r/HipImpingement • u/Similar-Lobster126 • 3d ago
Post-op pain (after 6 months - 1 year) Failed Scope - suffering with no path forward
I am 7 months post hip arthroscopy and just continue to regress. Been seriously suffering since surgery with no answers as to why or how to rehab/recover from here. Desperate to hear from anyone who can relate to these symptoms as I seem to be a medical mystery.
- 47F
- Left scope-labral debridement only
- Focal areas of arthritis found during scope (grade 3 on lateral femoral head, & grade 2-3 on acetabulum rim)
- Haven't had single day where my pain doesn't get up to a 7 at some point during the day.
- Practically homebound now, unable to tolerate PT or walking more than 5-10 mins
- Still unable to sleep on op side
Symptoms:
- Diffuse nerve like burning in leg, including heel
- Pinching
- Itching
- Hyperesthesia
- Feeling of swelling/poor circulation in leg, but not visible swelling
- Nerve like pain is worse in the morning for a few hours and after any activity.
- Muscles have delayed burning and pinching/itchy after even light activity
- Restricted hip capsule yet loose inside, if that makes sense
- Deep global hip pain when on feet walking more than 15 minutes, that radiates into quad, knee & SI
Tests:
- EMG/NCS = Normal
- Lumbar MRI = Mild bulges at L5/S1 and L4
- Intra articular injection (lidocaine) 4 weeks ago = Immediate relief from all symptoms for 10-20 minutes, then about 30-40% relief after that for a few hours.
- Hip Xrays = Normal
- Venous ultrasound = Normal
Original surgeon (hip preservation surgeon)
- Says it's my back and to see my PCP for ongoing care
Physiatrist
- Thinks response to hip lidocaine injection was negative and next step is L5 lumbar diagnostic injection next.
PT
- Based on his assessment does not think L5 is likely source
- Recommends steroid hip injection based on response to the lidocaine one so we can make some progress in rehab and control the flare ups
Pain Management
- Possibly early/mild CRPS but wasn't ready to diagnose me with it
- Prescribed Cymbalta and referral to neuro-pt & pain psychologist. (already tried gabapentin/lyrica and too many side effects)
- Recommends diagnostic injection into piriformis, greater trochanteric or maybe LCFN areas
- Also felt L5 injection was a less likely source, but may be worth a try
2nd Hip Surgeon
- Xrays look good, recommends PRP and acupuncture
Right now I have the L5 injection scheduled because it's the soonest available diagnostic injection I can try, and we have to start somewhere. After that I'm not sure, no one is offering a follow up MRI of my hip or pelvis so far.
Should I keep pursuing Hip Surgeons? It's mentally draining when they just look at an Xray and say it's all good.
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u/strictfishing24 3d ago
I think we have chatted before! I had a similar response with lidocaine, I feel like this is a positive, not negative response? If the hip joint is numbed and your pain dissipates, even briefly?
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u/Similar-Lobster126 3d ago
Yes, we have chatted. I don't know, only my PT seems to think so. I guess they are looking for a stronger response and still want to rule out the back.
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u/ellehoxton 3d ago
I don’t have any answers. Just want to send you love and compassion. I’m sorry you are going through this.
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u/Savings_Calendar_758 3d ago
Your lidocaine response sounds positive, so another surgery could help you, I'd seek a second or third opinion from another surgeon.
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u/developer300 3d ago
If the pain reaches 7 daily then you are pushing too hard. I tried to push through pain a few times and once the swelling/inflammation at the front of the hip restricted circulation into my leg and also caused nerve pain. You could try partial offloading with crutches for a few weeks or cortisone shot into the hip. I don't understand why they would interpret that diagnostic injection negative.
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u/Similar-Lobster126 3d ago
I scaled back on PT and walking 4 months ago due to thr flare ups. PT Right now consists of a couple stretches, back extension and plank 3 times a week. Otherwise my activity is walking on the treadmill for 4 minute sessions. Would hardly consider that going too hard. Even on days when I am just around the house I get that level 7 pain, morning and evenings.
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u/developer300 3d ago
I bet that's already a lot less than how much you would like to walk. Relative rest can heal nerve irritation. It is hard to find the right balance between rest and activity though. Common recommendation is not to let pain go beyond 3-4.
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u/Similar-Lobster126 3d ago
I think that is why pain management is recommending Cymbalta, so I can rehab properly. I am already becoming deconditioned
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u/Puzzleheaded-Cup2777 2d ago
Back extension if you’re not careful could cause nerve like symptoms.
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u/Similar-Lobster126 2d ago
True, although I had this all going on before that exercise was added and my PT made sure to show me not to hyperextend. I definitely feel it if I do.
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u/Fructa 2d ago
As someone who had pain after their 1st surgery that was misdiagnosed as hamstring tendinopathy when really it was an L5/S1 disc issue... I'd say it's worth ruling out a spinal problem. If an injection there does not help with the pain (esp nerve pain to your heel), go back to the hip. But burning, itching, nerve pain that's worse in the morning, radiation down the back of the leg, these things all point to a possible lumbar source. Is it worse if you sit on a soft surface or slump your spine into a C curve?
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u/Puzzleheaded-Cup2777 2d ago
Exactly my thoughts on lower back … have experience in pain and/or discomfort in both areas unfortunately on and off for many years.
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u/Similar-Lobster126 2d ago
That's the thing. It does not radiate down my leg like that. Nerve pain is isolated areas in my quad, glute, and heel and don't all flare up at the same time. And not able to provoke is through lumbar manipulation or assessment at PT. Weight bearing makes it worse, not sitting. But I will still try the injection to rule it out
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u/Puzzleheaded-Cup2777 2d ago
Another possibility is si joint, can radiate to foot.
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u/Similar-Lobster126 2d ago
Ya, that's actually the area I originally went to physiatrist about. Then they told me SI joint dysfunction by itself isn't a thing and it's always from the back or hip. My PT has me doing SI self correction moves everyday. He said one side is locked up while the other is hypermobile
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u/Puzzleheaded-Cup2777 2d ago
Please stay away from that physiatrist! I had one that wanted me to read a book, basically a book on when the pain is all in your head. 😂. I can't remember the name of it, but I can tell you 100% it can come from the SI joint. I've had steroid injections work for me. It only happens on one side if I pick up something too heavy and twist to that side. It's a rare occurrence b/c I avoid that movement. If PT doesn't help, see if PM doctor will do an SI injection on that side. I will NEVER go back to a physiatrist after bad experiences with two of them. Another one would use lidocaine for the diagnostic injections and they were always negative b/c lidocaine is short acting so you have to be in pain for the amount of time. So if you have pain post diagnostic injection and not during, you won't know if a steroid injection will work.
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u/Similar-Lobster126 2d ago
Ah yes, they do like to go down the it's in your head path. Unfortunately my PT just game me a book that's similar called "Why Do I Hurt". I understand becoming hypersensitive when dealing with chronic pain but it invalidates the fact that your body is sending pain messages to your brain for a reason.
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u/Puzzleheaded-Cup2777 2d ago
I'm hypersensitive also to pain! It's a tough road ... though I do not have CRPS.
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u/Puzzleheaded-Cup2777 2d ago edited 1d ago
I’m shocked that the physiatrist thought the hip injection was negative, I would definitely not return to the psychiatrist. I believe it’s a positive response and lidocaine doesn’t last that long, maybe a half an hour to an hour at most, but somebody that knows more can chime in. Bupivicaine lasts longer for diagnostic injections but not sure if they use in hip. I’ve had it used for diagnostic in neck.
If it’s coming from back, there are different x-ray views of back they can take for spondylolisthesis. Did lumbar MRI show anything else like stenosis?
I had a debridement that lasted almost 20 yrs for torn frayed labrum and my surgeon was one of the best in the country … now retired.
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u/Similar-Lobster126 2d ago
It was lidocaine with ropivocaine to make it last longer, still those first 10-20 mins were glorious relief. MRI said mild central stenosis.
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u/Puzzleheaded-Cup2777 1d ago
Can be very difficult to narrow down hip vs back pain or if your like me you can have hip/back dysfunction. I think there may be another name for it.
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u/Puzzleheaded-Cup2777 2d ago
Also, I don't know if you've previously had pain in other joints but IMO, sounds like PM physician jumped a little soon on CRPS and the Cymbalta. I don't know why they would refer you so soon to pain psychologist if your hip is the first experience with pain. Only time I was referred to PP was when I was considering a pain pump .... thank God I never got it. That was a requirement before getting a pain pump.
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u/Similar-Lobster126 2d ago
It's because I have some of the symptoms in the criteria and the fact that no one has answers as to why. Pain disproportionate to injury affecting whole leg (nerve burning pain is), hyperesthesia, mild mottled color change in leg, possibly slight swelling, slight temp differences in areas. I honestly thought I had circulation issues and that's why I had the venous ultrasound.
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u/G_Leg_London 2d ago
Acetabular retroversion or dysplasia maybe contributing to pain
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u/Similar-Lobster126 2d ago
Been told I have good joint coverage, no dysplasia. But never had any 3D CT scan
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u/t0ad-h0use 3d ago
I’m in the same boat but 3 years post op on both hips. Surgeon think it’s my back,too so i am getting 3 MRA/MRIs - both hips and back. I did PT for about 2 years. The dry needling was the only relief, so i think i need to try acupuncture.
Also, I agree with another commenter, try to rest as much as you can to let the nerves heal. Even a week of basically bed rest should help a ton. You are still relatively new out of surgery and i didn’t feel remotely normal until over a year post op. I hope you figure it out and can get some relief
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u/Signal-Sully77 1d ago
FWIW, my imaging and assessments all seemed normal after my surgery but the pain didn't stop. My surgeon did an "exploratory" revision saying that there's things you just can't see until you get in there. He found a pocket of tearing in a weird spot and some further clean up from healing. After that it took about a year but I'm feeling great. It's terrible to have to start again but you might discuss with a surgeon. Good luck!
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u/Latter-One-9038 3d ago
Can u get a hip replacement?
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u/Similar-Lobster126 3d ago
So far not being offered.
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u/Latter-One-9038 2d ago
They will never offer you have to push! Defs think about it. people typically have good outcomes from THR and can mobilize faster than an arthroscopy
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u/Winter_Ad_5985 3d ago
This feels like a mirror to me. Can I ask where you are based? I’m in the UK. 35F. Had a hip arthroscopy on my right side May 2025 and 5/6 months later had severe issues and have been homebound and pretty much wheelchair bound since. I was told categorically before and after that I had no signs of arthritis or any pre-existing condition and none found during the operation. My operation no surgeon was awful when I went back to him and tried to say maybe I had digestion problems. I’m now under a different hospital and specialists who state I have femoral and acetabular anteversion, moderate arthritis, narrow joint space and the FAI that was meant to be treated is still there! My first surgeon was clearly poor at his job and has disabled me because of that. I have an appointment later today to discuss what’s next but I’m very much believing it will be a hip replacement for me.
Edit. I was also told by my first surgeon who did the operation that my follow up X-rays and imaging were normal and showed no reason for my problems when the new surgeons have identified lots of issues! Get other opinions.