THR So much pain after 8 months

Stellamac

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Hello I am new to forum. I have been reading a lot on here and have found so much helpful information. I had my surgery of right hip on 1/28/19 and I feel as if I have hit a roadblock. One day I have a feeling of euphoria, and then the next day I have a setback and feel like I can not do anything. My right knee has a lot of pain (some swelling) and my hip has a feeling of clicking when I walk. I am currently walking with a cane but sometime I do try to walk without. Is it normal for the knee to hurt so much? And has anyone ever felt the clicking sensation in the hip? Any advice would be helpful on what to expect in this recovery. I really think that in my mind I thought this surgery would not be this tough and I would be more active by now. Boy was I wrong? I just really need to know what to expect. Thanks for any help and advice moving forward.
 
@Stellamac
Welcome to BoneSmart, glad you joined us!

You are less than a month out from your THR, recovery is not a straight line, it is 2 steps forward, one step back.
My guess is on the days you feel good, you do too much, and pay for it the next day. Take a step back, spend time Resting, Icing, Elevation, and Medicating on schedule as prescribed, and let your hip heal.
 
Hi, Welcome to BoneSmart and Recovery. Thanks for joining us.
No worries, all you've mentioned are very common concerns and considered normal.
There are ups and downs in recovery. It does ebb and flow.

Your knee is most likely bothering you due to the aggressive manner it was manipulated during the dislocation process. Ice it right along with your hip and it should gradually ease. I suffered the same as do many others. The clicking sensation is also normal and will ease in time as all the surrounding soft tissue heals.

It's advised you use an assistive device until you're no longer limping. If you're still limping here is a tip -
Try heel-toe walking when / if you're limping. Let your heel hit the ground first followed by toes.
It takes a concentrated effort but I believe you'll notice a difference. Give it a try.

Please thoroughly read the Recovery Guidelines. I believe a lot of your questions will be answered and your mind eased as you move through the process.

Stop by often with questions, concerns or updates. We'll help and support in any way we're able.
A great day to you!
 
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One last thing....please target icing (hip & knee) several times per day at 40-60 mins each session, no less, as recommended by the forum Nurse, Josephine.
It should help with pain and swelling.
@Stellamac
 
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 discomfo
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 these
5. At week 4 and after you should follow this
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 that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
 
You have reached a very common point in recovery. Ups and downs are very common and with it comes the blues. Pain in the knee is very common, look at an anatomy illustration of the muscles in your leg. They terminate at the knee and that is where they send the pain memo from when they get mad. Mine would hurt and sometimes have a burning sensation at the knee cap, especially if I walked up or down hills. Clicking is also pretty common and I still get it once in a while in the morning right after getting out of bed.
The good news is that with rest and ice you'll feel better until the next plateau. Don't get discouraged you've got a way to go yet.
 
Hang in there, a month is nothing. I was like you. It’s very hard but worth it. Someone on here said compare the weeks rather than days!!! Think about it, you’re only a month and you’re walking wow!! It’s amazing really.
My knee was so swollen I thought it would never go down. It began to reduce at around week 6 I think it was. Forget about rushing and going without crutch/cane. Just perfect your walk. I followed the slow and steady pace and I’m painfree. I’m walking with no crutch but not very much but I’m not stressing. If I feel I need it, I’ll use it.
Good luck and keep the faith x
 
I can relate completely to these feelings. For me, the ups and downs have more to do with my outlook than with specific physical causes. Of course, after overdoing and then being in pain, it's natural to feel down. But, I find the ups and downs to be part of an ongoing cycle. I am not out of that cycle yet, but I feel that I am moving toward more "up" days than down, and moving toward a position of equilibrium that is complete wellness. Wellness is something I believe is always relative. People with chronic conditions, acute pain such as after surgery, or with no health issues can achieve it.
And, related to this (though I hope I am not getting toooooo philosophical on everyone), this idea reminds me of the Buddhist concept that emotions are not us, they move through us. Thinking of it that way has helped me, because it makes me realize I am not ever "stuck" when I feel down in the dumps.
 
Thank you all for your responses and helpful information. I guess I just really thought this would be a little easier. I don’t know what I was actually thinking in terms of this surgery before I had it. All I knew is that I was in constant pain and I wanted it to go away. I know that it will be worth it in the future just by reading some of the stories on this forum, but that day just needs to come faster. I guess I am just inpatient. So what did everyone do to fill their days while they were down and could not move around. Do you feel like the walls were closing in? Due to never having major surgery I don’t really know how this will affect me?
 
I remember it making me a little crazy when people would tell me I was so early in recovery and not to worry about the pains. Like you, I wanted to be ready to move on, and get my life back. I was very lucky, and my recovery was pretty smooth, but even so, I remember the 4-6 week mark being filled with various aches and pains. I had expected my recovery to be consistent, and it wasn't. The more active I got, even in a reasonable way, the more little pains would pop up. I've always been pretty good at listening to my body, and that, coupled with the advice of my surgeon and folks on this forum helped me so much.

If you are like most of us, we spend our lives active and busy. To be forced to slow down really is a gift, but it doesn't feel like it when we don't have a choice. So maybe if you pretend you really want some down time, and think of books, movies, friends, naps, bubble baths.....things you'd enjoy under other circumstances, it would help. And if you are having a hard time finding an upside to things after awhile, do let your doctor know. :console2:
 
It really is early days and feeling like you do is very common...one month can be prime time for the post op blues to set in.
Unless you were Fortunate enough to find Bonesmart well in advance (I didn't) there isn't alot of information imparted to tell us what recovery will "feel" like.
You might want to read this article from our library about post op blues.
http://bonesmart.org/forum/threads/post-op-blues-is-a-reality-be-prepared-for-it.7591/
All temporary recovery business and you will be glad that you spent this hurry up and wait time to give your hip the opportunity to heal so Spring will be Sweet!
:flwrysmile:
 
Impatience will not only make it seem longer, it will be longer if you push too hard. There's so much misinformation spread around about this surgery by people that have never had it done most think it's 2 weeks and you're back to normal. It's not that way at all as you're finding. Very disappointing that most OS don't prepare their patients for what's in store for them.
As far as what to do to pass the days. I really enjoyed the time I could spend watching movies, surfing the net and reading, things I never found time for pre-op. I found this site while recovering and reading about THR recovery as I wanted to do it right. Once I passed the 2 week mark I could drive so I could go to the store for walks when the weather was bad. I would walk down my road and back or go to the park and walk. There were times where the walking made my knee hurt so I had to limit the distance. That's where you learn not to walk any further away from the starting point then you can make it back. I stood and leaned on a fencepost on my road for quite a while before I could make it back home when I pushed too far.
 
That article really hit every feeling I have been having. I do feel a little inadequate because I can not any of the things I am use to normally do. I am very independent and feel some kind of way with people taking care of me. I am not a center of attention kind of gal. I should love that feeling but I just don’t. As far as enjoying the time off, it has been nice to just have some down time bc I have never had this much time off from work since I had children. So how long is the out of work time? I haven’t really been told by my doctor, but Hans read here that some return to work within 6 weeks. I am a social worker and my job is 50% desk and 50% in and out of homes. The thought of getting in and out of a car at this moment makes me nervous. I feel ok but my walking is very slow and I am using a cane still. I have only had 2 days of PT at this point so I am still very weak and sore. I like some of it because it really stretches the hip muscle. It is so tight and feels like is pulling in my groin area so the stretches help. I know PT is not necessarily good for hips, but what is recommendation of those who have had it and how did it make you feel.
 
The best schedule for work is 3mo, which is usually what FMLA will allow you. The energy drain is still pretty rough at 6 weeks. I was prepared for the recovery but I didn't know just how much this op would drain me. I've had ortho surgeries before and some I pushed and went back to work in a few days because I had my own business. The reality of how draining this was when I noticed it took 2 weeks for me to get my color back. I looked very gray post op as my body had better uses for the blood!
I never went to PT, my OS warned against it. His words, they'll hurt you! His program gave me a book with all of the info and illustrations on what he wanted post op. It was the basic ankle pumps and stretches while lying in bed. That broke up a lot of the day as I would do my stretching 3 times a day. The stretches still make me feel good and I'm still tight and still get sore.
 
Hi @Stellamac
A Phased Return To Work is advised if your circumstances allow. Following is an interesting article -
http://bonesmart.org/forum/threads/phased-return-to-work.5696/

Those who've experienced PT may stop by and share but keep in mind the Big Tip -

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.

Wishing you a peaceful weekend! :SUNsmile:
 
The Big Tip seems to be helpful for many by preventing them from doing too much too soon and causing a significant increase in pain. The pain in turn can slow down the recovery process by limiting normal activity such as walking.

I am surprised by what seems to be advice to do no focused exercise at all, however. It might discourage people who could be helped by PT. In my case, I have found my PT sessions to be very helpful in correcting some bad habits with my gait, improving balance, and identifying particularly weak muscles. Of course, it is excellent advice to refuse or delay exercises that hurt or cause excessive soreness the next day. But it seems unnecessary to put off all exercise until all healing is complete. I an striving to find a happy medium where I am challenging myself in a reasonable and gentle way and learning about what my new joint can and cannot do. In that respect, I have found a short course of PT very helpful. I feel better at the end of a session with perhaps mild fatigue but in a good way.

Each person has a unique situation with their new joint depending on their physical condition before surgery, problems they may have with other joints, and complications encountered during surgery. PT may be very helpful to some and not so much for others. One size does not fit all. I would listen to my surgeon, listen to my body, and if desired find a competent therapist who believes in achieving that happy medium. The bottom line is that PT should help, not hurt.

@Stellamac, you are still early in your recovery. I hope you see continued progress and are able to take enough time to heal before returning to work. Best of luck to you.
 
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Thank you so much @prairienut your advice is spot on. There is so much controversy about PT. The tiMEs I have gone it has truly made me feel better. Of course I am a little tired after but my hip does feel a little less stiff. None of the exercises have been difficult. They got me on the stationary bike where you sit down, I was a little apprehensive at first but I rode it for 5 mins and it felt awesome. I did 3 rounds of physical therapy before my surgery and it never helped at all. I did do a lot if relaxation/breathing techniques that were helpful. My therapist gave me these because I was always in pain which caused me a lot of anxiety and the techniques were helpful. I do have some pain which people say is healing pain and I am trying to differentiate if that is what it is compared to the pain before. I have always had a lot of pain in the middle of my bottom and I still have some of that. It is so hard to explain that pain but it is in the middle and when I began to have hip issues that is where the pain started. And in the groin; I think this is why it took them so long to find out that it was my hip. Has anyone had this pain and if so did it go away after? I truly appreciate all the comments bc this has been a long, tiring journey for me as I am sure you all have had the same experience. Your help has been a lifeline for me during this time.
 
Hi @Stellamac, I have been doing some slow stationary cycling in PT with no resistance, and it does feel good to get the leg moving again within a safe range. I also really need the guidance for improving my balance. I don't want to be falling on my shiny new hip. I adore my PT. She has helped me understand what is going on as I heal. No regrets.

Groin pain is very typical for a hip that is bone-on-bone or nearly so. It almost seems diagnostic for the hip joint. Haven't heard about middle-of-the-bottom pain associated with a bad hip although it seems plausible that once the joint starts to become unstable that adjoining tissues start to get affected.
 
I’m sorry I am just now getting back to you @prairienut. My pain before my surgery was mostly in my buttocks and my groin. I no longer have the groin pain but still continue to have some buttock pain. I mentioned this to my surgeon when I saw him last week. He told me it was my piriformius muscle that was really tight and inflamed which causes it to irritate my sciatica. If that makes any sense? My journey in all of this is very long bc I saw so mamy different doctors before they actually found out was wrong. I saw a orthopedic for 3 years who never listened to a word I said about the pain in my groin and kept treating me for my back. After 3 years of getting injections, nerve conduction tests, and x-rays he basically said there was nothing more he could do. He sent me to pain management which I was very reluctant about going but I’m very glad I did. The PA I saw ( who worked in orthopedics before going to PM) examined me and did a arthogram MRI to check me for pirformius and found out what was wrong and sent me to the surgeon who performed my surgery. Very frustrating... I say all this to say that whatever this piriformius muscle is, it causes me lots of pain. So now PT is working to help me with loosening that muscle. I saw on your profile you had to have a revision? Do u mind if I ask why? I am terrified that I am gonna do something to hurt my new hip.. any little ache or click I have makes me think there is something wrong. Stressful to say the least. I’m trying to stay positive but it can be difficult at times. I hope you are feeling well and making progress.
 
I had THR replacement on Jan 28, 2019 so I am essentially 8 weeks out. I am having a lot of pain in the groin and glutes. The groin pain feels like it is on pubic bone and flute pain is in middle of bottom. I feel like what is causing the glute pain is piriformis muscle but no idea what the groin pain is at this point? Is it too early to have an injection to calm the piriformis muscle down? Has anyone experienced the groin pain after surgery? As we all know after THR we want to be all better and it is so frustrating for me that I still feel all these aches. I do feel some of the pain comes from moving around too much but if I do not move I get stiff and that is just as bad. Sorry for long post but has anyone had an injection 8 weeks out? Or is there a timeframe of when you can have one!
Any info on this is welcomed!
 

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