THR Sciatic pain and thigh numbness

[KatieP]

Hi fellow THR rehabers,
I'm 18 days post LTHR, I had the Mako robotic surgery and returned home the day after surgery.. certainly it is much more of a surgery than I envisaged.. it's no walk in the park, but at day 10 I felt I'd turned the corner using just a crutch .. I found sitting and lying on my back the most painful because of sitting on the wound and feeling nerve pain as well as surgical pain.. as the surgical pain has eased, the nerve pain has not, it's so unpleasant, simply raising my operated leg to climb the stairs sends horrible sciatic pain right from my Butt ( at the scar level) and this radiates down my leg to the calf.. I've pretty much given up on exercises that put me in that position ( marching on the spot and sliding the operated leg towards me when lying down) I can find nothing on websites about this potential recovery issue other than to say damage to the sciatic nerve is a devastating complication.. which I didn't want to read.. I'm hoping that swelling and inflammation in the gluteal area ( posterior approach) is aggravating this, but because I have upper thigh numbness too I'm concerned that I've had nerve damage.. surgeons nurse said it should come back but I haven't mentioned the sciatic pain yet.. I suspect they will say wait and see... I'd be grateful for anyone whose heard of this issue or had a similar experience during recovery..

 

[Jaycey]

@KatieP Welcome to BoneSmart! What was the date of your surgery? I'll put it in your signature for you.

I experienced the same issue post LTHR (posterior approach). I have lower back issues and had a major sciatic flare after my op. It's horrid and very worrying I know.

I found doing hamstring stretches from a seated position very helpful in easing this. Start very gently as your hamstrings may be very tight. You might not be able to lift that op leg at first. If not, just stretch your leg out in front of you and pull your toes toward your body. As you get more strength, lift your leg and pull the toes towards you.

I found this works well if you having a pain flare. It also helps ease any chronic sciatic pain that I have. In addition, sitting on an ice pack helps. This will all ease with time.

Here are your recovery guidelines:

Hip Recovery: The Guidelines
We are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for YOU.“ Your doctor(s), physiotherapist(s) and BoneSmart are here to help. But you have the final decision as to what approach you use.

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 discomfort:

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 this BoneSmart philosophy for sensible post op therapy
5. Here is a week-by-week guide for Activity progression for THRs
6. Access these pages on the website

Oral And Intravenous Pain Medications​

Wound Closure​

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.

 

[KatieP]

Thank you so much for your prompt reply.. I will do these exercises. My operation date was 30/12.. so I'm at 18 days post op. The sciatic pain became more of an issue following my first PT appt.. she was so impressed that I could walk unaided ( a couple of strides) that she recommended I not use the crutches around my house, this seemed wrong and during the session I struggled as I didn't have sufficient strength.. but I did my best to follow this physiotherapists recommendations. By the time i got home I felt I was In Trouble and decided to rest the hip until I felt better.. Over the next few days ( 1 week) i had to up my medication and couldn't raise my leg sufficiently to climb the stairs without experiencing a real pinch in the buttocks nerves, so I have avoided anything that agrivates it. I really feel that her advice was not appropriate.. your reply gives me hope that this will sort itself outI am hoping that the numbness in my mid thigh also resolves, as it's not only numb the outer area is quite uncomfortable and prickly, almost like bad sunburn.. I know that sensation in the skin can take time to come back but I worry that it will effect my muscle recovery.. it's a very odd feeling. Glad to have found this forum and I will do my best to share any of my experiences should anyone have any quesrions about their upcoming surgery or post op recovery

 

[Jaycey]

she recommended I not use the crutches around my house

Oh dear - not a good idea so early out - especially if you are having sciatic problems. In my experience you need at least one crutch to keep the weight off that side that is having a flare.

Just keep in mind this is all temporary. A pain in the butt (literally), but all will ease with time. Walking may also ease this. And walking is really the only therapy needed post THR. There is plenty of time for strength training once that hip is healed.

 

[subie2021]

Ouch! Sciatic pain is just miserable! I hope yours resolves soon.
As far as PT, you're allowed to Just Say No if you feel that you aren't ready for certain exercises. Don't be shy about telling them that you don't feel ready yet. After all, the therapists are there to work for you, not you there to work for them. In my experience with many rounds of PT, not one therapist ever was put off by me declining; they either let it slide entirely or modified the move for me.
Good luck through the process of healing, and best wishes that you feel better soon.

 

[Hip4life]

Oh, I’m so sorry you’re dealing with sciatica. You are still in the early stages of recovery. You are so right not to give up your assistive devices until you feel comfortable doing so. As long as you’re in pain, feel weak, or have a limp you should be using something. I used mine for many weeks. Also, I cannot emphasize the frequent icing and for the time BoneSmart recommends: at least 45-60 mins each session. It not only helps with swelling and inflammation but also with pain control. It will even help with those itchy, burning sensations around the incision. Just make sure you have a cloth barrier between your skin and the ice pack.

Many of these sensations are very normal but thankfully, also temporary. It’s hard not to worry about everything. The sciatica is definitely a challenge but you’re doing great listening to your body and trusting your instincts. Just continue to be patient and kind to yourself. We’re here to cheer you on and support you any way we can. Keep us posted. Blessings.

 

[Layla]

Hello Katie,
Welcome to BoneSmart and thanks for joining us. I’m really sorry you’re dealing with sciatic pain. Hopefully with rest and a big dose of TLC it eases quickly for you.

I am hoping that the numbness in my mid thigh also resolves, as it's not only numb the outer area is quite uncomfortable and prickly, almost like bad sunburn. I know that sensation in the skin can take time to come back, but I worry that it will effect my muscle recovery, it's a very odd feeling.

Here is some information that helps explain those sensations -
Small sensory nerve fibers are cut with the incision. These nerve fibers run from the inside to the outside of the hip and cutting them causes the hip to feel numb after surgery. It is a temporary sensation that normally resolves over a period of six months to one year post op.

While healing you may experience sensations of tingling, pins and needles, itching, burning and even the feeling of a minor electrical shock. These are usually good signs that the nerves are spontaneously firing through the regeneration process.

Take good care and don’t hesitant to let us know if you need any encouragement. We’ll be here.

 

[Layla]

Happy One Month Anniversary!
I hope you’re doing better since you last posted. Let us know when you have time. We’re available if you need any advice or support.
Have a nice Sunday and a great week.
@KatieP

 

[KatieP]

Sorry for the delay in replying, re: the sciatica.
I spent the following week really taking it easy, I didn't do any movement that agrivated the nerve further, I took regular pain meds ( paracetamol and ibuprofen) and iced the area a few times a day, eventually things did settle and at my following physio session I told my therapist about the effects that overdoing it had had on me and that I was reluctant to engage in any further therapy that was likely to trigger the pain again.. she booked me in for some hydrotherapy to get confidence back and I've had one session already ( very nice) things have def settled, so much so that I have been overdoing it again ( not resting enough) and walking without crutches over a couple of days ( more as a test ).. yesterday I started feeling the pinch again which is frustrating, so I'm still not there yet , it's not as severe as before and I guess the lesson is to go slow and listen to my body.. I'm currently 4 weeks and 4 days post op.

 

[Klassy]

Absolutely agree with you, listen to your body and take it easy. I am on my second hip, and I really believe now that there is no way of hurrying the recovery process. It is frustrating that the process can be so much slower than we are led to expect, but I don’t think we can shorten the natural length of the journey, we can only make it painful.

There are some people who recover very quickly, but the slow and steady ones like me get there too.

 

[Layla]

things have def settled, so much so that I have been overdoing it again (not resting enough)

Some favorite phrases -

Your Current Situation Is Not Your Permanent Destination

Go Slow Now To Go Fast Later

Pain Is Your Body Asking For Change (listen)

Look upon this operation as an investment in your future.
Look after it now and it will serve you well for years to come.

Four weeks is extremely early in the entire scheme of things. Especially considering how long you’ll hopefully have the implant. Heal safely and effectively by taking it s-l-o-w and easy.

Have a nice week!
@KatieP

 

[Elf1]

@KatieP you mentioned hydrotherapy. You have to be very careful to not overdo when doing hydrotherapy. It feels so wonderful when you're in the water, it takes the weight and pressure off your joints and the pain seems to melt away. That's when we get ourselves in trouble, we don't realize we're overdoing it until after we get out, that night or next day. I unfortunately found out the hard way, was having one of those calgon take me away moments. Bit me in the bum later on.

 

[KatieP]

Thank you so much for that advice, I've already had one session and i agree, the whole weightless feeling is great when You're in the water, exercises feel easier too and I noted that I was able to raise my leg and go further with exercises... It def affected me that evening though and the following day( more swelling) so I will have to mention that to her too.. I'm left believing that maybe rehab ( actual exercises) should be restricted for the first 6 weeks or so, I'm starting to view physios as menace's

 

[Jaycey]

@KatieP Hips don't really need exercise. Just walking. Unfortunately many physios add strength training to the sessions which only results in discomfort. Slow and steady works every time.