Joining the hip pain club

[QUOTE=x-halt-salute;8286700]
Calling the hip pain crew!

I’m going to talk with my doctor in early September about surgery. I’m not 100% decided but I’m leaning toward going through with it. And doing so while I have good insurance (there’s not a lot of job or healthcare security in my line of work so there’s real potential for the out-of-pocket expenses to become prohibitive if don’t get it done before my current contract ends).

So, I’m making a list of questions to ask the doctor. Is there anything you wish in retrospect you’d asked before having hip surgery that might not be an obvious question for someone who hasn’t been through it?

And, just because I’m curious about the range of recovery experiences, how long after surgery (arthroscopy) did it take before you could walk without crutches? drive a car? do barn chores? ride a horse? I’m a single person with no family in the area, so the recovery is a major consideration.

As always, thanks for sharing your perspectives and for the support![/QUOTE]

Is it one or both hips or don’t you know yet? We thought mine was only the left until I recovered from the left and found out the right was even worse than the left! Mine has been a long road but well worth it, I just wish they had found out this was the problem sooner.

[QUOTE=Laurierace;8244245]
In the midst of yet another bought of gluteal tendinitis which is as much of a pain in the butt as it sounds like. It is only on the right side which is good because last time it was both. A steroid injection in my piraformus and ischial bursa on the left must have kept that side from flaring up this time too. It freaking SUCKS though and I am getting really tired of this whole hip, butt, SI nightmare.[/QUOTE]

I saw a second doctor about my hip and he suggested an injection (IA). I went to see a different ortho for back xrays and he was wondering if my back pain wasn’t the source of my hip pain (xrays show old compression fracture at T12 which goes along with where I was pointing to and complaining of pain). I do think they are separate issues, but the back doctor has ordered a bone scan. In the meantime, I rode and was in terrible pain afterward (I don’t ride, I eventually feel better, so I ride and then I’m in so much pain!). It is definitely lateral/posterior. My guesses, based on my reading, are hip bursitis, gluteal tendinitis, or IT band.

How was your tendinitis diagnosed? Did you have an MRI to confirm? I feel like there’s a lot of guessing and “we could try this” approach, but isn’t an MRI the best way to get a definitive dx?

I had lots of MRI’s over the years they were trying to figure out what was wrong with me. I did not have an MRI for the tendinitis as it was pretty obvious what it was from palpation and symptoms and was not there before the surgeries. It was just a matter of overdoing things as I was getting back into the swing of things I guess. Treatment was rest, ice, PT so none of that was going to hurt anything had it been an incorrect diagnosis. Knock on something, but I am feeling pretty good at the moment so hopefully this it for a while.

[QUOTE=ironbessflint;8286765]
x-halt, I’ve had four hip scopes now…[/QUOTE]

It puts my mind at ease to hear that your hips are feeling good now, even if it took four(!) scope surgeries to get there. And all that you’ve shared is incredibly helpful to me as I prepare for this. Having some sense for how the recovery goes (esp. from fellow equestrians who understand the movements/forces involved in picking stalls and riding!) is tremendously helpful.

Thank you, ironbessflint!

[QUOTE=Laurierace;8287263]
Is it one or both hips or don’t you know yet? We thought mine was only the left until I recovered from the left and found out the right was even worse than the left! Mine has been a long road but well worth it, I just wish they had found out this was the problem sooner.[/QUOTE]

I only have a labral tear diagnosis in the right hip, though I’m a little worried that it could be happening in both, as I’ve gotten stabby pain in my left hip after riding several times recently. A very similar post-ride pain is how I first started noticing the right one…

I’ll put the possibility of labrum issues in the left hip on my ortho questions list.

If you don’t mind me asking, how did you find out that the right one was bad if it wasn’t apparent before you had your left hip surgery? Was it a matter of increasing pain, or the surgery not resolving the pain you had attributed to the left hip or something else entirely?

[QUOTE=Pocket Pony;8287348]
In the meantime, I rode and was in terrible pain afterward (I don’t ride, I eventually feel better, so I ride and then I’m in so much pain!). It is definitely lateral/posterior. My guesses, based on my reading, are hip bursitis, gluteal tendinitis, or IT band. [/QUOTE]

I’ve been through the ride-pain-rest-relief-ride-pain cycle a few times and it is so frustrating! I’ve got my fingers crossed that you’ll be able to identify the source of the pain, Pocket Pony, and get it under control soon.

[QUOTE=x-halt-salute;8288059]
I only have a labral tear diagnosis in the right hip, though I’m a little worried that it could be happening in both, as I’ve gotten stabby pain in my left hip after riding several times recently. A very similar post-ride pain is how I first started noticing the right one…

I’ll put the possibility of labrum issues in the left hip on my ortho questions list.

If you don’t mind me asking, how did you find out that the right one was bad if it wasn’t apparent before you had your left hip surgery? Was it a matter of increasing pain, or the surgery not resolving the pain you had attributed to the left hip or something else entirely?[/QUOTE]

My pain wasn’t in my hip, it was completely in my left SI which is why it took four years to find it. After I started getting back to normal activity levels after the surgery on the left I got SI pain on the right.

x-halt…

how long you are off of what depends on what they do. a simple debridement is easier than a repair, which is easier than fai surgery, which is easier than adding in microfracture.

i had the ‘works’ and was weight-bearing at 20% for 6 weeks. unfortunately, i never got beyond 50% so never got off the crutches.

every doc i talked to said that when they get into a joint it is worse than they expect based on imaging.

so i’d ask the doc what he sees on imaging, what percent of his patients are satisfied w/ the surgery, if he would just be debriding the tear or if he would be doing repairs, bone work, or what…

and make VERy, VERY sure that the PT you end up with is EXTREMELY familiar w/ the injury and the surgery…

[QUOTE=tollertwins;8288659]
x-halt…

how long you are off of what depends on what they do. a simple debridement is easier than a repair, which is easier than fai surgery, which is easier than adding in microfracture.

i had the ‘works’ and was weight-bearing at 20% for 6 weeks. unfortunately, i never got beyond 50% so never got off the crutches.

every doc i talked to said that when they get into a joint it is worse than they expect based on imaging.

so i’d ask the doc what he sees on imaging, what percent of his patients are satisfied w/ the surgery, if he would just be debriding the tear or if he would be doing repairs, bone work, or what…

and make VERy, VERY sure that the PT you end up with is EXTREMELY familiar w/ the injury and the surgery…[/QUOTE]
Never, as in you are still on crutches!? That is terrifying!

[QUOTE=x-halt-salute;8288074]
I’ve been through the ride-pain-rest-relief-ride-pain cycle a few times and it is so frustrating! I’ve got my fingers crossed that you’ll be able to identify the source of the pain, Pocket Pony, and get it under control soon.[/QUOTE]

Aw, thanks. I got the order for a bone scan but it is only lower back. I went back and asked the ortho (via his assistant) to include the hips. I mean, if they are injecting me with dye and taking a picture and I’m complaining of multiple symptoms, doesn’t it make sense to get a picture of everything I’m complaining of?! I’m waiting to hear back.

Four years prior to my THR, I had surgery for a labral repair, fai correction and extensive microfracture. I was on crutches for 10 weeks and in a CPM machine 8-10 hours a day for 8 weeks. I had PT 5 days a week for 6 weeks, then 3 times a week for a month. (I had exceeded my 30 visits per year which were covered by insurance before the surgery - so the PT costs were out of pocket.)

MAN - I wish I had done the THR rather than the arthroscopic surgery, which only slightly alleviated my pain.

Best of luck to everyone in the hip pain club…

laurie race - i’m not on crutches anymore, but was for the better part of a year.

had the FAI surgery in April and got a THR the January of the next year…AND had a slow recovery from that because the muscles in my leg were so atrophied by that point.

also the leg was soooo bad by that time that the THR wasn’t as successful as it could have been. i have ongoing issues w/ psoas tendinosis in that leg now.

[QUOTE=Pocket Pony;8289064]
Aw, thanks. I got the order for a bone scan but it is only lower back. I went back and asked the ortho (via his assistant) to include the hips. I mean, if they are injecting me with dye and taking a picture and I’m complaining of multiple symptoms, doesn’t it make sense to get a picture of everything I’m complaining of?! I’m waiting to hear back.[/QUOTE]

Before you guys sign yourselves up for more iatrogenic (medically caused) mayhem, disability and torture than Nature is meting out to you to start with, PLEASE read Dr. Nortin Hadler’s book, Stabbed In The Back.

He’s the big back-wonk down at Chapel Hill, and an editor of the journal Spine. According to the studies he cites (and they are legion), the only surgery that provides long-term benefit for actual arthritic hip degeneration is THR, which most people wait too long to do. The other stuff has nothing outcome-based to recommend it. Please remember the plural of anecdotes is not “data.” And based on the anecdotes in this thread, I’ll PASS!

The DATA show that imaging studies of all kinds beyond an x-ray are nearly useless to dignose and cure pain of lumbar and SI origin, ubiquitous in the population, due to the unfortunate fact that nearly all of it is idiopathic–unrelated to any of the pathoanatomical “unsoundnesses” that might be uncovered. Which means in layman’s terms, 4 surgeries later your pain is the same if not WORSE, and the only thing that’s “cured” is your surgeon’s boat mortgage. Because he was “shooting” at a “target” that’s obscure, if not invisible.

The only thing that makes much sense (as per evidence-based medicine) is to do enough Dx to eliminate degenerative hip disease, tumors, and infections from the picture. Barring those, quite frankly Western allopathic medicine has not-one-THING better to offer you for the pain than 2 aspirins every 4 hours or as needed. Nothing else has proven to work better, nothing else has shown a clear benefit, nothing else has a superior risk/benefit relationship. Nothing. Not PT, not surgery, not chiro, or needling, girdling, or exercise.

That’s what the data shows, gathered over 35 years in all Western countries.

Most of the time it isn’t your hip hurting. It’s something coming from one of a major handful of spinal nerves and the muscles they run through in your lumbar-sacral region, which is like looking for a needle in the haystack. And there IS no cure. If they SAY there is, they’re LYING.

I was just as glad to read that gimping around the yard on an aspirin does about as much good as anything. :cool:

The other thing nobody wants to hear is that by age 40-55, most of us who’ve lived a life of athletic excess are going to be about as sound as our 20-year-old former Prelim. horses. Not much you can do about it except compare aches when you get together for drinks. Extra points when you join the Hip Replacement Club–then you can go back foxhunting! :smiley:

in one kind of twisted way, i’m glad i didn’t go for the THR first…as everybody wanted to do a metal-on-metal hip, in spite of the fact that I thot I might have a metal allergy.

guy I got referred to by the hip doctor took one look at me when i mentioned that and went ‘you have every risk factor in the BOOK for that!’…so now I’m happily ceramic on xlnk poly.

x-halt…if you read this - you might want to check out thefaifix.com.

not surgery - mostly about how to get your glutes doing most of the work, getting your IT band loose, and some other stuff.

it sounds similar to what i’ve been doing to keep mine civil. i’m coming off surgery right now, but am planning on ordering it when i can exercise again.

they have a LOT of vids on youtube explaining what they are doing…and it’s WAY cheaper than surgery. they also have a couple explaining why PT makes a lot of us worse…

[QUOTE=tollertwins;8302106]
x-halt…if you read this - you might want to check out thefaifix.com.

not surgery - mostly about how to get your glutes doing most of the work, getting your IT band loose, and some other stuff.

it sounds similar to what i’ve been doing to keep mine civil. i’m coming off surgery right now, but am planning on ordering it when i can exercise again.

they have a LOT of vids on youtube explaining what they are doing…and it’s WAY cheaper than surgery. they also have a couple explaining why PT makes a lot of us worse…[/QUOTE]

Thanks so much, tollertwins! I’m going to check that out right now. I’ve been thinking that it would be good to try to do some serious strengthening so that the joint doesn’t take so much stress day-in and day-out. This looks like just the ticket as far as programs designed to stabilize hips and prevent FAI/labrum pain!

I finally bit the bullet and have a date for THR surgery in October. Thank you who shared your experiences. I will do so too afterwards.

Alternative to THR

I know I keep beating this drum, but … please, please look into Hip Resurfacing before committing to a THR. It may not be the alternative that works for you, but it sure did for me. I’ve had both resurfaced and am back to competitive running, riding big stocky horses including jumping, mountain biking, yada yada yada, with NO restrictions on impact and the procedure is permanent. I did not like the statistics on THR and at 50 was way too young to be thinking about having to do it all over again in 15 years … There’s an awesome online forum ‘surfacehippy’ with great info on doctors and the procedure. My surgeon was Thomas Gross at GrossOrtho and his website is awesome as well. PM if you want more details. Good luck with whatever you choose … I’m just so happy to be back to running and riding with NO PAIN.

Just a quick note. do not rely on Dr Hadler report and books. I don’t want to get sued but please remember just because someone writes a book, does a great job of promoting themselves DOES NOT make them the guru of back/hip disease.
I live in a area with quite a few “famous” doctors between Duke and UNC, It sure is different to live near the famous and know what really goes on. Those in the know stay away but then I guess if you need help we just end up going to another town where we don’t know the truth.
I recently had a surgery that didn’t go well at UNC . Got my medical records and they did not mention the complications, the emergency visits and the on-going trouble and pain. I used another famous surgeon, yep i fell for it. I was astonished and furious to read my medical record “everything went well,normal progress” Just lies and thats means that when i go for help to another surgeon the surgical notes are useless just trash. Oh can u tell i’m angry.
Medicine in the US is in awful shape,good luck…

[QUOTE=walkers;8306474]
just because someone writes a book, does a great job of promoting themselves DOES NOT make them the guru of back/hip disease. [/QUOTE]

Amen! I didn’t want to engage in debate with Lady E again, because I think much of what she’s saying is totally irrelevant to my situation, but I’m wary of M.D.s who put so much time into popular press publications and self-promotion. I don’t think it’s a problem with the medical field in particular, though – in my own area of science the people who write books for popular audiences tend to be people whose research isn’t likely to rise to the top through citation of peer-reviewed publications, or people who care more about their bottom line than they do about the advancement of the field. Which is really fine by me, especially since nobody’s reading of a pop sci book in my field will have any impact on their health. But there’s no way in hell I’d get medical information from a pop med book. As for the ethics of the doctor you saw, false reporting of patient outcomes is way beyond the pale.

This Hadler guy has written a number of books, all of which seem to push an “everyone is relying too heavily on medical interventions” agenda. Am I going to trust the rheumatologist who’s never seen my chart who seems to be a M.D. spokesperson for a political healthcare reform movement? Or am I going to put more stock in the orthopedist who’s been involved in my diagnosis from the beginning and has published peer reviewed literature on the very procedure I am considering? Not a hard decision.

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