THR Why so much pain after THR 2/2

[Cammieoh]

I had an anterior THR- people seem to be perplexed I’m not farther along in my recovery- some going so far as to say I should have no pain and should feel like this is the best thing I ever did. But I don’t feel like that! I have groin pain and constant pain in my thigh. I can walk w/o a cane but use one bc I don’t want to hurt worse. I walk around the house but my pt exercises hurt my thigh especially bending at the knee. Should I be doing something different? I am crossing my legs sometimes while sitting bc I heard with anterior that was fine- should I stop that? Should I be taking Tylenol and ibuprofen all day or just when pain gets bad? I have a few Tramadol left but that doesn’t seem to do anything. Should I be stretching? Please help! I’m so frustrated

 

[CricketHip]

Hello @Cammieoh
to BoneSmart! Many of your concerns are the usual worries after a THR.. you are doing fine!
How many of those well meaning people have had a THR themselves? This is a big surgery, no matter what approach was used. Let me leave you our recovery guidelines and if you read through them, I think you will find that most of your questions are answered there.
As for pain meds, those are pretty mild ones and I found staying on a schedule helped immensely. Why don't you try taking them as directly through your days and nights and see how you feel?
Are you icing? We at BoneSmart believe in icing like it is your job. Because it is!
Ice for at least 40 minutes then take a little break and start icing again. It's nature's natural anti inflammatory. Just be sure to keep a thin barrier between the ice pack and your skin.


If Tramadol isn't helping, is it because you only take them when the pain gets bad? Maybe it's time to ask your surgeon for something else, or at least for a refill, so you can take them more regularly.

It does get better/easier. You just need more time.
Here are your recovery guidelines. There's some very helpful tidbits there.


HIP RECOVERY GUIDELINES

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.

If you want to use something to assist with healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.

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 these
BoneSmart philosophy for sensible post op therapy
5. At week 4 and after you should follow this
Activity progression for THRs
The recovery articles
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.

 

[CricketHip]

@Cammieoh Which hip was replaced? We will add that information with your surgery date to your signature.

 

[Cammieoh]

Thank you so much for the info. My right hip was replaced. I feel like a drug seeker when asking my surgeon for meds. He filled Tramadol for 7 days- 3 times a day so only 21. I didn’t want to take it three times a day so I could make it last. I have 4 left so I’m going to take it three times today then ask for a refill. Does it work better along with Tylenol and/or ibuprofen?

 

[CricketHip]

For myself, I found it worked great with both! But we are all different with different metabolisms.. I think this may be your issue in that you were attempting to make the meds last and didn't give your body the relief it needed?
You may need to be emphatic to them that you still need help. Hopefully you will get another refill.
If they say no, don't despair, try taking the tylenol and anti inflammatories regularly for at least maybe a week and see how you feel? Well, that is what I would try. I hope you can get a refill on the tramadol, though.

Thank you for the information about it being your right hip!

 

[Eman85]

people seem to be perplexed I’m not farther along in my recovery

You won't find any of those people here. Everyone on this board has had at least one hip replaced and can give you real world stories about what a THR is.
Tell us about what exercises you are doing. You ask about crossing your legs, when you say that is it crossing ankles or figure 4 crossing? I had posterior and there were restrictions about crossing legs. The movements that are restricted or discouraged are because of the chance of dislocation. Twisting movements in the direction we were dislocated to perform the surgery is what the problem is. If you had anterior it means they dislocated you femur and rotated the ball towards the front of you and where the scar is, with posterior they rotate the other way. In normal life we do more things that put strain rotating towards the rear which is why the restrictions.

 

[Abbylayla]

Everyone heals differently. I had posterior in October. I had very minimal pain. But I also know people who struggled. Everyone is different. Don't let anyone make you feel like you should be in a place your bodies not ready for. You know your body better than anyone. Go at your own pace!

 

[benne68]

Welcome, @Cammieoh. Glad you found us.

I agree with Crickethip. Taking your pain meds on schedule contributes to your healing. When you try to "save" pills by stretching out the doses, you may be setting yourself back.

If you haven't already, please take a look at this helpful article about managing pain:

Pain management: importance of managing pain after a TKR and the pain chart

The process of pain/swelling/healing and all is this In other words, it's not so much that pain causes swelling but that the after effects of surgery is swelling as the after effects of any trauma to the tissues is swelling. So you have a double causative effect (otherwise known as a...

bonesmart.org

 

[Hip4life]

I understand the feeling like you are a drug seeker when you certainly are not! While in the hospital for my THR, a night nurse had a heart to heart with me about staying on schedule with my meds. She told me not to be scared about "addiction" as the meds would only be short term. I happened to have a regular appointment with my family doc still in my early recovery period and he was the one that gave me a tramadol prescription with refill and suggested taking it with Tylenol. I found it much more effective taking the two together. Thus, I wound up not having to take it quite as often because it actually worked. So that is another avenue for you.

I, too, had a bit longer initial recovery period. As my OS said: "It just takes the time it takes." You're doing just fine. Don't let PT cause you pain. I had no PT and none was prescribed. Icing and elevation were my best friends and I just politely deflected people's "kind" concern. Then I would turn to my friends here on BoneSmart and feel relieved that all was well and that someone understood. Continued healing blessings. Keep us posted.

 

[Cammieoh]

Thank you so much for the encouragement! I have to learn not to push myself. My sister has had several hip knee shoulder replacements and she feels she is an “expert.” I assisted her after a few surgeries and she had very little pain! I think she has a higher pain tolerance or something.

 

[Layla]

Ugh, I understand. My mom was like this with me, lol.
She had a hip replaced years before me and couldn't stand that I had a Lift Recliner. I think she thought I was being lazy and made it a point to remind me that she didn't need a chair to catapult her into a standing position in her recovery. "Catapult"?! C'mon mom! Some people have an art of making others feel "less than". I think a good response is that your surgeon is pleased with your progress and that's all that matters to you.
Don't push yourself. You will get there when your body is ready.
Lots of comfort and a great weekend to you!
@Cammieoh

 

[Debru4]

The more tuned into your own body you are, the better you will be in the long run. A certain amount of pain is normal, but that doesn't necessarily mean it should be ignored. Using the Tramadol, which is a much milder narcotic than most of the others, along with acetaminophen to address pain, and even to stay ahead of it until you find yourself having many more pain free times, is a good idea. Checking in with others here on the forum can help as well---the encouragement and support helps alleviate a lot of stress, which only adds to the pain.

If you are really worried, and the pain meds, icing, and limiting activities that cause you pain don't help out noticeably, you should always feel comfortable contacting your doctor. They can either offer assurance that all is well, or help determine why you are having the pain that isn't improving. One thing that is important to remember is that just as we all are unique when healthy, we equally unique in our recovery to surgery or injuries. Give yourself grace.

 

[Cammieoh]

As an update: I phoned my surgeon and he got me right in. I have hip flexor tendinitis hence the groin pain. I am in oral steroids for 10 days. If my pain doesn’t go away I will need a steroid injection (ouch.) he told me to take it easy no exercise but walking. X-rays show new joint is in perfect place.
I’m continuing to ice ice ice. Trying not to sit too long and small walks every 30 mins or so.
Any thoughts? Has anyone else dealt with this?

 

[Debru4]

I'm so glad you decided to check in with your doctor---reassuring to know your joint is fine, and to have a diagnosis/plan for the pain!

 

[Cammieoh]

Yes! At least I have a response for those well meaning people who kept telling me that I shouldn’t be in pain at this stage!

 

[Layla]

I am sorry you're hurting, but I'll bet your'e relieved you touched base with your surgeon and received a diagnosis.
Your hip is irritated and inflamed so the best remedies will be ice, rest and elevation. It may take longer than ten days for the pain to begin easing up. If it's severe, it may take even longer. You can try the SEARCH on the top right of the page typing in key words, like Hip Tendinitis and all threads where it's been mentioned will pop up.
Wishing you speedy relief!
@Cammieoh

 

[Cammieoh]

The next step for my hip flexor tendinitis (due to my THR) is an injection in my tendon guided by altrasound. How painful is this injection? I know they numb the skin area but I’ve heard it’s really painful and doesn’t start working for a few days. Right now this is my next option since I am still unable to lift my leg to drive. Any advice?

 

[ladyj]

I am interested in your posting, because it seems so near to what is happening to me.
I was fine, doing more all the time, starting to get many of the chores off my husbands list and onto mine.
Then I did a reasonable length walk, probably not much more than half a mile, and the next day I could barely stand to get out of bed.
I increased my dose of painkiller, but then started to limp. I saw the physio who gave me crutches and told me to rest it.
I am doing, but now the pain down my thigh is very bad.
In view of your experience I have left a message with my surgeons secretary just to get it checked out.
Wishing you a very speedy recovery.

 

[Eman85]

Did your OS have any suggestions as to what might have caused tendonitis in your hip flexor? Was it just the result of the surgery or a strain?

 

[ladyj]

The next step for my hip flexor tendinitis (due to my THR) is an injection in my tendon guided by altrasound. How painful is this injection? I know they numb the skin area but I’ve heard it’s really painful and doesn’t start working for a few days. Right now this is my next option since I am still unable to lift my leg to drive. Any advice?

I had a cortisone injection before my hip replacement, and it was absolutely fine!