Hip OA and Thigh Numbness?

[TotalWus]

Hi again, everybody. I haven't posted in a long time, because my symptoms have been manageable, but now that I'm at the end of Procrastination Road, I'm planning on scheduling my BHR for sometime next month. I've mentioned my likely surgeon before, but not going to repeat it here, just so that I can express my concerns without attaching his name to them, unnecessarily.

Since my diagnosis (bone on bone) 3 years ago, I've managed by adding resistance-band exercises, stretching, and cutting my skating down to 1 or 2 games and 1 short practice per week. Minor aches after skating and tying my left shoe, but otherwise, no real problems until last week. The day after a leg workout, I experienced a lot of pain sitting and bending over both in my hip and also from pretty bad (probable) femoral nerve and femoral cutaneous nerve tingling and numbness that runs down the front and outside of my thigh to the outside of my shin on the OA hip leg. In retrospect, I'd begun feeling some tingling high on the front of my thigh a week or two earlier, also the day after doing my legs, which I thought was just some cramping from doing too many front leg lifts as part of my resistance-band workouts. The day before it really became an issue, I did my legs and some elliptical work, which I had stopped doing lately when my hip first started to bother me again about two months ago.

Saw my surgeon. He's 100% sure it's referred pain from my hip and/or OA inflammation spread to the affected nerves. I understand that completely. The issue is he didn't provide any meaningful answer (besides confident reassurance that this is from my hip) to the question: How do you distinguish possible sciatica from a disc issue related to my weight training since there's so much overlap in symptoms? My concern is that he didn't examine me or test my reflexes or really even look at the back X-Rays and I get the feeling that all he thinks about is hips, hips, hips.

No doubt I need hip surgery and I'm ready; but I don't want to live with a pinched nerve (or whatever) until then and I definitely don't want to go into hip surgery not knowing whether I have an unrelated pinched nerve only to find out during recovery from surgery that I also have a disc issue. I've always been extremely skeptical about chiropractic, but I think a possible pinched nerve is one of the only ailments legitimately treatable through spinal manipulation. So, while I'm making preparations for my BHR, I'm now also going to try to see an osteopath or PT/MD, or a chiropractor, just in case what I have isn't caused by my hip and might actually be something fixable by a back manipulation. Right now, I'm on Celebrex and no longer in constant thigh pain; but I still can't sit or tie my shoes or drive; I can only stand, walk, and lie flat without pain. X-Rays show typical spinal degeneration and remodeling in various areas typical of 50+ lifelong weightlifters and Grade 1 L4/5 anterolisthesis, which is from an injury 30+ years ago. If I drive for any length of time, most of my leg gets numb and I can't walk.

I guess what I'm hoping to hear is that some of you also experienced this same sciatica-like nerve pain on the side and front of your thighs on your OA hip side as some of your symptoms. Thanks in advance, as always, for your input. 

[John C]

I will offer a couple of very non-expert thoughts. In my own experience, I had hip and buttock pain 35 years ago that some diagnosed as hip issues and some as back issues. I worked with deep tissue massage for the hip and Chiropractors for the back for 6 months until I could barely walk or move, and was in constant severe pain. I finally went to a spine surgeon who immediately did an MRI which clearly showed a disc rupture pressing on a nerve. While I still go to Chiropractors for minor back tweaks, in that case it seems clear that the Chiropractic adjustments made the disc rupture problem worse, and the numerous x-rays that were taken were not useful for showing nerve compression. Within a couple of months after back surgery the problem resolved and I was back to full time skiing. About 10 years later I started having problems that were clearly hip related, and since then I have had both hips resurfaced, one ten years ago and one 3 months ago. For me, the hip symptoms were very different from the disc problem. In my case, which I think is common, sciatic pain tends to be in the buttocks and down the back of the leg. My hip pain leading to resurfacing was more in the front of the hip and groin.
I guess the main piece of advice from my experience is that x-rays are not great at evaluating spinal nerve compression, and an MRI instantly clarified the diagnosis.

[TotalWus]

I worked with deep tissue massage for the hip and Chiropractors for the back for 6 months until I could barely walk or move, and was in constant severe pain. I finally went to a spine surgeon who immediately did an MRI which clearly showed a disc rupture pressing on a nerve. While I still go to Chiropractors for minor back tweaks, in that case it seems clear that the Chiropractic adjustments made the disc rupture problem worse, and the numerous x-rays that were taken were not useful for showing nerve compression. ... x-rays are not great at evaluating spinal nerve compression, and an MRI instantly clarified the diagnosis.

Thanks, John. That is, precisely, my concern and I don't trust chiropractors to err on side of not doing anything that could make it worse. I'm going the safe route and seeing a DO tomorrow for a thorough exam.

[karlos.bell]

  Hi Total Wus.
Yep I loss the use of my right leg and half of my left leg due to swelling of the hip capsule.
It is spaghetti junction down that way in the groin area and there is some times not a great deal of room.


Did the feeling and use come back, yep it did. Full use not quite yet been 3 .5 years.
My suggestion don't let it get to that point the recovery and issues are just as bad if not worse.
Example if you damage some of those nerves in surgery sometimes they never comeback. Foot drop is a common 1. Foot drop can also happen if left too long.


Suggestion get it done.
Cheers K

[TotalWus]

Hey, everybody. Long time no talk. Long story short is it was a good thing that I played it safe and chose to see someone to rule out a back injury before trusting my prospective BHR surgeon who assured me 100% that my symptoms were from my hip and not my back. He lost my trust by giving me that assurance despite doing absolutely nothing to rule out a back injury while telling me to trust him that it was all hip-related symptoms. He also claimed never to have had a single patient with MoM issues from the S&N implant, which sounded like BS to me at the time.

Sure enough, the MRI revealed a massively herniated (extruded) L2/3 disc and I'd have been royally f'd had I trusted this guy and just let him fill his schedule by taking the cancelled spot about 3 weeks away and undergone BHR with an acutely-herniated disc issue. I spent 3 months mostly on my back, another 3 doing (my own) rehab at home after consulting the back specialist and a PhD PT. Returned to skating after 6 months and have been playing competitively again since early May.

My hip still bothers me after skating and working out, but the Celebrex and stretching and continuing PT-type hip exercises seem to have helped, because it's much better than it was when I first signed up here to ask about BHR. Still, I know I'm on borrowed time and that I'll have to have the hip done eventually. The last hip surgeon I saw was Allan Inglis, in between the BHR surgeon who assured me that my symptoms were hip-related and the MRI that diagnosed the disc injury. Dr. Inglis only does THR and, while I'm still open-minded about BHR, the MoM thing scares me, and I like the fact that the THR is a less-invasive procedure with an easier recovery, notwithstanding the longer life of the BHR. Dr. Inglis uses the largest possible ball component for athletes and also said that he's done "many" BHR revisions necessitated by MoM issues.

I'm curious about the current state of the ceramic BHR components since the last time I visited this forum, because I understand the long-term advantages of BHR vs. THR. Thanks in advance for any input.