THR Continuing pain after one week

FraidyCat

member
Joined
May 31, 2013
Messages
248
Age
72
Gender
Female
Country
United States United States
My surgery was last Tuesday and seemed to have gone well. The acute pain seemed to be changing to an aching but tolerable pain after about three days. Then without any apparent reason the knife-like pain recurred; it kicks in with any weight-bearing whatsoever. I’ve been preoccupied dealing with an unreliable home care company but the pain problem is beginning to dominate. I know I should try to get in touch with the surgeon but I am starting to fear that something has gone wrong that could be permanent. When I had the other hip replaced in 2016, I barely had to take any pain meds, whereas now if I don’t take them at least every six hours I can barely function at all.

Has anyone else experienced an initial pain improvement that then reversed the way I’ve described?
 

CricketHip

Staff member since June 2019
BoneSmart Staff
Joined
Jul 12, 2015
Messages
6,307
Age
67
Location
PA.
Gender
Female
Country
United States United States
I'm sorry you are worrying so! If it helps, many of us have had a joint replacement that was much different/more painful that the earlier ones and it does rev up the worry muscle..
Another reason could be that your OS injected your surgical area with a nerve blocking medication which helps to get through the first several days easier.. but can also be a bit of surprise and not in a good way when it wears off.

You mentioned unreliable help, is this causing you extra worry and tension? Or worse yet, are you trying to do things on your own because of it?

Please don't fear contacting your OS for any reason, the reassurance will be so helpful to you and if, on the very slim chance that something is wrong, the surgeon (and you) will benefit from addressing it sooner than later.
I sincerely hope that you begin feeling better soon.. :flwrysmile:
 

Layla

Staff member since November 2017
BoneSmart Staff
Joined
Jun 26, 2017
Messages
30,235
Gender
Female
Country
United States United States
Hello and Welcome to recovery. I’m sorry you’re struggling with increasing pain.
I am wondering if you’re icing? If not please start, it’s great for swelling and the resulting pain and stiffness. You can ice as often as you’d like, for as long as you‘re comfortable doing so. Take care to place fabric between the ice source and your bare skin. Also, take your meds on schedule and don’t hesitate to contact your surgeon’s office if what you were prescribed isn’t effective.
Wishing you lots of comfort and some restorative rest.

As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.

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
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 these

5. Here is a week-by-week guide

6. Access to these pages on the website

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 the at each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
 

Boofit

member
Joined
May 28, 2022
Messages
215
Gender
Female
Country
Hong Kong Hong Kong
When I had the other hip replaced in 2016, I barely had to take any pain meds, whereas now if I don’t take them at least every six hours I can barely function at all.
Hi @FraidyCat , don't worry about the pain, it is early days yet (just around one week) and will probably get better very soon. Each recovery is different, and it is not unusual to have different types of pain in different parts of the operated leg in the early post-op weeks. If you remember for your first THR in 2016 you had "intense pain ... requiring pain meds" at the two week point, and it did get better after that, right?

I had my THR less than 5 weeks ago, a few days ago I was still taking pain meds at 9am, 3pm, and 9pm. I have only started skipping my 3pm meds two days ago.

Hope you feel better soon! Sending hugs from Hong Kong!:console2:
 
OP
OP
FraidyCat

FraidyCat

member
Joined
May 31, 2013
Messages
248
Age
72
Gender
Female
Country
United States United States
Hi Boofit, That is interesting if I wrote that after my prior hip surgery since my recollection is very different. You say you were still taking frequent pain meds weeks after your surgery – – but was your situation one in which you were moving pretty well for instance with stairs for several days and then the pain made that activity much more difficult again? It’s the seeming inexplicable switch from pretty good to really bad that concerns me the most.

I did speak with the surgeon, both last night and this morning; oddly, he seems to be favoring that I stop the opioids and merely continue on baby aspirin, Celebrex, and Tylenol. I didn’t think to ask him the question about the radical change in pain level from good to terrible within a few days – or maybe I did and I’m just misremembering. My thinking is starting to get more confused as this ordeal continues.
 
OP
OP
FraidyCat

FraidyCat

member
Joined
May 31, 2013
Messages
248
Age
72
Gender
Female
Country
United States United States
Thank you, Cricket Hip. As I wrote to Boofit just now, I did speak with the surgeon both last night and today. The same concern I wrote to Boofit: does it make sense to you that I would have returned from the hospital able to climb stairs without much difficulty on Thursday of last week but then on Sunday and Monday the stair climbing became excruciatingly painful? Until today, I was continuing the pain meds on a six hour schedule but they didn’t seem to be helping much, and now the surgeon is suggesting that I stop them except for perhaps overnight.
 

subie2021

senior
Joined
Jul 22, 2021
Messages
308
Age
72
Gender
Female
Country
United States United States
Hi FraidyCat,
I don't think it's unusual to be relatively painless in the first days after surgery, then to have pain days later. It seems like common practice for OSs to inject or wash the surgical area (inside, before they close the wound) with Exparel which gives is a day or three of pain relief. When it wears off, we find out Yep, really did have my leg traumatized! I know from reading my op report, that I was given plenty of drugs in the hospital, all of which I wasn't aware of at the time, and I think they lingered to help out too. We're druggified so we can get those pt requirements done so we can go home lol.
I hope you feel better soon.
 

Boofit

member
Joined
May 28, 2022
Messages
215
Gender
Female
Country
Hong Kong Hong Kong
Hi Boofit, That is interesting if I wrote that after my prior hip surgery since my recollection is very different.
Yes FraidyCat, that is why it is so good to keep a record of one's recovery! That was I read in your post on 5 Nov 2016, 2 weeks after your RTHR:
Two weeks out from surgery but other than good mobility feel like I'm going backwards. Intense thigh/knee pain, requiring pain meds, which I thought I'd gotten off of about a week ago.

It’s the seeming inexplicable switch from pretty good to really bad that concerns me the most.
I am sorry to hear you are having bad pain. I have not changed from "pretty good" to "really bad" and certainly hope not to:beg:. Have experienced changes from pretty good and no pain to level 3 pain though. Last night is one example. I have been sleeping on my side for almost a week now, and the last few nights (except for last night) were pain free. Last night I had inexplicable pain inside the joint that woke me up. It wasn't too bad though, a level 3 sort of pain. So today I am icing more.

And yes, I agree going from pretty good to really bad would cause alarm and I think that should be reported to one's OS to find out if everything is in order or if the pain meds need to be increased.

Celebrex and Tylenol are both pain killers (Celebrex is an NSAID an anti-inflammatory drug which relieves pain and swelling).
Given that your pain has intensified I am somewhat puzzled by your surgeon suggesting that you stop your pain meds except for perhaps overnight!
Until today, I was continuing the pain meds on a six hour schedule but they didn’t seem to be helping much, and now the surgeon is suggesting that I stop them except for perhaps overnight.

Is there anyway you can go back to your surgeon if you continue to have the intense pain?
I hope you feel better soon.
 

Eman85

supremo
Joined
Mar 4, 2018
Messages
2,927
Age
66
Location
E Tennesee
Gender
Male
Country
United States United States
It seems we all get to feeling better and less pain so what do we do? We start going up and down stairs and walking more and even doing PT and the pain elevates. Most times going back to resting and icing gets things calmed down and the pain subsides, but while the pain is there we all think there is something bad wrong with the hip. For most of us it takes quie a few episodes of this before we don't get totally worried and realize that we've caused the pain by something we did a day or 2 before that has caused it to elevate.
 

Lyla

member
Joined
May 21, 2022
Messages
164
Age
46
Gender
Female
Country
Canada Canada
My surgery was last Tuesday and seemed to have gone well. The acute pain seemed to be changing to an aching but tolerable pain after about three days. Then without any apparent reason the knife-like pain recurred; it kicks in with any weight-bearing whatsoever. I’ve been preoccupied dealing with an unreliable home care company but the pain problem is beginning to dominate. I know I should try to get in touch with the surgeon but I am starting to fear that something has gone wrong that could be permanent. When I had the other hip replaced in 2016, I barely had to take any pain meds, whereas now if I don’t take them at least every six hours I can barely function at all.

Has anyone else experienced an initial pain improvement that then reversed the way I’ve described?
Absolutely! I used the walker for 2 weeks and 2 days. Then shifted to a cane but put a lot of my weight to the right side to allow the left to heal. I read someone standing on one foot to strengthen … big mistake for me because ouch!! Caused pain for days. I still get some pain in some areas on occasion. Take it easy and allow it to heal. Keep up with ice and elevation. It will get better.
Here I got to see my surgeon at 2 weeks. If you get to see yours then have a talk with him if any of your concerns.
 

CricketHip

Staff member since June 2019
BoneSmart Staff
Joined
Jul 12, 2015
Messages
6,307
Age
67
Location
PA.
Gender
Female
Country
United States United States
Hi Fraidy, I thought I'd stroll over and check up on how you are doing?
You were sounding a bit discouraged last week, hopefully things are looking up?

I'm leaving you with a nice illustration of how a joint replacement usually goes:

rollercoasterexample-gif.74641


We are here for support whenever it's needed.
 

Doglover7

member
Joined
Nov 4, 2021
Messages
106
Age
56
Gender
Female
Country
United States United States
Fraidycat
Yes I am doing the same thing. I thought I had got thru the worst of it was doing well about 8 days? After then the same groin pain like before surgery, not as bad but there. Today was the first day I took a few steps unaided and limping but not the grinding teeth clutching pain as before surgery. I'm at 3 weeks today.
I am wondering if its muscle, when I ice it gets better. Until I walk to much.
 
OP
OP
FraidyCat

FraidyCat

member
Joined
May 31, 2013
Messages
248
Age
72
Gender
Female
Country
United States United States
Thanks, everyone, for your input, which I am just seeing now. For some reason I haven’t been getting notifications of when responses have been posted.

I did speak a couple of times with the surgeon since I last posted. He was at a loss to explain the severe pain that began after several days of feeling relatively OK. However, I think I may have gotten my answer: the physical therapist who was initially sent to my home was very inexperienced; he asked if I was using crutches to go up and down the stairs, to which I replied I was doing OK just using the railing. He should have immediately corrected me but instead he let it slide. A little over a week ago, after I requested and was given more experienced PT, I found out that I needed to be using a cane on the stairs, and the new PT showed me how. It seems that most of my weight was being transferred to the operated hip before I started using the can and was using only the stair rail, which led to the severe pain and swelling. Within less than a day of her instruction, the pain subsided to the point where I could go upstairs and downstairs multiple times per day without major discomfort. I’ve also been elevating the leg on a 10-inch wedge pillow as much as I can stand to do it, including while asleep, which has helped with the swelling.

Tuesday will be three weeks since the surgery but I am still relying on a walker in the house and not able to go outside beyond the porch. The PT said she will start to instruct me on use of crutches starting next week. So to sum up, I feel like my situation has been improving gradually.

Something that the PT said baffles me, which is that the anterior approach, which the surgeon used, takes longer to recover from than the standard posterior approach. I had thought the anterior approach was being more widely used now because supposedly it’s less invasive and therefore recovery is quicker, But I’ve found the opposite: the posterior approach that I had in 2016 caused less pain and mobility was restored more quickly. Have any of you experienced a less than smooth recovery with the anterior approach?

Thanks again for the feedback.
 

Mojo333

Staff member since August 2017
BoneSmart Staff
Joined
Mar 8, 2017
Messages
27,600
Age
59
Location
GA
Gender
Female
Country
United States United States
Hi @FraidyCat
I'm glad the PT is giving you some guidance on using the assistive devices so you can continue to baby that new hip as this is indeed still early days.
Something that the PT said baffles me, which is that the anterior approach, which the surgeon used, takes longer to recover from than the standard posterior approach. I had thought the anterior approach was being more widely used now because supposedly it’s less invasive and therefore recovery is quicker,
Possibly both of these things could be true.
I had bilateral THR via anterior approach May 2017, and found that when I began reading other recoveries and ever since... the recovery timelines, with all things considered , with the approaches converge at some point.

As a physical therapist, perhaps your PT has noted that the patients with anterior seem to struggle longer.

I have noticed that anterior members who are convinced that the approach is less invasive and often have fewer restrictions tend to become too active too soon, and possibly don't give theirselves the "down time" they need... hence, they suffer setbacks.

I can certainly note, from my time on the forum, that a slower initial recovery certainly doesn't seem to be a harbinger of a less successful long term outcome.
I have certainly seen Super Recoverers that have managed to quickly overdo and unfortunately cause issues like tendonitis and bursitis.

Slow and steady is definitely the best way. All Temporary.

Hope your weekend is Sweet:flwrysmile:
 

Zoebichon

member
Joined
Feb 20, 2022
Messages
157
Age
65
Gender
Female
Country
United States United States
I have read that patients recovering from the anterior approach tend to have far fewer dislocations but MORE loosening of the stem. The article said that due to no restrictions, plus the patient often feeling good, they do too much too soon, before the bone has a chance to grow properly into the stem implant.

When I was barely out of surgery, a woman (PT?) stood in front of me doing mini air squats, and she told me “don’t do this”. I was sent home same day and the next day the home PT arrived. I told her what I remembered and she opened my surgeon’s PT file and in big letters it said no mini air squats. So I hadn’t made it up!

PT said air squats used to be routinely prescribed after surgery and some patients suffered a loosening of the stem so they no longer do them.

My written discharge papers also said no air squats! Along with back leg extensions.

I had double anterior surgeries 8 weeks ago. I had stiffness and some initial swelling but no real pain. Although the stiffness, especially every evening, was painful! I am just happy I’ve never had incision pain. Too many posteriors complain of incision pain, especially having to sit on them. Ouch!
 

Eman85

supremo
Joined
Mar 4, 2018
Messages
2,927
Age
66
Location
E Tennesee
Gender
Male
Country
United States United States
I've had 2 posteriors so I can't and hope to never be able to compare. Interesting that now you've had one of each and say that the posterior was easier. I often wonder why the anterior, which has become the popular approach, is used as much. I asked my OS why he used posterior just before my second and he felt it allowed better access and he preferred it. my first required access as I had hardware that needed removing. While in there doing my second he found a large bone cyst in my pelvis and filled it. Makes you wonder if he would have seen it if anterior.
I didn't have incision pain and all I had was a clear piece of tape on the incision, no staples or stitches.
 

Zoebichon

member
Joined
Feb 20, 2022
Messages
157
Age
65
Gender
Female
Country
United States United States
Interesting about the bone cyst. I had anterior and the OS got in their and saw a large ganglion cyst, which he removed. Posterior gives surgeons more visual but anteriors, due to the Hana table, can utilize live X-rays throughout. So a different visual.
 
OP
OP
FraidyCat

FraidyCat

member
Joined
May 31, 2013
Messages
248
Age
72
Gender
Female
Country
United States United States
I wish I could report that I’m doing better by now but unfortunately that isn’t the case. After initially going through a week of massive pain on weight-bearing, apparently triggered by using only handrails to ascend/descend stairs for several days, followed by a new PT showing me how to use a cane for the stairs and about a week of decreasing pain, pain and mobility started to plateau and since last weekend have worsened again. I called the surgeon’s office and they rescheduled my postop appointment for one week from now instead of having to wait until August 9 but they weren’t receptive to my coming in sooner. I’d have to go through the ER in order to do that and that doesn’t seem appropriate unless I become completely immobilized.

One thing I’m wondering about, since everyone including me is at a loss as to my failure to progress: I go up and down the stairs an average of five times a day: to prepare meals, fetch the ice pack out of the refrigerator, or let the PT or the occasional home helper into the house. Is this potentially too much stair activity even though I’m now three weeks postop? I’d been going on the supposition that the more the better, but perhaps I’ve been wrong about that and it’s “overuse,” which I know could trigger pain.
 

Mojo333

Staff member since August 2017
BoneSmart Staff
Joined
Mar 8, 2017
Messages
27,600
Age
59
Location
GA
Gender
Female
Country
United States United States
:hi: @FraidyCat
So sorry you are still having alot of pain:sad:
I go up and down the stairs an average of five times a day: to prepare meals, fetch the ice pack out of the refrigerator, or let the PT or the occasional home helper into the house. Is this potentially too much stair activity even though I’m now three weeks postop?
Wondering...How many stairs?
I do think this is an awful lot of stress on still healing muscles and soft tissues.
I know my quads were super sore and injured and stair climbing / descending is much harder on new hippies than flat terrain walking. There's a reason they use stair climbers for exercise...it engages alot of muscles.
And you have been doing this since earlier days of recovery?....
I’d been going on the supposition that the more the better, but perhaps I’ve been wrong about that and it’s “overuse,” which I know could trigger pain.
More is definitely not better.:unsure:
Asking still healing soft tissue to perform repetitive tasks before it can properly recover can lead to tendonitis and is painful and only resolved with rest.

Hope there is a way you can minimize the trips on the stairs.:console2:
 

Eman85

supremo
Joined
Mar 4, 2018
Messages
2,927
Age
66
Location
E Tennesee
Gender
Male
Country
United States United States
It seems to me using a cane on the stairs would be harder and almost dangerous. I used the handrail and went one step at a time using my non op leg as the one doing all of the work, so no strain on the op hip and leg. 5 times a day up and down depending on how many steps might be a bit much.
The more the better only applies to ice and rest. The no pain no gain thinking seems to only gain more pain and setbacks in recovery.
 

BoneSmart #1 Best Blog

Forum statistics

Threads
60,173
Messages
1,511,851
BoneSmarties
36,714
Latest member
Mickimouse
Recent bookmarks
0
Top Bottom