spinal tumours in that one.

I have reduced the Matrifen from 25 to 12 as I found the nausea and the fatigue really difficult to deal with and I reckon that will lose the 12 patch after another couple of weeks. Unfortunately Tramadol makes me so sick that I can't take it.

Thank you Josephine

 

[CanukTriMom]

@mattyb In order to do more with your children later on, you are going to have to slow way down. The only time I left my house was when driving in a car driven by someone else. Tomorrow will be exactly 3 weeks since my surgery and the most I walk outside is to the end of the street and back. Oh yes and in the house up and down but the rest of the time I spend doing my exercises, elevating and icing. Husband and son can easily take care of themselv s as well as me.

Hope you feel better soon.

Cheryl

 

[Jamie]

It is possible to have back pain after hip surgery. Your body compensated for your bad hip by tilting your pelvis. Then suddenly things were put right with the surgery. It will take a while for your pelvis to readjust to the new normal and settle down. Jaycey's suggestion about getting new shoes is also a critical part of this healing process. If you have not pitched all your old shoes with wear patterns and bought yourself some new ones, I suggest you do so now.

This is a time where you're just going to need to be patient with your body. It takes time to heal. Be sure you're not pushing yourself to do things when it hurts. That is counterproductive.

 

[pepperpots]

Hi

Yes I originally signed up as pepperpots then had computer problems and could not sign in so I had to set up a new account as mattyb, same problems happened again after a couple of day but can now sign in again as pepperpots but is nownot recognising matty b password. I think certain little fingers in this house may have been playing with my laptop! Apologies.

Thanks Janie and CanuckTriMomi for your advice. I don't really feel that I am doing enough walking but I'm sure you are all more experienced than me. I think because I read about so many people being able to do so much and being able to walk miles that it scares e that I am not doing enough! I guess 3 and a half weeks out is early days?

Thank you so much