Pain Experienced

[Dennisp]

I am (or should say was) a very active 62 year old that will be having a left hip replacement in the next month and have a question regarding the pain that I am currently experiencing. I clearly have pain in the immediate area of the problem hip joint but I also have a tremendous amount of pain on the outside area of the hip (in the area of the bursa and various tendons/muscles - but very clearly on the outside area of the hip - especially if any weight bearing on that left leg is involved ). Over the past 9 months I have tried a steroid injection to the bursa, a cortizone injection to the outer hip area, 20 sessions of physical therapy, icing the outside area, applying heat to the outside area, and lastly acupuncture - nothing seems to help. I saw a sports doctor yesterday and he said that the unstable hip joint was causing the pain to the outside hip area by irritating the tendons/muscles. Is this type and location of pain typical for a person needing a hip replacement?

Dennisp

 

[Josephine]

Short answer, Dennis - yes! You need to remember that old saying "everything is connect to everything else"! Fact of the matter is, anything around that area is very close to the joint and it's not just the hip joint that is affected. Arthritis is a degenerative condition that affects not only the joint but all the surrounding structures.

Therefore you can get symptoms in the lower back, the buttocks, the groin, the outer aspect of the thigh, the inner aspect of the thigh, the hamstrings and even the calf. This is because all the muscles in those places are intimately involved with the hip joint as you can see here ...




So any inflammatory process that occurs in the joint will naturally manifest in the muscles - arthritis is an inflammatory process. The bursa you referred to is usually either where the piriformis muscle is attached to the outer side of the thigh bone or where the psoas major is attached to the inner side. But note that neither of these points is more than about 3-4" from the joint itself. inflammation can travel a lot farther than that!

You find that for some little while after your replacement it might still be painful there but it will abate with time as the primary source of the inflammation is gone.

 

[Dennisp]

Josephine: Thanks for the reply. You have put my mind at ease about this a very great deal.

 

[Josephine]

My pleasure, Dennis!



(I love this job!!)

 

[JGosse]

I am 56 and had both hips done this year (January and Septmeber) due to "N" stage arthritis. My right hip was done in Sept. and my recovery went fast, but now I am experiencing pretty severe pain in the top of my femur when I step. It doesn't hurt at all at rest, only when I walk. The longer I have been sitting, the worse it is when I get up. I can kind of "walk it off" and it gets a bit better after I have been on my feet for about 10 minutes, but it does not go away. My surgeon isn't alarmed, and told me to up the Advil and take it easy of the PT for a while. I'm taking a lot of Advil and have to actually take a half a Vicodin sometimes. Is this going to get better? Is there anything else I can do? Is it possibly that my muscles are not strong enough yet and I should change my exercises to increase strength in my quad and flexor? I didn't have this with my other hip. In fact, I never even notice that one any more. All in all, this was a very worthwhile experience, but I want to stop limping.

 

[Josephine]

I suspect it's more in the bone or a mixture thereof. At any rate, the bone can take time to get accustomed to the presence and unnatural loading of the prosthesis. It's not uncommon and can last a goodish while though I would be loath to put a time frame on it as it varies so from person to person. The really annoying fact for people like yourself is that, as you have discovered, not everybody experiences it. Just bad luck, I'm afraid so, as your surgeon so adroitly put it "keep taking the tablets" and wait until it settles! Because it will, in time. It will settle and you will be striding out just like you did with the other one.

 

[SherryOP]

Dennisp:

I had my surgery 2 weeks ago and now have 0 pain from the arthritis like I had before, same as you described. I also had bone spurs which were not too user friendly.

Hopefully a THR will help you as well.

Best of luck, Sherry

 

[Dennisp]

Hi Sherry:
Thanks for the info. I just can't wait to get this all over with and get on with the recovery. Unfortunately there is a relatively long wait in the Albuquerque area.

DennisP

 

[Josephine]

Thank your lucky stars you're not in the UK where patients have to wait up to 6 months for a consultation and another 6-8 for the surgery!

Hope you don't have to wait too long though.

Hope 2008 proves to be a better year for you.