THR Pain one year after, sigh

[HipButSquare]

I am having undiagnosed pain one year out from my posterior right hip replacement.

My recent MRI and blood work were fine. I had gotten up to walking a mile and a half and now can barely walk around the block.

I’m on Gabapentin but I don’t think it helps much. I take Tylenol once in a while.

I’ve put on almost twenty pounds since the surgery and can’t exercise to take off the weight. I will cut calories.

My pain is mainly in the quad, with numbness in the outside of the hip.

My surgeon is puzzled and he has decades of experience doing hip replacements. He’s not going to do exploratory surgery.

It so frustrating to not know if I’ll be able to get past this pain.

Hi. I’m a tear out and have been experiencing quad pain and pain in the bursa. My consultant believes I have bursitis which commonly presents through the quad area. He’s arranging a steroid injection for it which I’m he hopes will sort it. I’m so fed up. I’m only 45 and can hardly walk at all with it at times. It’s a really sharp pain that nearly knocks me off my feet. Also gained weight too since surgery and it’s really getting me down. I’m in the UK.

I’m sorry to hear about your pain. I also feel down about my failure to recover after a year.

Today, I had my second dose of Shingrix, so, I get to experience two pains instead of one.

 

[hhhooray]

Hey, I didn’t see what method was used during your surgeries. Mine was anterior and my surgeon told me in about 1/3 of surgeries, the numbness is permanent. I have the numbness in a spot on on the outside of my left 11 months out but it doesn’t bother me as the outside of my thigh isn’t a spot that I pay much attention too.

As for thigh pain, I do not have any insight as mine dissipated within a couple weeks on both.

Hope you get some answers.

I had the anterior as well and I'm 16 months out and I still have some numbness on the outside as well and it's not a showstopper. Though little by little, and it's so slow and hard to define, but it is getting better with time. It may never come all the way back but having had radial nerve palsy in my right arm once, I know nerves take A LONG TIME to recover if ever...

 

[hhhooray]

What I don’t understand is how I can go so quickly from no pain to excruciating pain.

I slept all night without pain. I put my legs over the edge of the bed to get up I’m in a world of pain and can barely move my leg. That’s with putting no weight on the leg.

Then, when I put weight on the leg, the pain is terrible but after hobbling around a bit, it often goes away and I can walk without pain for a while before being hit again with pain.

Is this muscular? Is this the appliance? We might as well speculate because the MRI and the bloodwork say everything is fine, and yet, I have this debilitating pain that comes and goes.

Hi HipButSquare! I'm not sure I can give much insight though I do know in my experience our bodies and our experiences in recovery are all different, but I found it difficult to differentiate from what was muscular pain or real bone/surgery pain for a long time. I did need a shot for the bursa in my psoas area 6 months out and complete rest after that for a period of time to really to start to heal and begin to strengthen the muscles again. With that said, for me, I'd find a good PT, physiatrist to really help get some strength and mobility exercises going especially if all the xrays/mri's etc look good. They may be able to assist you in figuring out if it's muscular, soft tissue or bone related pain/discomfort, and with your surgeon, find a path forward. I'm not talking about starting crossfit or anything but simple and fairly gentle dynamic stretching/strengthening exercises. One thing I do know and that is the longer it is for you to be able to start strengthening that hip, the longer it's going to be for recovery.

 

[spaniel]

I had a very long recovery as well and tend not to be on here often. I am doing reasonably well despite what is likely a permanent limp,leg length discrepancy, and likely permanent paresthesias in the unoperated side. THR was 2/22 anterior. As much as you like your doctor,…and frankly that’s great… being “stumped” at this point does not seem reasonable to me. I would absolutely get a second opinion as well as a referral to a great PT,even if the PT is very slow. I did PT for over a year and a half and the feedback was invaluable. And for second opinion, try to get a very seasoned person if possible.

 

[HipButSquare]

I had a very long recovery as well and tend not to be on here often. I am doing reasonably well despite what is likely a permanent limp,leg length discrepancy, and likely permanent paresthesias in the unoperated side. THR was 2/22 anterior. As much as you like your doctor,…and frankly that’s great… being “stumped” at this point does not seem reasonable to me. I would absolutely get a second opinion as well as a referral to a great PT,even if the PT is very slow. I did PT for over a year and a half and the feedback was invaluable. And for second opinion, try to get a very seasoned person if possible.

My surgeon has close to three decades of experience with joint replacement. Some people take longer to recover from pain than others. My surgeon has seen people at over a year out still struggling with pain.

I’m sorry to hear about your troubles. I think the robot, which can set leg length much more accurately than a human, helped me out in that department.

I’ve had follow up X-rays, an MRI, and blood work. None of the tests show a problem. I can understand why the surgeon is stumped.

If my pain grows much worse then I will look for a second opinion. At this point, things seem a little better after reducing my activity and alternating Advil and Tylenol, with 100mg of Gabapentin at night.

I hope my body finds a way to recover. I wish you good luck as well.

 

[HelenaM]

I have not been on this website for a long time because I feel that my hip is now very good and my pain level is close to zero or maybe zero.

At one year post surgery for right anterior hip replacement, I still had pain near the scar and down the outside of my thigh My surgeon said he saw nothing wrong, and I consulted three other respected surgeons and a pain orthopedist who agreed and said I had meralgia paresthetica or maybe IT band problems or maybe tendinitis or all of these.

I am glad to say that I experienced a lot of improvement in year 2 and some in year 3. I did have pt in year 2 that really helped and included massaging the scar. In retrospect, I think that I healed more slowly than some people for whatever reason. I can do almost everything I did before the arthritis except I still walk a little slower and maybe shorter distances, but even that is improving. I am working on it.

So, it may help to consult another surgeon, or it may be time that helps... I am somedays surprised and thankful that mine is as good as it is because of the discouraging first year.
Best wishes to you.

 

[HipButSquare]

I have not been on this website for a long time because I feel that my hip is now very good and my pain level is close to zero or maybe zero.

At one year post surgery for right anterior hip replacement, I still had pain near the scar and down the outside of my thigh My surgeon said he saw nothing wrong, and I consulted three other respected surgeons and a pain orthopedist who agreed and said I had meralgia paresthetica or maybe IT band problems or maybe tendinitis or all of these.

I am glad to say that I experienced a lot of improvement in year 2 and some in year 3. I did have pt in year 2 that really helped and included massaging the scar. In retrospect, I think that I healed more slowly than some people for whatever reason. I can do almost everything I did before the arthritis except I still walk a little slower and maybe shorter distances, but even that is improving. I am working on it.

So, it may help to consult another surgeon, or it may be time that helps... I am somedays surprised and thankful that mine is as good as it is because of the discouraging first year.
Best wishes to you.

I am glad to hear that there can be improvement in years 2 and 3. Thanks for posting.

It is been 14 months for me.

Yesterday, I managed to walk a mile to the bakery and back. That is the longest I’ve walked in many months because of pain.

I hope this is a good sign. I felt a lot of pain later in the day so I rested.

 

[myglasshalffull]

Dear Hipbut square,
You are learning to listen to your body it's not an easy task to be patient when all we want is to get back to our lives before hip replacement.
I had different "milestones" along the way where I felt I was "back" but I was only half way back possibly.
But now, 19 months??? later I really can wake up and get on with my day and not have to stop and sit and ice or scale back what I want to do. I still take a rest period a couple of days per week in afternoon to just enjoy a show I may have recorded or take a 15 minute nap! I'm an early riser so by 3PM I'm usually a little tired but if I take a quick rest I'm ready to face rest of day and evening.
I'm in Texas for next week dog sitting my son's two dogs while him and my DIL bring my grand daughters to their respective colleges on West Coast, Oregon and Seattle, then they are taking a 3 day getaway for themselves.
Nice pool here that I've been enjoying everyday plus walking. Feel great.

 

[HipButSquare]

So, after over a year of not being able to exercise, gaining weight, and feeling down, today I ordered a machine that will raise my heart rate and help me to start getting back into shape.

Meet the SkiErg. I’ve used one of these in a rowing class. This machine provides a strenuous workout and I think the slight bend in the hips will not risk dislocation of my hip replacement.
Check it out at - Concept 2 SkiErg

 

[Layla]

I hope you love it, HipButSquare, and achieve the desired results.
Good Luck and Enjoy!
@HipButSquare

 

[HipButSquare]

Oh, I’m sorry I posted a link to the SkiErg.

Here is an update.

I’m using the machine every day now and it definitely raises my heart rate and gives me a good workout. It does not appear to cause pain in my hip.

My numbness and pain levels are about the same, perhaps improved some. I can walk two miles, to the bakery and back. A friend said I should stop walking to the bakery in order to lose weight, lol.

My workouts on the machine are just six minutes. You do not have to go at it for hours. It makes the triceps sore. Once I strengthen them, I think I’ll be able to SkiErg longer.

This machine is also used by wheelchair athletes while sitting in a chair.

My mood levels have improved with more exercise. My wife also likes the SkiErg.

I’ve always been kind of a cardio junkie. This machine will improve my cardiac fitness.

 

[Hippie Chick]

Exercise is great for boosting one’s mood!

 

[LucyVanPelt]

So sorry to hear you are having such pain after surgery. We go through THR because we are already in extreme pain and we want to be pain free. I am one week post op for LTHR.

Prior to my hip replacement, I struggled with severe pain for 3 years. Went to my GP in 2020 and he sent me to PT for my lower back. I thought he had missed it, because I didn't feel ANY pain in my lower back. I felt extreme pain deep in my buttocks and on the outsides of both legs from the hip bones to the knees.

I learned pain is a weird thing. Pain is caused by nerves. My PT said when the body experiences severe lower back pain, it pushes the pain out and down. And the more severe the pain, the further down it gets pushed.

My brain had a hard time accepting this. My body is telling me I hurt deep in my buttocks and down the sides of both thighs, but you're telling me this is not true. The truth is that I'm hurting in my lower back? Yes. And if I want the pain to go away, I don't do exercises for where I feel pain, I do exercises for my back? Yes.

So the PT worked on my left SI Joint and kept realigning it over and over. It was slipping out of place and pinching nerves. Sometimes he realigned my L5 vertebrae too. I did the prescribed exercises to strengthen my core and hold everything in place. One day, the pain suddenly vanished from my buttocks and thighs, and I felt pain in my lower back. When this happened, the PT said, "You're almost well!" The pain had lessened enough that I could actually feel it where it originated.

Today, my back is stable and pain free. Well... it was before surgery! I am feeling a few twinges in my lower back since having THR. I will go to the PT when my restrictions are lifted and get him to realign my back. Everyone keeps telling me the surgeon had to WRENCH my ball out of my socket, and then he SAWED OFF the head of my femur, and then he POUNDED etc. At this point I put my hands over my ears and start going "La, la, la, I am not listening to you!"

Your surgeon cannot see anything amiss, but is it fair to say that something has to be pinching or irritating a nerve? And since at one time post surgery you felt less pain and today you feel more pain, it should be reversible if you can figure out where it actually originates? All lower body nerves branch off from the spine, right? Is there a medical school near you? Medical schools have doctors who routinely think outside the box. They are the inventors and innovators. Perhaps a visit to the nearest medical school's orthopedic and/or neurology departments might shed some light on your situation.

I wish you great success in your quest to be pain free. You deserve to be pain free! Please don't give up.

 

[HipButSquare]

Thank you for your kind words.

Wow, you have been through quite a journey. I am happy to hear that your pain levels have decreased.

My pain is manageable. Before surgery, I could barely get any sleep. Now, I can sleep. Life without sleep is misery.

I hope that strengthening my body would help me. I will report more results over the next year.

 

[HipButSquare]

I have been doing well with the SkiErg but now, I seem to have taken a turn for the worse, in terms of the pain in my hip.

I’m going to cut out the squatting part of the exercise and do the workout seated in a chair.

I have pain and stiffness at the top of my hip, and on the front and side. I also feel pain at the top of my hip bone, and above my knee.

I’m icing with the Breg Polar cube before I go to bed and have dropped the Tylenol and Advil, and am taking just 100mg of Gabapentin.

I’m worried that something is wrong with my device. How could I tell?

It doesn’t not seem to be getting better and I am feeling down about it.

 

[HipButSquare]

So, I’m kind of wondering if the pain above my knee is related to the stem and its position in the femur. Could it possibly be moving?

I believe my surgeon referred to this as windshield wiper movement but said there was no evidence of that back in June when I had an X-ray.

I have another appointment in December so I will see.

 

[springs12]

@HipButSquare Just a thought. I'm certainly no expert. Have they looked at your other hip? Sometimes pain is felt on the "good" side from compensating. Maybe someone has thrown this thought. Also as mentioned, could be lower back. Pain is strange. I had my right hip replaced in June, and I showed a ton of improvement, but I got to the point where I told my PT that I felt like it improved as much as it could bc my left side was holding it back. Did the left hip 9 days ago...so we shall see.

EDIT: you may have mentioned this as well. I read you are on gabapentin...or were. Have you had nerve testing done to see if you have nerve damage?

 

[HipButSquare]

@HipButSquare Just a thought. I'm certainly no expert. Have they looked at your other hip? Sometimes pain is felt on the "good" side from compensating. Maybe someone has thrown this thought. Also as mentioned, could be lower back. Pain is strange. I had my right hip replaced in June, and I showed a ton of improvement, but I got to the point where I told my PT that I felt like it improved as much as it could bc my left side was holding it back. Did the left hip 9 days ago...so we shall see.

EDIT: you may have mentioned this as well. I read you are on gabapentin...or were. Have you had nerve testing done to see if you have nerve damage?

I don’t have any pain on my good side. All of my pain is on the side where I had the hip replaced.

I also don’t have any pain in my lower back.

I’m limping because of pain in the stem area. I have numbness near the ball socket and on the side of my hip but that I can tolerate that and it does not interfere with walking like the pain lower in my leg does.

I’m on 100mg of Gabapentin. That’s not much. I was trying to get off of Advil and Tylenol.

I don’t believe nerve damage can be repaired and, it seems to me that nerve pain should not cause a pronounced limp.

The icing is not helping at all.

Good luck with the other hip. I can’t imagine having both done considering how bad one side has gotten.

 

[springs12]

@HipButSquare I hear what you are saying, and I am so sorry that you are still in pain. I ask my questions because pain is weird. Prior to even being diagnosed when I was trying to figure out what was wrong with me, my PTs would tell me that what I would feel wouldn't always match what they would feel soft tissue or back wise.

I read that you didn't want to do PT you didn't want them to manipulate you. PTs can evaluate the soft tissues and perform soft tissue work and allow you perform exercises to strengthen muscles they find are weak. If you find a good PT, you can call the shots and say that certain exercises are a no go bc they increase pain.

The reason I throw out investigating some other areas is 1) sometimes when there is a bad hip, we feel it in the good hip due to compensations bc the joint pain may not always be felt if the muscles are working harder, and 2) nerve pain is a strange thing. You mention numbness and quad pain and pain in the stem area. I 100% understand that it feels deep in the stem area and I'm so sorry that is your case and I would too wonder if it has to do with the implant. I ask about nerve pain because yes, nerve pain could cause a limp. I know that you mentioned you didn't feel it was sciatica bc the pain is not deep in your buttock, but I think of all the people I know with sciatica who do limp when it is acting up due to the pain it creates. The femoral nerve innervates the quad and although I read you had the posterior approach (there is greater risk of damage to this nerve with the anterior approach), the nerve still runs through the lumbar spine, which is why I say checking out your back could be worth a shot. As I mentioned, and as you describe, you have checked the implant with imaging and your surgeon, and sometimes it can take time for problems to reveal themselves on imaging. It stinks when that is the case too.

I really hope you can find answers because I can only imagine this is very frustrating to you.

 

[Clairebella]

I’m only 3 months out and struggled with pain this whole time and have a long way to go, sorry to hear you are having pain at your point.

I would recommend you seeing a physiotherapist for a good work up. A good PT like mine has excellent knowledge of all the soft tissue and muscle groups, the nerves the facia the dermatome’s etc etc.

Did you have mako robot?
Do you have a cemented stem?