still have pain after 3 and half months post surgery

[Nina P]

HI, everyone--I had surgery on February 3rd on my right hip.  All went well, was in the hospital (Hospital for Special Surgery in NYC) for about 4 days.  Did well with 2 crutches, then one crutch then a cane for a bit and was walking after about a month.  I did have in-house physical therapy about a week after surgery.  I am not sure how much experience the PT had with hip resurfacing patients and I was doing a lot of strengthening exercises along with stretching.  I then started going to a PT in my neighborhood, and again, do not think that PT had much experience with hip resurfacing either. I started feeling worse and then went to a PT who my doctor uses, but at that point I think the "damage" was done. He also said that I had probably been doing too much strengthening instead of just stretching at the early stages of PT.  Bottom line is that I may have developed tendinitis of the hip flexor muscle.  I stopped going to PT completely after speaking with Dr. Su because I always felt worse after PT.  I also started taking arthrotec, a very effective anti-inflammatory, which seems to help, but I'm not sure if it just "masks" the pain or if it is actually healing the problem.  The pain is in the front groin area and hurts going from a sitting position to standing and I also can't put my full weight on the leg without some pain.  After I walk it off, I feel better, but it's always there. It isn't terrible, but I just thought I'd be more pain free by now.  Dr. Su isn't too concerned, but am I too optimistic about being pain free at 3 and half months?

Any similar experiences out there?

Thanks in advance for any help....

[Pat Walter]

Hi Nina

You are correct that most of the time people don't have much pain or problems after 3 or 4 months post op, but there are always the exceptions.  I have known some people that took 6 months to a year to get back to normal.

Only a doctor can tell you what is wrong, but most patients will tell you that patience always helps.  If you are having probelms, I would think you should cut back on your PT and activities.  Some people never to any PT after surgery and end up just like the people that do a lot of it.  I never did anything but walk, walk and walk.  I think sometimes, as you mentioned, too vigorous PT can cause more problems than it solves - only my opinion since I am not a doctor.

My doctor, De Smet, always says - if it hurts - don't do it.  Listen to your body.  Your body is telling you something.  Maybe you should have back off earlier.  It also takes some bodies a very long time to heal.  Have you tried any water therapy.  I was very stiff at 6 weeks with start up pain for the first few steps, then I started water walking and stretching.  After a few sessions, it solved the problem for me.  You might want to think about getting into the water.  I have my exercises here  http://www.surfacehippy.info/poolexercises.php   I definitely would not choose to do anything very agressive since you are having probelms.

I hope things get better for you soon. 

Pat

[Nina P]

HI, Pat--thank you so much for writing back to me.  I think I will try the water exercises.  Dr. Su actually mentioned that, although he didn't give me any specific exercises.  Thank you for sending those to me.  I am willing to be patient with getting to a pain free state, but it's a bit disappointing to still have issues.  I walk a LOT, as I am a real estate broker in New York City and walk everywhere and I am an avid walker for exercise.  Walking is fine, although my stamina isn't what it used to be!  It is getting better, though.  I am just waiting for the day when I don't even think about the hip.  Hopefully one day soon.

Thank you again for your thoughts and good wishes.  The website is wonderful.

Nina

[Jed]

Nina, I had my right hip resurfaced on February 11, so we are on the same path. My PT had no experience with resurfacing, and I had persistent problems with straight leg raises. After I stopped doing them things went well, but then he started forcing the range of motion. Not only felt bad the way he was doing it, but it really set me back. So no more PT and I am doing fine. Sometimes standing on the leg hurts ( putting on pants) but it is transistory. So keep with the walking and you'll be fine. The last couple of weeks I've felt better than in years. I think the trick is to forget about that hip, get on wiht your life and the hip will sort itself out.

[saadjallad]

Hi Nina,

I  did my right hip with Mr. Mcminn and Birmingham almost 6 months ago and still feel this deep burning, suffocating sensation that is always present in my right hip/groin area. 

I did absolutely NO PT- only stretches during the first few weeks.  We may just be slow healers.  As you know it may take up to a year to be pain free. 

I swim whenever I can and it always feels better after that.  Im  sure if I was more consistent with swimming I would be in a lot better shape.  So try getting in the pool for 6 days straight and see what happens.

[Nina P]

Thanks to all who wrote back.  It really helps to hear from others who have had the same experience.  I guess it was my expectation to feel fairly pain free by now and since that isn't the case, it's kind of upsetting.  I did try doing some water therapy this weekend, which was not at all painful, but I thought I felt worse the next day.  That is the tricky part--should I stop doing whatever seems to make it feel worse, or keep trying exercises that hopefully over time will make the pain lessen.  It's a tough call between "listening to your body" or just keeping on doing exercises that hopefully will help in the long run.

[karenj_m]

Hey Nina:

My very experienced surgeon said "expect aches and pains" up to a year.

There's alot of "stuff" healing in there...and the "soft tissue" takes longer than the bone. Bone heals approximately anywhere from a good 4-6 months (depending on your bone quality/density), but soft tissue (muscles, tendons, etc.) can take "up" to a year to finally stop bugging you.

The front groin pain you describe when getting up from a seated position, most of us called "start up" pain (you can see info on it in the forums). Mine finally went away completely around 4-5 months...it wasn't brutal or anything, but more of a nuisance hobbling for a few steps and then fine.

Regarding crutches or a cane...how long do they want you using it? At 3 1/2 months, you are probably close to giving up the cane very soon (unless you have been instructed to use it by your surgeon for a specific reason - always follow your surgeon's instructions/restrictions).

The cool thing around this hip surgery, is that your keep improving well into a year or more.

Follow gentle PT, do some good walking, practice walking in your home without the cane (nice and slow), it will come.

Take care!

[Nina P]

Hi, Karen--thank you SO much for writing back.  Again, it really helps to know that I'm not alone in experiencing this problem.  I saw the surgeon again on Tuesday, had another x-ray taken and the outcome of that is that it is most definitely soft tissue, as the x-ray is perfect--good bone structure and the implant (or whatever they call it) looks fine.  I am taking the arthrotec (anti-inflammatory) which is really helpful in relieving the pain and I hope that I will start to feel its healing effects soon.  I also have an appointment to get a shot (cortizone, I guess) in 2 weeks if I'm still having problems.  I only used the cane for a couple weeks and was able to walk well, I'd say 2 months out of surgery.  That's why all this pain now is depressing, since I feel like I'm going backwards!  But Dr. Su seems confident this inflammation will work itself out over time and I am happy to wait it out, knowing that it is something that will get better over time.  He said it wasn't common, but has had patients (particularly women) who do get the inflammation in the hip flexor muscle.  I also feel other aches and pains in my thigh and even a tenderness on the side of my thigh if I press it, which again, is supposedly normal and agrees with what you are saying.  I am hoping to play tennis again one of these days, so that's really my goal. I am doing easy stretching exercises and Pat was kind enough to forward exercises to do in the pool, which I am doing on the weekends when I have access to a pool. 

 Thank you again for your kind words and for letting me know that I am in the normal range of healing.  I hope to be writing back soon that I am feeling better...(fingers crossed!).

Nina

[Pat Walter]

Hi Nina

Glad to hear you saw Dr. Su and he is working with you on your pain problem.

I still would take it easy if it were me.  If something you do causes more pain the next day, I would just back off.  You still have plenty of time to do PT after your hip starts to heal.  Many people do no special PT and end up pain free and active.  So I just mention that so you don't think you need to work thru the pain.  I would not think that very appropriate at this point.

I hope you start to feel better soon.  Don't forget, sometimes we take a step forward and two backwards.  Not normally, but it does happen.  Keep an optimistic attitude and take it easy.  Let your body heal.

Pat

[John C]

I think that for many of us, recovery continues to be a roller coaster for longer than we anticipated. I am coming up on one year, and am having more pain in walking and doing stairs, than since one month after surgery. Two of my friends who had resurfacings have had similar experiences at a year out. In all cases, x-rays look good, but soft tissue pain during walking is a frustration. Mine is diagnosed as trochanteric bursitis, which feels correct, but there are at least two or three areas of pain going on right now. I am back on Celebrex, and it changes from hour to hour, day to day.

[Nina P]

Hi, All--thanks again for your thoughts.  I went for an injection last week (I guess it's cortisone).  So far I haven't noticed any improvement, which the doctor said could happen.  Some people don't respond and others get relief right away.  I have emailed Dr. Su to see what he thinks.  I was considering physical therapy (although Pat seems to think that's perhaps not a good idea), but I will certainly not do anything too strenuous.  My biggest problem is "start up" pain, meaning that going from a sitting position to a standing position is problematic.  When I get up from sitting, I can't put weight on my leg without pain.  After I hobble about a bit and start walking it settles down, but it's disappointing to still be dealing with this at 5 months post surgery.  From what some of you have told me, I know I'm not alone in this situation.  I am willing to be patient and just hope that over time, this will all straighten out.  I'll keep you posted as time goes by and hopefully will have good news one of these days that the pain has subsided. 
Nina