Groin, Quad and Glut pain

[Tberry04]

    I have a pair of BHR's. They were installed roughly 3 years ago in Denver. I started to have groin pain, then Glut pain just before Xmas while I was building a house. I slowly found that my Piriformus was tight and spent some time massaging the knots to get some comfort, but nothing that would last beyond 12 hours.
   
    Eventually in early January my limping took my back out, diagnosis a bulge at S1-L5. My local Doctor says all the nerve pain, which I have now is associated with the bulge, yet I seem to have nerve impingements in numerous nerve bundles that are associated with L2-L3-L4-L5-S1 and S2. Does anyone out there have any ideas? I've been a bad patient, because I'm trying to research what I could be having, because it would seem that a bulge would cause the same nerve pinches or effect the same areas in whatever Dermatome my body follows. Is it possible to have both the Piriformus and Psoas looked up and pinching both the femoral and sciatic nerves?

     I have had a hard time associating a bulge with the fact that I'm unable to walk, and put any weight on my leg because of hip pain and the hip abductors throw pain spears into my thigh. Most the muscles associated with the hip area are painful and fail when weight is on them. My right leg has retracted one inch and my pelvis is rotated up and back. I don't have a fever; it hurts to move my leg using any muscles. My Piriformus aches, and all the ligaments in the hip seem to be irritated from maybe the rotation of my hip and miss-alignment. The nerve signs I do get seem to be variable. Sometimes the outside of my calf has tingles, sometimes the inside. Sometimes the IT band seems to be where the tingle comes from. I have no tenderness in my back, only where the Piriformus is in my glut area. I can put my back in differing positions and the tingle and nerve issues I get are unchanged. The general position of comfort is slightly bent at the waist, which gets rid of the tingle and any burning sensation.

     I have six hour drive to my hip doctor, which I’m probably going to see after a nerve study, next week. I was very active up to this point. Anyone have any thoughts.

[Pat Walter]

Hi Tberry

I am not a doctor or medically trained, so I can't give you any detailed info about your muscles, etc.

The one thing I would definitely do, if I were you, is to get some x-rays of the operated hip on the side of the bulge and make sure your hip resurfacing surgeon is looking at them.  If anything has shifted, changed or a loss of bone happened, you need an x-ray to show the hip device.  I know you feel it is the muscles, but what is making this all happen?  It seems that a few people are having problems at 3 and 4 years out from their BHRs.  The problems are few and far between, but there have been some due to misplaced acetabular cups, loose cups, loss of bone around the device on the femur side. 

Most people that have hip problems also have back problems.  That is because we have walked unbalanced for many years due to your bad hips.  That knocks the balance of the body out of wack.  I lived at my chiropractors office before my hip and visited many times after.  Now at 4 years post op, I visit a couple times a year.  It is not easy to get your gait back properly,your balance back properly and your back in place properly.

If your surgeon does not have an answer for you, then you can get a free consultation from several of the top surgeons in the world including Dr. Gross, Dr. De Smet and Dr. Bose - amoung a few.  You need some answers to make sure your hip devices are still seated properly and working properly including the acetaublar cups.  That has been the largest problem - cups at the wrong angles from the early surgeries when the surgeons were still in their learning curves.

Please stay in touch.

Pat

[Tberry04]

        So….After six weeks of Doctors and massage therapist telling me that I had a bulging disk that was supported by an MRI, I still could not get an x-ray of my pelvis. At roughly the 4 ½ week mark, PT on my back and mobility exercises of my hip, I was able to walk without a cane. Unfortunately and quickly by week 5 the pain increased and my ability to walk and put weight on my right leg, quickly went away. By 5 ½ weeks I got a referral to a spinal surgeon for disk surgery.
   My appointment with the back surgeon was great, we chatted about differing things, and he agreed that some of the pain and numbness could be a result of a very displaced pelvis (which was easy to see in exam of my pelvis). He agreed to x-ray my pelvis with all the other normal views of my spine. After the films came to our room, he entered somewhat puzzled. He told me “yea you have a bulge, nothing bad, but you have something else you need to fix” When I saw the x-ray I began to cry. My hip had broken. The end of the femur was up against the pelvis. The Birmingham joint was still in place and the remainder of the femur end (trocantor) was not visible.
   The original surgeon who did my hips was able to get me in ASAP for a total. I’m still at a loss how I could walk with a very broken hip joint. The first I noticed the leg length discrepancy was early in January (I argued with my local doctor how it was not normal for me), so I had the busted joint for most of the six weeks. I still cannot understand when I broke it. I fell on some ice in early December with enough Mechanism of Injury to break it, but I never felt the pain or discomfort in or anywhere around my pelvis. I had probably some whiplash since my neck hurt for a week. I went about life in my normal day-to-day routine and the pain started after a Physical Exam Battery (fitness standards for my work). Over Xmas the pain slowly increased until early January when I went to see my local MD. I noticed the leg length difference a day or so after my first appointment with my local MD.
   I’m curious if any one else who was had a revision had a similar experience? I really never had the pain that is associated with a broken hip and femur.  My hip surgeon has seen two BHR’s fail. My hip joint, and one other, where a patient fell on the joint at 8 weeks. I’m young, healthy and have modified my lifestyle to avoid high impact things on my hip joints. I do though still accomplish huge tasks and push hard to get things done.

[Pat Walter]

Hi

That is amazing.  I would never have guessed you could have been moving around with such a problem.  At least you now have an answer.  It is not a nice prospect having surgery again, but at least it will solve your problem.  A MOM THR is not a bad solution to hip problems and hopefully, you will recover and be active again.

Please keep us updated when you can.  We will all keep you in our thoughts and prayers.

Pat

[Tberry04]

   The joy of healing. New Smith and Nephew Anthology Hip. Since I only had surgical trauma to the femur I'm healing quickly. I hope the bone growth and this model hip will last well. This is the third hip operation in 4 years, I'm getting tired of this schedule. Thank You Pat for notes and comments.

[stephen]

I too have a major lower back injury and it hurts like the dickens daily. So much that it will immobilize me if I move wrong. I just got my LBHR 4 weeks ago and with it my Physical Therapy. My therapist has given me some very simple stretching exercises that help my pain tremendously in my back. I do them a lot during the day and when I am in the gym I found by hanging onto a weight bar in a squat rack and trying to do a squat, my lower back actually starts to bend in the opposite direction and stretches my lower back out. I have always squatted to get it to stretch and my chiropractor can witness how well it does me. What is does is makes my body bend forward thus rounding out the lower back and stretching those hard to reach muscles that are real tight.

I also have a lot of stiffness in my hip muscles and all my doctors agree I will require hard outpatient therapy and deep tissue massages to loosen it up again. Again a slow process.