THR Pain developed after 14 months<

[Sunnysept]

Update. I’m still suffering from psoas/groin pain . The odd pains I had elsewhere went away for three months and other than the groin pain I was feeling a lot better.
However, been going to physio and massage, still trying to get rid of the psoas pain. However, last week the therapist realised my inguinal ligament was in trouble so worked in that a bit and since then I’ve been in a lot more pain again. Literally starting as I got off the table I’m getting sacroiliac pain now and more shooting pains, in addition to the darned psoas I’d been trying to work on. Today I’m finding it as painful to walk as I did before the op!
Would really appreciate some recommendations of sympathetic surgeons/physical therapists etc in the south of UK to whom I can get myself referred. I need to see someone now as this has gone on too long and it’s really starting to affect me mentally as well as physically .
Would also appreciate some insight as to what’s going on here? Feeling quite desperate now. @Josephine can you help at all?

 

[Mojo333]

Hi @Sunnysept
Sure wish you were coming back with better news

Would really appreciate some recommendations of sympathetic surgeons/physical therapists etc in the south of UK to whom I can get myself referred. I need to see someone now as this has gone on too long and it’s really starting to affect me mentally as well as physically .

I sympathize with the pain and frustration this is causing you.

Maybe @Josephine has recommendation?

 

[Josephine]

Only the ones in the article.

 

[Sunnysept]

Oh. Ok.

 

[Layla]

Hi @Sunnysept
I'm sorry you're struggling and in pain. I hope someone else who resides in the UK stops by with a recommendation for you in regard to a surgeon you could seek an opinion from.
Wishing you comfort and relief from the pain.

 

[SaraK]

@Sunnysept - Many of your symptoms sound like mine did. Lifting leg or climbing stairs was painful. Walking uphill worse than on level but pain after very much walking. Painful to lift leg to get into car. Painful (and woke me up in the night) rolling over, etc. Josephine mentioned earlier the possibility of a "nick" in the psoas. I had this same sort of procedure on New Year's Eve (after steroid injection into psoas tendon to confirm the diagnosis of psoas impingement). It has made a world of difference. There is weakness and it may take a few months to get full strength back, but I've had pain free motion since very shortly after the surgery and, within just a few weeks, was able to do most things I could pre-THR. The passive range of motion is back and its the "upper limits" of activity that I can't do unassisted (i.e., I can use my hands to left my knee above waist high and it doesn't hurt but I can't lift the knee above the waist without helping with my hands). I was told that these motions that you don't do every day just take more work to get back (if you are concerned enough about getting them back). if you have questions about my symptoms or my experience with the surgery, etc. you can peek at the last few pages of my thread or you can ask them here - just tag me so I know to look in!

 

[Sunnysept]

if you have questions about my symptoms or my experience with the surgery, etc. you can peek at the last few pages of my thread or you can ask them here - just tag me so I know to look in!

Thank you SO much. That was really supportive and helpful of you. How long after the steroid injection did you have the op and was it keyhole ? Did the steroid injection leave it feeling even worse after the positive effects had worn off?

 

[Mojo333]

I'm going tag @SaraK so she will see it.
Sending you all the best mojo!

 

[SaraK]

I had the steroid injection on 10/24. I could feel an immediate difference because of the "Caine" drug included in the mix. That wore off within an hour. I started feeling the benefit within a couple of days and felt great for about 2 - 2-1/2 weeks then pain came slamming back. I wouldn't say the pain was worse so much as it took my breath away because it came back so quickly and completely. I was then referred to an ortho that does hip arthroscopy (keyhole) and was able to get on his schedule for 12/31 (which was quick for that time of year - in US, there is often a push for surgeries at the end of the year because of insurance and tax impacts). I was worried they would make me wait 3 months after like they do for hip replacement but wasn't an issue.

There are a few ways and locations to do the release. Some do small nicks along tendon and some (like mine) do one larger cut with the intent to effectively lengthen the tendon. Some do the cut by the greater trochanter but mine did right by the acetabular cup because he feels it better preserves the muscle strength and mobility. While this surgery used to be done open, I would suspect that anyone who's up to speed with current procedures would do arthroscopically.

I have 3 small incisions (1-2 cm each) at the top of my thigh. I had some pain there and some pain in groin in the first few days, but not much - primarily stiffness/swelling and that went down quickly.

Best thing I ever did was the hip replacements. Second best was continuing to push for correct diagnosis and get this surgery.

 

[Sunnysept]

I’ve had ongoing psoas issues from 1 year post thr and still ongoing. Finally got a steroid injection under ultrasound at the end of June but I haven’t had any pain relief whatsoever. Consultant said he can see the cup ever so slightly proud and it must be irritating the tendon. There’s a lot of bursitis there around the hip capsule and the tendon is unhappy, but obviously too much for one little steroid injection to deal with, even temporarily. The consultant wouldn’t inject the bursa directly for fear of infection, but injected the space between the ligament and the muscle.
Now 6 weeks on, I’d probably say that my groin pain is worse if anything and I got no benefit whatsoever. I’ve also got trochanteric bursitis (evident on ultrasound) and although I don’t find that painful to lie on, I think it may be now causing a pain when I’m walking - an odd intermittent pain which I can only describe as coming from deep within the trochanter area and literally can be there one minute and gone the next - and back again the next . Weird. And if I press hard on this area as I’m walking, I can feel a clicking as I step out.
Has anyone else had psoas impingement after thr and not had any effect from a steroid injection ? What did you do next? Does is sound like these are just bursitis issues or could they be something more serious - like a failing hip?
Very fed up.

 

[Sunnysept]

I guess if nothing else my post chronicles my history and may just help someone else who has similar symptoms as I do, even if no one can help, empathise or add anything which might help me.

I am very low. I had hoped for the last 30 years that the hip replacement I knew I had to have someday would or at least should give me my mobility and in many ways my life back. I could start joining in family walks, play tennis for fun again with my friends and not feel pain every time I walked to the pub. Ordinary things. It was good for a year. Now I’m feeling pain that is reminiscent of a few years prior to surgery, when it started to get very bad. Not as bad as just prior to having the op, but I’m thinking this is all very **** .

 

[Layla]

Hello @Sunnysept
I'm sorry for your struggles, pain and suffering. My heart goes out to you. I honestly don't know how to advise. The forum nurse is currently away or I'd consider tagging her for you. Hopefully someone will stop by who's experienced the same and has something constructive to offer. We're here for you and we do care, but we don't always have answers...What does the consultant advise you do?
Wishing you comfort and resolution.

 

[Jamie]

Hi, @Sunnysept....I'm so sorry you've had such a continued saga of pain and problems. Did this last consultant you saw give you any options to resolve the irritation? I can understand your frustration because you obviously have had pain since your hip replacement and not a lot of help from your doctors getting to the bottom of it. If this surgeon cannot provide a suggestion other than "live with it," then I'm afraid you'll need to keep looking for the right doctor to help you. It could mean traveling quite a distance to get to a larger hospital that has surgeons who specialize in problem cases. I wish I could offer something definitive for you, but you've tried so many non-surgical options that have not helped, I'm not sure what else there is to try. Are you able to and willing to travel to London to see someone? That would be my suggestion if it's at all possible for you.

 

[Fiona444]

Hi @Sunnysept i am so very sorry to read about your issues post THR. It must be horrible for you. If the injection didn’t work what does the surgeon suggest next? If he can see the cup is sitting proud then surely he can suggest a resolution and not leave you in pain? I would definitely recommend getting a second opinion. Would it be an option to pay for a private consultant to look? That doesn’t mean you can’t continue treatment on the NHS but it might get the ball rolling for you

 

[Mojo333]

So sorry that you are still struggling so.

Has anyone else had psoas impingement after thr and not had any effect from a steroid injection ? What did you do next?

Yes. SaraK! Who is doing very well now.

I had the steroid injection on 10/24. I could feel an immediate difference because of the "Caine" drug included in the mix. That wore off within an hour. I started feeling the benefit within a couple of days and felt great for about 2 - 2-1/2 weeks then pain came slamming back.

I have 3 small incisions (1-2 cm each) at the top of my thigh. I had some pain there and some pain in groin in the first few days, but not much - primarily stiffness/swelling and that went down quickly.

Best thing I ever did was the hip replacements. Second best was continuing to push for correct diagnosis and get this surgery.

Please try to look into this and don't give up.
for getting something rolling soon.

 

[SaraK]

Hey, @Sunnysept - I've been where you are and have come out through to the other side which can be sunny indeed! I felt as low as your are now as I dealt with pain and physical limitations that just kept getting worse. I first had some injections into the muscle as it came off the spine (doctor thought it was back problem) and that helped some but now very long. Then found the right doctor and got an injection into the tendon itself. So much relief but again very short lived.

That's when they scheduled a hip arthroscopic with tenotomy to cut/release/lengthen the psoas tendon. That left some weakness as I has to "grow into" the longer tendon/muscle but almost immediate pain relief.

If they can see that the cup is a tad prominent, are they talking about this procedure? If not, please ask about it. The other surgical treatment I have heard of is to do a revision and move the cup. That seems like a more drastic approach and I'd think they'd leave that as the last resort.

At least you have that diagnosis, though. It took me forever to get anyone to listen and believe that diagnosis was possible!

Tag me or give me a holler any time you want to talk.

 

[Jaycey]

@Sunnysept I have been doing some research for you. First - can you tell me who did your original surgery and at what hospital?

 

[Sunnysept]

Hi . Thanks all . I get so tearful about all this some days and don’t know where to start.
I had my original surgery in Gloucester and decided to get a second opinion from a consultant in Bristol (already 60 miles away) which I paid privately for. It’s he who sent me for the dynamic ultrasound and steroid injection.
I don’t know what the plan is now that the steroid didn’t work at all. No pain relief from it. I’m reluctant to pay another £220 just for him to say “that’s it” , after the first one I paid for plus the cost of the steroid /ultrasound I’ve just had.
I do know that cup revision isn’t an option until absolutely necessary as I dont have much bone left . I also know that this second consultant does an arthroscopic tenotomy - complete cut . Not sure where about’s exactly he cuts it but from SaraK post that’s something I’d like to ask him .
Ive asked about Botox too but I dont know whether that will prove/do anything.
I am wondering if there’s a chance the steroid went in the wrong place or not enough for such a chronic problem . I don’t know. All things I’d like to ask the consultant before I decide where to go next .

 

[Jaycey]

@Sunnysept I don't think you should go back to the OS in Bristol. But if you answer my questions in post #57 I'll try and recommend some surgeons near you.

 

[Sunnysept]

Sorry - how do I know which is post 57 and can I direct message you the info if it’s the message sent yesterday ?