THR Possible revision surgery after 3 years

[benne68]

I hesitate to go to physical therapy because I’m afraid they’ll cause me more pain.

I totally understand your concern. Too many PT practices out there have a one-size-fits-all approach.

Have you looked into having an assessment done by a Doctor of Physical Therapy? They take a "total body" approach to diagnosing issues like this and develop customized treatment based on your needs. Mine does a lot of hands on therapy.

Another option is a physiatrist, if you haven't already seen one. They are medical doctors who diagnose and treat conditions affecting the muscles, bones, and nerves.

 

[Jamie]

The idea of a Doctor of Physical Therapy is a good one. But I don’t know enough about the healthcare system in the UK to know if they have such a designation.

The pain you describe sounds like stem loosening and I I still think you might explore getting an MRI to completely rule that out. It can be missed on an X-ray. Can you make an appointment with a different surgeon completely unrelated to your current doctor and request that? Are you coming back to the USA any time soon?

 

[Jamie]

I just took a look at the structure of the physical therapy field in France and it sounds as though it’s not possible to see a Doctor of Physical Therapy. Their medical system does not have a doctorate level program for this and any therapist you see will only have a bachelor level of training.

The point of the Doctorate that we have in this country is that it requires additional training so someone who completes that level is able to diagnose problems with joints in relation to the whole body. While you might find a PT who had enough experience to identify what is going on with your leg, having someone trained at the Doctorate level would be a much better guarantee that you’d have a correct diagnosis and treatment. So, based on that, I agree with your thoughts about going to therapy while you are in France.

 

[HipButSquare]

I’m in the states.

I’m not in France or the UK.

 

[HipButSquare]

The orthopedic surgeon wants to see me in 6-8 weeks if I my symptoms don’t improve.

I’m doing more clamshells to see if it is just bursitis but I still have pain.

 

[Jamie]

Thanks for clarifying your location. Then the suggestion to see a therapist has a Doctorate degree might be helpful for you. These folks can diagnose pain issues very well.

 

[HipButSquare]

This morning, I took out my hiking sticks and did a short walk around the block. The pain was minimal.

I spent all day walking around the house, and alternated with periods where I lie down to rest the leg.

At night, right before bed, the pain gets much worse. It can feel like the leg is cramping or locking up.

I lie down, sleep, and it gets better.

This cycle repeats itself every day.

 

[Jamie]

This is very normal. If you get a significant amount of pain at night, you might try to cut back a bit on your activity. The pain indicates you’ve pushed yourself a little too hard for this stage of your recovery. It’s great that it disappears overnight, but the goal is to be just active enough during the day to challenge yourself, but not so much that you tire your muscles out to the point of pain. The pain gives you swelling, which is the number one thing you want to avoid while recovering from joint replacement surgery. It can make your recovery slower because your body is constantly fighting the swelling and that energy isn’t going to healing. It’s a tricky balance. And it changes as you get stronger later in recovery. Right now you are very early in the recovery process and you want to do everything you can not to overdo things.

 

[HipButSquare]

It has been 3 years since my hip replacement.

I’m not early in my recovery. I’m trying to figure out what has gone wrong with my replacement.

I was up to walking two miles a day a couple of months ago and now I can barely walk down the street.

 

[Deni444]

At night, right before bed, the pain gets much worse. It can feel like the leg is cramping or locking up.

I imagine that sometimes the admins who are covering a lot of different threads, understandably get their responses mixed up.

I'm sorry that I can't really offer much to ease your mind. The one thing that resonated with me was the leg cramping and locking up. This was one of my main symptoms on my left side prior to hip replacement. It would ease if I rested but return upon being on my feet again. I don't think my symptoms were typical but it did resolve after surgery.

Could you maybe go back and ask for an appointment sooner because it is getting worse not better? In the meantime, I hope you can find a little relief from the exercising you're doing. Maybe some massage could help?

 

[HipButSquare]

Sadly, I think the exercise is increasing my pain. By exercise, I mean walking outside for 15 minutes while on level ground.

It is a mystery to me why the implant can look good on the X-ray and bone scan yet cause me so much pain.

If I sit on the edge of the bed, I get sharp pain where the mattress crosses the thigh.

I will tough it out until September 16th, my next appointment with the orthopedic surgeon. One reason to wait is to see if it improved with conservative measures. Another is to limit my exposure to radiation if it is decided that I should have an MRI.

There are problems with seeing the implant on an MRI so it is not necessarily a better image for treatment.

 

[Jamie]

@HipButSquare Oh my….I apologize!! It was my error not to see that you were three years out from your hip replacement. This is a completely different matter.

I think it’s prudent to see if you can help things by taking it easy until your September appointment with your surgeon. My guess is that he’s going to tell you the pain is related to soft tissue problems which normally would be resolved with physical therapy. The fact that you have muscle pain sitting on the edge of the mattress certainly would suggest this. If you haven’t tried ice and/or heat to the area that hurts, I would give both a try.

You’re right that after a joint replacement, MRIs have to be done in a specific way to get the best imaging possible. It is tricky sometimes to get the settings correct. But remember this imaging is done magnetically, so there is no radiation involved like you would get with a CT scan or x-ray. But what an MRI might be able to do is identify exactly the area that is your problem. So, if you’re still having pain, I hope that would be the next step suggested by your surgeon.

 

[Layla]

Wishing you comfort, HipButSquare.
Another three and a half weeks to wait in pain is a lot. I hope your next appointment is enlightening and in some way leads to resolving the pain. Please keep us posted.
@HipButSquare

 

[HipButSquare]

Thanks for the advice.

Yes, three and a half weeks is a long time to wait in pain.

Every day, I am doing one short circuit of a block in my neighborhood using trekking poles. Still, I struggle with pain.

This pain does not feel like muscle pain to me. It feels deeper. It feels like this pain is in the bone. As a runner, I had quad and hamstring pain for years. This feels different.

Yes, I hope an MRI is the next step if I am still in pain at my next appointment.

 

[HipButSquare]

I think I’m going to try to walk outside every other day to see if that helps reduce the pain.

Still, the distance I cover is so short that it is demoralizing.

I have to go to New York on business in September or October. I don’t know how I’m going to tolerate all of the walking involved with that.

 

[Layla]

I think I’m going to try to walk outside every other day to see if that helps reduce the pain.

That's a good idea. Hopefully you do notice a difference. Let us know.
Lots of comfort to you, and a pleasant weekend too.

 

[benne68]

have to go to New York on business in September or October. I don’t know how I’m going to tolerate all of the walking

I'm sorry that you have to travel when you are dealing with this kind of pain. Try to use cabs/Uber as much as possible. Don't try to do it without your trekking poles or a cane or some other walking aid. I had to go to New York just before my last hip replacement and I thought about leaving the cane at home; I'm glad I didn't -- even though it was a bit embarrassing to have to explain to clients.

 

[Jamie]

If you can delay the trip until you see your surgeon, that might be a good idea. Hopefully then you’d at least know what you’re dealing with.

Also, be sure to take advantage of the wheel chair assistance that is basically free (you just need to tip the person who assists you). That would at least let you avoid all the walking in airport terminals (assuming you are flying). One bonus is that you get through lines MUCH faster and are first to board.

 

[HipButSquare]

I will see my surgeon before the trip but I won’t anything done before the trip.

A surgery would take months to arrange and months to recover from.

We will be flying. I’m not up for driving 9 hours each way.

I have a black carbon fiber cane. I assume that New Yorkers are still wearing black. As someone said when arrived in New York, who died?

I spent over 20 years living in Manhattan. If we move out of the country next year, this may be the last time I see New York. There is some sadness in that.

 

[Layla]

I have a black carbon fiber cane. I assume that New Yorkers are still wearing black. As someone said when arrived in New York, who died?

Hahaha. You'll fit right in as black is foundational and loved by many, myself included, a great backdrop for fun accessorizing. I'll bet your visit to NYC will feel bittersweet, not knowing if you'll ever return to a place where you created many memories. I wish you the best in finding the least painful ways to navigate the city while you're there. Let us know how it goes.