The changing symptoms of hip OA

[bosoxgordon]

Hey all,
I had a question for all of you experienced hippys out there. When I first started having issues with my hip (I didn't know it was my hip at first) my symptoms were very different form what I'm experiencing now. At first I had extreme groin pain when sleeping on my side. Later it started to feel like sciatica down my left leg. I then started having low back pain and was very concerned about a back issue. It then moved to a pain and loss of ROM in my hip joint itself.

All of this happened over the course of a couple years with varying levels of activity throughout. (I am sedentary now compared to how active I used to be) I have my resurfacing scheduled for early April but the wierd thing now is that the bad pain in my hip has faded some and now I have pretty bad low back pain with a feeling of weakness in it. Many times I feel lke I can't stand up straight after being bent over or sitting in some types of chairs.

I was wondering if others of you have experienced this changing of symptoms with your OA. I do have FAI which is what brought on my early OA. I am particularly concerned about the low back pain now. I have had x-rays and an MRI of my back in the past and all looked fine. It's just hard to believe the hip OA can be felt so strongly in my back. Anyone have a similar experience?

[hernanu]

Hey Scott, I had definite transitions in how I felt as the OA progressed.

I do remember the first time I noticed pain from it. I was walking with a friend to lunch, I had this small groin pain that lasted all day long. Being very active and having just played soccer, I thought I had a small groin pull. It was completely gone the next day, which was unusual.

The next thing was extreme soreness in my back and groin after playing in league games for basketball and soccer. After each game (one to one and a half hours), I would get home and be so sore, I could barely walk around. I attributed it to getting old or maybe overdoing it.

There was one stretch where I was laying down a floor for a redo of my basement, playing soccer and doing Tae Kwon Do, that each night I just collapsed. It seemed natural, based on what I was doing, but in doing those kind of things the year before, I was never as sore as now.

Then I had to give up martial arts because my ROM declined rapidly and real pain hit when I tried to do some of the more limber kicks. Kicking the heavy bag became a crap shoot, I could hit it and be fine, or hit it and get that nice sciatic shot across the bow.

Then basketball became a casualty when I would jump, come down and get pain. That was the first actual hip pain, not groin, back, etc.

My ROM became so bad that all of my friends in soccer noticed I was running at half speed, moving at the same speed, but at half the stride. Moves that I had no problem with (step over was a favorite) became impossible because I couldn't go over the ball. Then my left hip started dislocating, popping out while I played. I would pop it back in and go on. This was in my death spiral phase, at the end of things.

What sealed the decision for me was the dislocations. The first one happened while moving my daughter into her dorm. I had run a van full of boxes up to her fourth floor room, when I was raising her bed in her room and all of a sudden, my hip moved. Wasn't sure what the deal was, and my daughter and a friend looked at me strangely. I took a couple of steps, but could not walk right. I twisted my leg, locking it and it snapped into place with a bit of pain.

It happened again while sleeping a few days later. I woke up and tried to walk it out, but it took a good twenty minutes before it 'attached' properly. By now I was upset, in pain and scared.

This, along with increasing lower back pain, extremely tight muscles everywhere, knee pain where I hadn't had any issues before, no sleep and a walk that was painful for others to watch were brutal. The muscle issues were so bad that my doctor went through a whole series of tests to eliminate afflictions that attack muscles or nerves. I tested for Lyme disease, nerve function tests (painful), etc.

So yeah, many issues expressed themselves and receded after the surgeries. I don't have any lower back, knee, tight muscles. No nerve problems, lack of sleep, ankle pain. Some other things also withdrew that we don't consider, since they're not physical - depression, pessimism, an ague and lack of hope. The OA drains you in many ways, taking care of it with HR (preferentially, to me) or THR is the best step possible.

It was an increased degradation in both my physical life and emotional life, and needed to be removed.

[chuckm]

My symptoms started as progressing low back pain. Then came tightness and pain in front of the hip. After a couple of years my back adapted to tight hip and resolved. Then hip pain moved to groin. Then hip pain moved to socket (very sharp). That all took about three years. I had FAI and arthritis. In my next life I will get the resurfacing done two years sooner.

ChuckM

[Miguelito]

Hi Scott,

Other than the early groin pain, and the fact that my hip was deteriorating for a little longer, I had very, very similar symptoms to the ones you are describing. In fact, I thought my real problem was sciatica in the lower back and down my leg, and not the hip. The groin pain and not being able to walk (for short periods) came relatively late to the party. The back and down the leg pain largely went away post-surgery (though I do still have more than the usual aches and pains, I think).

I can't guarantee anything, but I believe you are probably going to be very surprised post-surgery when the back pain largely goes away, as it did in my case.

It's hard to believe that that could have happened. The pain down my leg was so bad (at times) that if a doctor had told me that there was some crazy issue and they had to amputate my leg I would have just said "Get the saw". [I apologize for making light of that, I know others have far more serious health issues than I].

Regards,

Mike

[bosoxgordon]

I have to admit the way my symptoms have changed over time sometimes confuses me. I'm sure my back issue is due to the hip. I know low back pain is a typical symptom of FAI. It's just very strange how my actual hip pain has settled down quite a bit and now I have this low back weakness/pain. I can see how hip OA can be easily misdiagnosed as a back issue. If I didn't know better I would swear I have an issue with my back and not my hip.

As it is now, I am scheduled for surgery with Dr. Gross in early April. The lack of recent hip pain has caused me to second guess the timing of my surgery. However, I guess the back pain is a confirmation that it needs to be fixed. I'm also relying largely on the experience of others that have been through it. I have talked with dozens of people that have been resurfaced and I think all of them said they wished they had done it sooner. One gentlemen told me I won't really know how much pain I was in until I have the surgery and it is better. I hope this is true. I'm 40 years old but at times feel older than my 79 year old father.

[Miguelito]

It's a tough decision to make until it's not.

Yeah, my hip started behaving about a month before surgery too. Went bowling (Uncles's seventieth birthday party, and I went with the intention of not bowling, just drinking - yay drinking, woohoo!!!) with minimal ill effects. But even then I knew that if I had instead played a rond of golf I would be crawling to the bathroom two days later (because I couldn't walk).

[Tin Soldier]

I had a lot of odd pains and it seemed to be hard to tell where the source was and based on other's stories, I figured it was all due to OA in the hip.  I have none of that pain now, so I think it was all related, maybe much of it indirect, but still related to the OA.  The really obvisou sharp pains was in the front of the hip in the flexoers, assumed I had a labral tear.  I didn't have any of the groin pain which is a common sympton. 

I know exactly the position your'e in.  I went through that too.  I think one of the clinchers was my discussion with Pritchett.  He said, your OA will not get better, and you can wait but it will be a long time before there is something as good as HR, for an active young/middle-aged adult.  I often thought if I wait another 2 years, what are my options? the same as they are today.  8 to 10 years might be a different story, but do you want to live in pain and decreased ROM for 8 to 10 years?

[whyme]

I think Miguelito hits the nail:

It's a tough decision to make until it's not.

I was diagnosed with OA in 2008, at 41. It was a shock, sport was (and is) a big part of my life. All I wanted to know was how much time I had left and dreaded the thought of surgery as it was "the end".
Five years on I see the operation as "the beginning", a new opportunity (hopefully). Still, I'm a bit apprehensive, of course.
You might hit a plateau for a few years, where it doesn't get better, but it doesn't seem to get worse. But it does. So for me the decision is easy now, I'm at the other end.

Regarding symptoms, groin pain hasn't been one of them. In my case, it's all lateral, around the trochanteric area and the ITB, and the back of the leg (glutes and sacral area).

On one hand it seems alright:
Range of movement has reduced over time, but not dramatically (I still can reach my toes with the leg fully stretched).
I haven't taken any painkillers or antiinflamatories.
I still can cycle no problems (although the post cycling is getting worse) and swim.

On the other hand it is bad:
Stopped running over 1 year ago, too much pain and no enjoyment. The post-run was pretty bad generally. And the times worse and worse :-)
Walking is not fun and found that unconsciously I try to avoid it. My girlfriend was the one who told me I was limping (over a year ago), I hadn't even noticed.
Sitting down can be generally bad on anything but chairs.
Sometimes the ITB can torture me for hours or days.
Lately, for the first time, a few nights I couldn't sleep at all, the whole leg was in pain (all lateral).
The doctors tell me it's now bone on bone, and must fix it asap.

So we all live with these contradictory signals, and fool ourselves that "is not too bad yet".
I think you know when it's the right time.

[Dee Dee]

Scott,

I have found that when it comes to pain symptoms, your body can only handle so much input. Your hip does not seem to hurt because your back is flared up.  If your back was not giving you symptoms, the hip most likely would be the source of most pain.  OA does not go away, but we who have suffered can all tell you there are some good days where the pain is less and we feel almost normal. 

My PT tells me over and over how interrelated the hips and back and knees are.  They see it all the time. They preach core exercises for the back.

I have a bad back as well as hip issues.  My story started with my back which showed some degenerative disc, but the leg pain was getting worse.  Then I got some groin pain and Rom issues.  Buckling from labral tears. Spondilolisthesis showed up in the middle of my search for answers with terrible sciatica - got injections for that and it helped.  But hip ROM continued to deteriorate. Activity avoidance, meds and no good answers. Finally I found out about this website and chose Dr. gross.  He recognized dysplasia. My OA on the right leg was bone on bone in the middle of the socket.  My back still gives me some trouble but I am doing the core exercises to help the spine stability. New hips are great for weight bearing, working on getting back pain free ROM. 

Best wishes on your surgery. 

Dee

[Jon]

Just a bit of personal experience to add to this thread:

- Diagnosed with OA (degenerative) in 2004 after too much running
- Persistent and worsening pain for next several years
- Sleep disruption, limp, loss of ROM, chronic pain
- In no particular order, quit: running, skiing, golf, cycling, surfing and smiling
- Was told to hang on until inevitable total replacement
- Saw about a dozen orthopedists
- Decided on resurf in 2011
- Researched and interviewed a bunch of docs
- GREAT info from this site
- Referral from Vicky M. to McMinn
- Went to Birmingham late 2011
- Pain subsided, almost disappeared, week before surgery -- go figure!
- Resurfed Dec. 2011
- Woke up post-op with ZERO OA pain
- Stopped grimacing and started smiling
- Rehabbing really well since
- Resumed running, albeit gently, about three months ago
- Runs of 4-5 miles with no discomfort
- Resumed surfing last fall
- Resumed skiing this winter (started teaching my son)
- Spent last weekend in Beaver Creek, CO and enjoyed every run
- Will resume golf this spring
- All upside after decision to pull the trigger
- When done properly, I believe this is a remarkable solution to a lousy problem

Jon

[evant]

Jon- love your efficient, easy to read bullet point style.

Glad you're back running - don't know if I'll ever feel confident enough to try that again.

[Jon]

I'm really cautious about the whole running thing now.  Curious how others feel about this post-op...

I would enjoy going back to old routines, but I feel like it is just so unclear with respect to potential implications.  I feel very lucky to have left behind the pain and impairment, and I love being able to freely do stuff with my kids...

How much running is genuinely appropriate with metal parts...!?