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THR New member, pain 3 three years after THR

Tbolt

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Hello, new member here. I have lurked a bit as I try to figure out what to do. I appreciate the opportunity to join. Sorry for how wordy this is:

I have had both hips replaced. Right is doing very well, but I'm concerned about the left. THR was three years ago. On and off the last year or so I have had episodes of somewhat sudden pain and weakness, seems to be in the trochanter area. It usually lasted a few days and abated. Last April I had an event with more extreme pain while walking, to the extent that it took my breath away and I couldn't walk for a few minutes, and only with difficulty after that. I took the first appointment I could get with an ortho doctor, my surgeon had retired. X-rays were taken, I told him my story. He asked me to stand on that leg only and I easily did (by the time I saw him the pain ceased.) He said everything looked good and sent me on my way.

The last 4 days I have had a return of this, although not as painful. I'm trying to track what is setting it off. I'm good getting up and down from sitting, ROM is okay, no pain sitting or lying down. I am noticing it happens, not always, when I am pivoting to the left or making a lateral movement to the left while shifting weight to that side. When it happens, walking is painful and I'm limping for a bit. The rest of the time, no pain and no difficulty moving, including shifting weight.

I hope that makes sense. I'm thinking I need to make another appointment, although if it follows the past pattern, it will calm down and go away for a good while. Does this sound familiar? Stem loosening is my main concern, although the doctor saw nothing to support that at the last consultation.
 

Trudijane

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It sounds familiar to me, even though I am just 9-months post op.

I cannot explain your situation, but every once in awhile, I get a new & sharp pain, enough to scare me into thinking that something happened or I damaged something. Sometimes I can't tell whether it's my hip or my back - but just one pain like that freaks me out because I guess I still worry about the pain i used to have - and certainly don't want it back.

Pain means something though, and if I were you, I'd keep a log of how you feel every day, and if this on/off pain continues, go back to your Dr. until it can be figured out. If everything looks good, they usually think it is; and most often it is, and it will just disappear on it's own. I call it a pain setback.

But i have no idea what to expect 3 years later!!!

Good luck.
 
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Tbolt

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Thanks. A log is a great idea, don't know why I haven't so far, I do it for other things.
 

Elf1

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:wave: @Tbolt and welcome to Bone Smart, lots of great folks here and sharing of good info. Can you start by telling us when you had each surgery? It might help alert someone in your time frame of recovery. We'll get the dates added to your signature.

I agree that a log might be a great place to start, especially since the OS you saw said current Xrays look good. You mention the pain is in the area of your trochanter, you could possibly have trochanteric bursitis. I've been dealing with it for a while now though my doesn't seem to come and go. But, I am just about 7 months so a big difference in where were at in recovery so I am still dealing with the regular zipz, zaps, etc of recovery on top of it.

I'll leave you a little reading material from our library on it:

 

Going4fun

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Sorry to hear of the pain.

Well, you know the BS philosophy of not rushing into physical therapy immediately after surgery.

Well three years after surgery, when you have a problem like this one, this can be a time that seeing a really good PT could help, emphasis on "really good."

And the log idea is great because the better you can describe your pattern to a PT, the more data the PT has to make a judgment on what could be going on with your body ... and the better they can be in designing a plan to help you.
 

JoeGee

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Are you worried about the implant itself? There's all kinds of soft tissue stuff in that general area that can cause sharp repeated pain, I've had a ton off experience with that and have been able to do a lot for myself with self-massage and stetching. I learned a lot from a web site about pain science.

Not trying to say it isn't the implant though at all, of course I have no idea. Just another possibility. Good luck to you.
 
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Tbolt

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Thanks for the replies and advice, I really appreciate it. I fell off my bike and sustained a left femur fracture in June of 2015. Went to the ER, a rod and screw were put in. In August of 2015 I had a right THR and then in February of 2016, the rod was removed and I had a left THR. I recovered well from each THR, although the left hip was more troubled than the right, which makes sense due to the additional trauma. About a year after the left THR, I would occasionally have a day to several days of pain and limping causing me to return to using a cane. Last April, I had the episode above of extreme, sudden pain while walking in a store, out of nowhere, I hadn't stumbled or made any unusual movements.

That's when I went to a doctor who does THR, so about 10 months ago. It's happened maybe 7 or 8 times over the last 2 years, but most of the times has been pretty mild and resolved in a few days. That's where a log would be handy! I will start today.

I do have a lower back issue although no direct pain (stage one spondylolisthesis at L4 L5) and have wondered about referred pain. The part that seems not to fit with that explanation is that although most of the time these instances have involved only pain, a few times it has felt as though my hip is about to give way. That's been true the last 4 days. I guess that could be a reaction to the sudden sharp pain, instinctively wanting to unload that hip, but it does cause me to consider the implant.
 

JoeGee

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Again, I'm certainly not diagnosing you by any means, but in my case I would get sharp searing pain almost randomly in my right hip for a period of several years. It might be fine for a month and I would take a step and be right back in it, and once it started just putting my foot down wrong could send it right off the charts (it was my other hip that was replaced, after breaking my acetabulum).

While they've told me that I'll need replacement on the right eventually, it turned out that my body was doing what they call "guarding", essentially it was attempting to protect my arthritic hip joint by tightening the muscles, tendons and ligaments in that area, which was okay until it was sometimes too much and the muscles would go into spasm, causing the pain. And once it would zap me once it would keep doing it over and over, often for days and days. And it hurt. A lot. Did I mention it hurt?

After learning about trigger points and self-massage I've been able to drastically improve the function and reduce the pain in that joint and I'm in no great hurry to get it replaced at this point (especially since I now know firsthand that replacement isn't exactly a walk in the park!).

It's something to look into at least. It might help and it almost certainly won't cause any damage. And it's free (well it cost me $20 to learn about it), and you can do it yourself. I hope that's all it is, good luck to you.
 
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Tbolt

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Thanks, JoeGee, reading your experience is helpful. I understand diagnosis is not intended.

Good to know your into Paul Ingraham's stuff. I bought an ebook from him a long time ago when I was dealing with a different body part that was painful, also have read his take on frozen shoulder. I read Sciencebased Medicine, where he used to contribute and other neuroscience oriented movement sites.

“It might be fine for a month and I would take a step and be right back in it, and once it started just putting my foot down wrong could send it right off the charts.” This is what I am experiencing. And I definitely have a tendency toward guarding and hyper-vigilance, started with my frozen shoulder and intensified with the trauma of my broken femur.

I'm thinking that it is likely some sort of soft tissue irritation, not hardware, but i don't want to overlook that if it's there damage could be caused. I will give massage a go. If this worsens, I'll see an ortho again.

I'm open to PT again, but I've been through it many times over the last 15 years, with iffy results. Finding a great PT who is allowed to spend adequate time is the key to it, I'm sure.
 

Elf1

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@Tbolt I had/have Spondylolithesis at L5/S1 and it caused me pain all the way down my leg. I believe it was between stage II and III. Anyway, my disc was sliding off the other one every time I bent in any direction and was compressing nerves causing major pain, not just in the back.

After having surgery it took quite a while to get my doctors to realize that my hip was a problem because the pain and the areas it was in was very similar. They kept telling me it's your back, not your hip. My pain management finally caught on when spinal injections pretty much did nothing. You might want to get your spine checked out. Just a note, I'm definitely not a medical professional but my neurosurgeon was of the belief that back/spine surgery is not for everyone.
 

ceezee

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I do have a lower back issue although no direct pain (stage one spondylolisthesis at L4 L5) and have wondered about referred pain.
This is just my experience but I also have this condition with referred pain down my leg that mimicked an IT band issue. It also had me very concerned that maybe my stem was loose.

I had my femur fractured during my second hip replacement that wasn’t discovered for a month so I was concerned that the bone hadn't grown around the stem. But it did and the stem wasn’t loose.

I had very sharp sudden jolts of pain down by my knee and on the side of my thigh that made walking nearly impossible at times. After I saw a spine doctor, got the diagnosis, and had 2 weeks of PT to show me how to do Mackenzie Method stretches, in time, this pain and discomfort all went away. I have to be careful to sit and lay down correctly and keep my spine straight but it’s working.
 
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Tbolt

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@Elf1 and @ceezee. Thanks, that's helpful. Did your hip ever feel as though it was giving way? I did have spinal xrays that showed the L4L5 issue, but nothing since. I really don't want back surgery, but maybe I need PT.
 

VSlowLife

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It was a while ago, and it is startling. I think it mostly happened after using stairs. I think PT had me doing hip hikes to help remedy it. It may be a ligament slipping. My memory is fuzzy it was a while back and it did stop. PT would know.
 

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