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Degenerative disc disease, facet arthritis, labral tears and hip and spine arthritis

Got some new X-rays today after giving up on the “I can fix this with yoga and ibuprofen” idea and it appears that my entire pelvis is just falling the heck apart. My L5-S1 have moderate arthritis and narrowed joint space. My hips, which I just had surgery last year to fix the labrum and shave the bone, are back to having arthritis.

So, yes, I’m being referred to more PT. And muscle relaxers. But I’m trying to figure out whether riding is even going to be possible.

Right now I can ride comfortably in my hunt seat saddle (on narrow horses) because that takes the weight off of my back and distributes it down my legs. No go on the dressage saddle, or the western saddle.

Of course I’m slightly nervous about riding in the hunt seat saddle because I feel incredibly weak from the labral tear and osteoplasty. My horses are good horses but they are spicy nuggets and now they haven’t been ridden in a month because I’ve been in pain. Can’t ride the fat man right now anyhow due to his nail to the hoof, but I do have 2 others that need work.

Blergh. Anyone got any additional tips for keeping weight off the back and out of the hip joints?

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Is a hip replacement on the table? Since you had the labral repair, but also the shaving, and now have arthritic changes back, that would seem to be the next, and best option.

I thought my issue was soft tissue, I also went through increased work on mobility and flexibility exercises, and while none of it hurt, initially, it also didn’t get any better. And THEN things started hurting, and I still thought soft tissue, just injured this time, so I dealt with it that way for probably a year before it got bad enough I had to go find out what’s what. Long story short, left hip replacement 12 weeks ago

Arthritis just gets worse. I don’t know how mine looked 2 years ago, but by the time I was in enough pain regularly enough, it was bone on bone with giant spurs on several places on the ball.

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Labral repair etc does not address arthritis. Arthritis is a loss of articular cartilage, and that cannot be regrown or repaired.

All you can do at this point is consult for joint replacement (take any intra op images the arthroscopist obtained to show the state of the articular cartilage) and treat conservatively with injections until they no longer work to provide you the quality of life you expect.

Joint replacement is, by all reports, a FAR easier recovery than arthroscopy.

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It is. I’ve been trying to avoid it because it’s such a major surgery (I know, it’s easier these days) and it’s both hips. I think the back involvement has me a little shook, as now it’s spine arthritis and disc issues as well. Can someone just make me a new pelvis and spine? C’mon medicine (I’m joking I’m joking)

I’m glad to know I’m not the only one that tried to DIY it. I just so badly did not want for something to be really wrong.

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The last sentence is one I am wrestling with. I am 48, so what quality of life should I expect? I mean - I’m assuming I should be able to continue lifting weights and riding, neither of which are possible at the moment without severe modification, but is it actually possible to return me to a state where I’m not broken?

The bulging disc plus the hips has me a little like - ok, I know I can fix the hips, but where does the back leave me?

That sounds really tough. I’m sorry.

I don’t have anything useful to add, just wanted to express sympathy.

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Research your doctors carefully. I had doctors suggest and perform procedures that weren’t really appropriate. I was so sad that I was going to be crippled forever.

I had a couple false starts, but found a doctor who understood and has been able to properly address the pain from a disc that entirely left the building (my vertebrae are sitting directly on top of each other) and decided to press on my spine. I will have to have fusion eventually. With the right injections and proper medication, I go from needing to use a cane, to being able to basically get around -and ride. My main issue is that when I’m feeling better, I start moving hay bales and bags of feed which causes a relapse.

Don’t take the first or second doctor’s opinion as gospel.

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You should be able to do the things you want to do. Don’t limit your life.

Are you seeing a pain medicine specialist? If you’re not, find a good one, and start there. There are so many options for you here, for both the back and the hip, that you can work through before signing up for surgery. Pain medicine guys also have the biggest toolbox with regard to medication options.

Unfortunately, it can be a bit like kissing frogs to find a good pain med person. But if you don’t like who you find first, just keep looking. A good one is such a GREAT person to have in your corner, and also makes an excellent ring leader once you’re ready for surgical consults.

48 is definitely not the age when you accept that your world narrows because your body hurts. :heart:

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I’m so sorry that you’re dealing with this too.

Good point about the procedures. I do want to find the right balance between actually getting things addressed and having a ton of surgeries that don’t work.

And hay and feed….I own a farm with 4 horses of my own who I’ve been doing all the work for. I did nab some help cleaning stalls yesterday post diagnosis but I have no idea how I’m going to manage this. We have been considering selling anyway since my other business is taking so much of my time but…

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Thanks - yes, I have a referral to a pain med specialist among my flurry of all the rest of the referrals. Good to know they aren’t all the same too. Thankfully I live in an area with a ton of different options.

I didn’t mean to sound so fatalistic - I just don’t know what to expect. My dad slipped a disc around my age and had surgery and he has been restricted to lifting less than 30 lbs, and two other folks I know both had surgery for discs after car accidents and neither of them are supposed to lift. But the tech may have changed and my situation may not be like theirs.

I think I’m still in shock as well. I’m an active person. I hike, I lift weights, I have a farm and clean stalls daily and hork feed and bedding around…and I’ve still been doing these things.

I went in because being unable to walk after doing those things got really annoying, and and my hips and back started bothering me enough that riding was beyond painful.

I think I expected that I would be told that it was nothing and this is just what getting sore is like when you get older (feel free to laugh at me) and get admonished for not continuing my hip strengthening exercises (I have been) like my last visit with the surgeon who did my hips.

Thanks for the support! I’ll keep persisting in trying to get the issues fixed if living without restriction is truly possible! :slight_smile:

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The one thing to remember is that your body will automatically adjust to take the burden off the weakened area. So a bad back comes from compensating for a bad hip, and a bad hip comes from compensating for a bad back. That’s an oversimplification but hips and backs are related, and if you address one, it may help the other. Hip replacements these days, if done robotically, are a really easy recovery. Like 10 days. That’s because they stretch the muscle instead of cutting through it.

If you need a hip replacement, get one, and it may help save your back for a while. Spines cannot be replaced!

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Yes - it would be two replacements because my hip issues are bilateral - but totally.

I’ve been reading about Spine/Hip syndrome or Hip/Spine syndrome and I wonder why no one ever mentioned it to me before (also - why did they not check out my back when I went in for problems with my hips???)

My gait has been abnormal for years - since childhood. I walk pigeon-toed, and as of now very stiffly. I’ve been to doctors and no one ever really addressed it - except the one that said if I persisted in running long distance I’d need knee replacements at 30. Knees ache when I do a long hike or run but the knees seem fine. It’s the rest of the posterior chain that is messed up.

This all started when I had a huge fall with some whiplash (horse bolted while I was halfway off and I tried to save it) and landed on some seriously hard ground. Went to the ER after almost passing out and not being able to lift my legs to get out of the car and the only thing they said then was that I had sprained everything so I treated it like a sprain and never followed up. That was in my early 30s. I wonder if then I had injured the disc and they just didn’t see it because I’ve been struggling ever since.

I suppose it doesn’t matter who started it, back or hips, but it is certainly an interesting connection.

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Yes - the hips are mildly arthritic, the bone shaving was for FAI. I was majorly impinged in both hips so not only did he repair the labrum but he also removed all the spurs and extra bone. They were not fun surgeries to recover from.

I do know that actual replacements are supposed to be easier. I’ve just been loathe to be down for the count again especially since we now have the farm. I am not a pleasant patient at home - my poor husband. I think he needs the board’s sympathies more than I do LOL :smiley:

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Thank you :slight_smile: I appreciate the thoughts.

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I think maybe because you are so young? I had been in pain management for my spine for a few years when I finally begged my orthopedist for a hip xray. I was 53, and I had no cartilage in my right hip. None. The ball of my hip kept jamming in the socket and I couldn’t bend it at all and was just using my back to bend. When the ortho apologized profusely, she said, “but you are so young!”

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They clearly do not understand equestrians. I was chalking it up to also being a middle aged female because I’ve had a heck of a time with doctors dismissing me and then saying “oh, that really is bad”. That’s what happened with my thyroid, an ovarian cyst and my gall bladder. My gall bladder was an emergency and they were just going to send me home.

It’s a bit gaslight-y really. You start to believe that maybe it really all is in your head.

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They absolutely do not understand our high pain tolerance, for sure.

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Yes, it’s major surgery, but with that, you improve over time, whereas the arthritis keeps getting worse (as you know). I’m about to turn 59, so older than you but still way younger than many people seem to think is “suitable” for replacement. My younger brother has had both replaced already.

I’m in this Hip Replacement for Active People group and while not a lot, there are several people who had both replaced at the same time. I can’t imagine, but they really couldn’t afford to have one “good” hip going extra work while the other one recovered. Even more had the 2nd hip replaced about 3 months after the first, and as my 12 week milestone is tomorrow, I can easily see doing that (not that I need to).

I WILL tell you that the longer this goes on, the more you compensate and the harder it gets to get back to normal :frowning:

Yeah, it’s major surgery. The first week suuuuuuucked for me, but not everyone struggles that much, but it does seem to be the major part of the bell curve.

My brother also has a metal rod in his back to fix those issues, lots of degeneration. His back issues exasperated his first hip - compensation.

What I would not do at this point is try to get by with injections, unless you really, really need to because surgery is simply off the table for another couple months at least. You shouldn’t have surgery for 3 months after an injection, and the more injections, the more things degrade, and there’s no guarantee of any lasting pain relief. I started with an injection, and it lasted a whole 2 weeks, and once things started getting worse again, the pain increased at a rate much faster than it had been (maybe coincidence, maybe not).

I had just had xrays done at a PT office, but the ortho surgeon wanted his own, so expect that. Yes, the PT did send over the rads they took, but everyone has their particulars about angles and such, so just know they will likely want a new set, no matter how recent the old ones.

Only your Dr can answer that, but my brother - metal rod in his lower back, 2 new hips, he can do all the weight lifting he could before. He and his wife built a large shed and large greenhouse on their new property, and built a whole garden full of raised beds, in between hip surgeries and after the last one, and well after his back surgery,

That’s exactly what I expected as well, like “hey, it’s just overuse stuff, here’s some PT to work through it”. The PT actually did give me the standard sheet of exercises, and I really laughed when I saw them. They were everything I’ve done for years, with weights, like 50lb dumbbell for glute bridges and hip raises, so I said yeah, that’s not going to help (and he agreed once he knew…) Not ONCE in all my pain moments did I think arthritis, despite little bro’ having had both replaced already.

IMVHO and IME, these sorts of timelines need to be greatly tempered. The majority of THRs at least in the US, aren’t cutting muscle tissue anymore, thankfully. But after 10 days, I was nowhere near “recovered”, depending on what you mean. I transitioned from a walker to a cane at 7 days, but used a cane for 2 weeks. Sitting was very painful for about 5 weeks because of angry glute muscles. At 10 days, I was still not sleeping well due to discomfort, still taking some level of acetominophen, could still only go up and down stairs using the non-operative leg for all the work. And depending on which type of surgery, it’s really more than about just the operated area, your whole leg is really torqued. My knee was bruised and swollen for weeks, I still don’t have full ROM on it, though at least alll the bruising and tenderness is 95% gone (yep, 12 weeks later).

i don’t say that to scare the OP, but I heard comments like that a lot beforehand and while it IS lightyears better than having muscles cut, it’s still a fairly violent surgery, relatively speaking.

You’re not alone in your issues, I promise, unfortunately, but know there IS help, and while you may not be able to fix all your back problems, your hips can be vastly improved (I can’t say you’d ever be like you were at 20 lol), and it’s possible a metal rod can improve your back as well.

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I am comparing my timeline with the old type muscle cutting surgery with my DH’s robotic surgery last year. It took me 4 months to get back on a horse, and even then dismounting was unpleasant. He is a skier and did all of his ordinary activities in 10 days and was downhill skiing after 3 months (would have been sooner, but it was not the season.)

He needs his other hip done at some point, but it was far enough out that he didn’t do them at the same time. In fact, the only reason that he was able to get the famous doctor at New England Baptist to do his surgery was because the studies that he does compare patient outcomes in two surgeries at least five years apart with different techniques.

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That’s kind of what I was worried about but I suppose I’m running out of avoidance choices. The recovery from the other surgeries was tough, and sounds very similar. It wasn’t the pain that got me so much as the restriction. I’ve got sh*t to do, dammit!

Good to know about the injections too. A lengthy trial and error period is also something I’d prefer to avoid. I wish doctors understood how disheartening that can be. And painful.