Iliotibial band inflammation?

[PRGal]

I saw my OS last week, 3 months after direct anterior right THR, because while hip itself felt fine, other things bothered me. Specifically, pain with nearly every step down outer thigh from trochanter to knee (including an occasional snapping sensation); extreme tenderness at outer trochanter, especially at night (I'm a side sleeper); hypersensitivity of skin on outer thigh--electric shock feelings when my dog's tail brushed me.

He prescribed a topical cream for the hypersensitivity (which I've yet to get since my insurance won't cover it without preauthorization & he's on vacation), but that's it. He did say ITB irritation & bursitis weren't uncommon (symptoms 1 & 2), but didn't offer any treatment. (I think I was so relieved that Xrays showed everything was OK, I wasn't my usual persistent self!)

My other research shows that NSAIDs are usually the first course of treatment for both ITB syndrome & trochanteric bursitis, and I do alternate Aleve & ibuprofen, which helps some. Also trying to do some stretches, & he told me to go back to "using & abusing" my hip, but I'm thinking extra activity may irritate more than help.

I certainly don't have an issue with doing something challenging & pushing through the pain if it will help, but I'm pretty confused at this point. Will PT help? (Long story, but don't think my OS is a big believer in PT.) Should I go see my GP about this--or perhaps the first OS I saw? (Feel a bit bad about that--he was a traditional approach guy & I was dead set on anterior before I ever saw him."

Jo, saw on one of the knee areas, that you said ITB inflammation was "persistent." What do you think I should do?

I'm really SO happy with my THR, approach, etc., & recovery has been so uneventful, I'm just frustrated with these other issues . . .

 

[Judles]

Hi PR!!!! I wouldn't presume what to tell you,,,,which order of priority,etc, If it were me, and my OS encourages it, I would call HIS office first, No matter what kind of surgery or prosthesis you have,,,,,you need to be reassured by a professional! In the mean time, why don't you take a little break from PT to see how you feel. Aleve or Advil also wouldn't hurt,,,,and evena little icing! Feel better and take it easy! Keep us posted!

 

[Jamie]

PRgal....Judles' approach makes sense to me. I'd give it a try. Not much to lose except a little time and maybe your pain!

 

[JudyS]

PRGal
I've had problems with the ITBand after surgery. I never considered it anything major. In pt they worked on it by massaging the area, the type of massage that really hurts and tries really hard to bring tears to your eyes. I only went to pt for a short time and then continued to massage the painful areas on my own. Certainly no where near as hard.

My hip surgeon gave me a prescription for pt in case I wanted to go for a few weeks but did not think it was necessary after a THR. I just had a million questions about what equipment I could or could not use, he thought it would be safer if the pt's at their gym would show me.

I would say keep taking the anti inflammatories. Also using it is probbalby going to keep it irritated so cutting back on activity may help it clear up.


Judy

 

[Josephine]

Doug found some exercises for ITB he rated very highly. Search in the Knee Recovery forum and you might find them.

By persistent I meant often difficult to resolve. The specialist exercises seem to work for some, massage for others, pills for others and a combination of all the above for the rest. You just need to try stuff out and see what works.

 

[PRGal]

Jo--Found Doug's posts & links--thanks. Already knew about & have done most of these, but I'll keep at it.

Judles & Jamie--already taking Aleve/Advil & don't have PT--haven't ever. Just try to do stretches at home when I have time (went back to work at 5 weeks).

Judy--cutting back is probably the thing to do, but I became such a couch potato before THR because of the pain that I hate to backslide.

I'm to see my OS again Mar. 17, but may try to move that up & insist he suggest something concrete for dealing with the ITB and bursitis. I love my new hip so much, I REALLY want to use it--and forget I have it, if you know what I mean!

 

[JudyS]

PRGal I am an exercise junkie so cutting back sounds right but even when I overdid it at 4 weeks and was in bad pain (well not so bad now that I have a comparison to really bad pain) I still did not really cut back. I still walked my 1/2 mile to the pool, swam for an hour, then walked my 1/2 mile back home.
It did eventually get better.

Good Luck
Judy

 

[Josephine]

cutting back is probably the thing to do, but I became such a couch potato before THR because of the pain that I hate to backslide.

There is such a thing as degrees, PRGal. You can cut back without regressing to the point of couch spud! And I am sure with your new found vitality and enthusiasm, that is not going to happen. You still do need to be kind to yourself though!

 

[aussie]

Jo, I'm trying to find a thread that you put a diagram in yesterday I think, can't seem to locate it I wanted to see if the psoas (not sure that's correct but I know you will understand) muscle is on it.

Thanks Chris

 

[aussie]

Didn't find the one I was after but found the same diagram in a closed thread Jo and what the person describes is exactly what I am feeling. Nice to know physio and stretches should be able to correct the problem. It started ages ago about 6 months post op, I would just wake with a painful thigh in bed but as soon as I bent my leg it would be ok. Should have seen about it then but we had moved on to preparing for the KR then so didn't say anything. Now it has moved onto being getting in and out of the car, bed, going up stairs and can't do straight leg lifts. Thanks for all your wonderful insight and advice.

I'd better go to bed now.

Kindest regards

Chris

 

[phoggie]

It has been over a year (Feb. 11, 2008) since I had my THR......and what a year it has been!!!! My OS left me with an 1" LLD and this has caused what everyone is calling IT Band Syndrome....plus Bursitis for which I was given an injection....that did no good. To date, I have been to the PT over 50 times trying to overcome this ITBS....twice with ASTYM treatments....and the pain continues. I am so sorry I even had this done.

Now, I am having what they "think" is sciatica in the other leg...man, talk about pain!!!! It feels like someone sticks a knife in my back and runs it down my butt, thigh, calf to the back of my ankle. Never know when it will strike, so have confined myself to the house....mostly bed & sofa. I have gone to the pain management dr. and gotten injections (more to come) and to the neurologist for EMGs, MRIs, and etc. and he said that I had inflammation of the nerves.

Has anyone had experience with sciatica???? would love to hear from you.
I can not take much pain meds because of my Barrett's Esophagus so just try to tough it out.

This has been the worst year of my life and I thought I would get to enjoy retirement and do traveling.....all of my social life is PTs and Dr. offices!!!

 

[Josephine]

Hello, Phoggie! My you are having a rough time of it! Have you considered seeing a chiropractor? Personally I would do that before I let them do anymore injections since - as you are finding out - they just do not work!

God bless you, that's a dreadful situation to be in.

 

[phoggie]

Oh yes, I have had numerous trips to the chiropractor...and nothing has helped there. He does "instrument" adjustments and I am not sure he is getting to the problem with them.....and gets very defensive when I suggest something else.

 

[Josephine]

Shame on him! I'd try a different one!

Just came back to add - have you tried a TENS machine?

 

[JudyS]

I agree with Jo and go find another chiropractor. I know in my area there is no shortage.

As far as sciatica. I had cervical fusion surgery to start my whole surgery mania. My lumbar area has been a problem for awhile. I have sciatica a little at times, only seems to go down to just below my knee. I have occasional injections under anesthesia from my spine doc that works for a few months.

I did have a hip replacement in June. Love it although it is rather achey lately. I just had thoracic fusion surgery. Now there is the real experience with inflammed nerves.
There are many different meds for nerve pain. If the injections have not worked for you , I sure would not have any more.

Let us know how you are doing
Judy

 

[PRGal]

With a 1" LLD, hasn't anyone suggested the possibility of orthotics to help even you out a bit?