Did labral tear surgery reduce your PN/pelvic/perineal pain?

[donstore]

Hi Karyn,
As Elmwood said a hip resurfacing is indeed a type of hip replacement. My diagnosis was that all my cartilage was gone and there was no way to bring it back. It is really important to get an extremely experienced surgeon for this procedure so that the all metal components that are currently used will not wear and release metal ions into your bloodstream. If you are over 60 years old and not on your feet all day long then a standard hip replacement will very likely last you forever. I was concerned that I would need a revision before I died because I am on my feet all day long and therefore I decided to go for the resurfacing. As I said earlier the best guy in the New York area would probably be Dr. Edwin Su at the hospital for special surgery. My diagnosis was from a standard x-ray of my right hip.

Elmwood,
The thing about lyrica is that reaction to this drug is extremely subjective. The FDA standard of 600 mg per day maximum is probably why your pain doctor will not exceed that amount. You will know right away if if a higher dose is a problem for you. A few folks on the boards have reported dosages as high as 1200 mg per day in order to get the desired effect. I don't believe that there have been any reports of a higher dose killing anybody so you just have to see what works for you and find a doctor who is willing to think outside of the box. My first GP was unwilling to request a higher dosage than 600 mg per day. I got another GP and he appealed to my insurance using the talking points that I provided him and they approved it. I already knew from my own experience that a higher dose would work for me so it was just an issue of finding a doctor that would do what I needed.

Best Wishes,

Don

[Elmwood]

Yeah 450mgs doesn't appear to be doing it so I may have to go up to 600mg's. Strange thing is that 300mg's used to erase nearly all of my symptoms. For some reason when I came back on Lyrica again this past fall it didn't work anymore. I got to wondering if my condition had become worse and thats why 300mg no longer worked for me but I've since come off of the Lyrica and my symptoms were the same as always. Which is to say they were maddening but no more so than ever before. Who knows.

Thanks for your responses

[karenechelon]

I had hip labral tear surgery in October 2012. It's been several months and the pain is subsiding. One thing about the repair surgery is that the pain becomes less severe over time. It can take 1 year to 2 years to fully go away if it ever fully goes away. Some days, I am like...why did I even get this done. Other days, I feel so much better. I think most of my pain if not all of my pain was due to a torn hip tear in my cartilage.

[Elmwood]

Well thats great news to hear Karen! October isn't that far gone and you're already feeling better. Thats great. When you say your pain is subsiding do you mean PN pain, hip pain or both? Also what was the state of your cartilage in your hip? As in did you have much cartilage left? I did not have any cartilage left which leads me to believe I may not have much success when it comes to pain relief.

Which brings me to a question I've raised here before but never really got any responses. I also have not been able to find an answer anywhere else online. There appears to be no doubt that hip issues (specifically labral tearls and FAI) can lead to PN pain but does anybody have a theory why?

Glad to hear from you Karen and keep us updated.

[donstore]

I would say that anytime you have bone on bone contact in your hip that it can lead to generalized pain throughout your pelvis. It is easy to check on the progress of any repair surgery by having a standard hip x-ray. That will show whether or not the bone is in contact. Any procedure that does not provide a buffer between your femoral head and your acetabulum will always leave you with pain. Any type of hip replacement completely resolves these issues including a hip resurfacing.

Don

[Karyn]

I would say that anytime you have bone on bone contact in your hip that it can lead to generalized pain throughout your pelvis.

I had a standing x-ray of the hips this past summer. The findings were "bilateral os acetabuli" http://www.ncbi.nlm.nih.gov/pubmed/19219806. When I asked the ordering physician what my next steps may be, I was informed, "None. No further imaging or treatment ... findings not clinically significant".
I do plan to pursue this matter again, soon. I was going to ask for a hip arthrogram, but would also like a complete hip study. Are they one of the same, or separate studies?
Thanks for any insight you can share!
Kind regards,
Karyn

[Elmwood]

There's probably people on this site (including Donstore) who probably know more about this than me. But before I got my hips done they did x rays, an MRI and an MRA. They also did the basic in office checks to see what caused me pain. So you may want to see an orthopedist before an orthopedic surgeon. Before all of this I would not have known there was a difference and there may in fact not be a difference. But when I was seen at the Lahey Clinic (not far from you), an orthopedist diagnosed me with the hip issues and then passed me off to a surgeon to do the work. In fact he was one the first professional i've ever seen who said "well you've seen every other kind of medical expert with no luck and now your hips hurt, it seems like that could be the cause of your other issues." I ended up going to B&W's for the surgery instead but anyway.....

Donstore, I sort of assumed the same thing with the whole "bone on bone" stuff. But didn't you say you had hip replacements but still have PN pain? I've had PN issues since I was 20, long before I had hip pain. Surely I still had cartilage left way back then and it was not bone on bone like it is now? When my surgeon did my hip he said there was no cartilage left but he was able to take some from somewhere else and put it in the hip socket. Who knows I guess. If I get cured without ever knowing what the problem was I'll be fine with that.

[donstore]

Hi Elmwood and Karen,
It is true that I had PN issues way before I had hip pain. Problems in your hip are certainly characterized by sharp pain that is centralized in your hip. My hip pain became so bad that it completely overshadowed my PN pain. I knew that I had hip problems because of my x-rays and also that I was limping. Diagnosis in my case was extremely easy although I'm sure that other imaging studies would be useful if the problems were not as clear-cut. An arthogram involves injection of contrast dye into the hip joint which can show more subtle issues. My hip problems made my perineal pain worse because I was tensing my muscles every time I sat down or stood up because of the sharp pains centered in my hip. As I have said before my surgery completely resolved my hip problems. Elmwood, hope your cartilage replacement is successful. You will know soon enough because you'll know if you're able to walk without pain. Since I am not an orthopedic surgeon it is hard for me to comment authoritatively on the procedure that you received. As I have said before I would point out that a surgeon who felt that the current hip resurfacing procedure is not a good alternative would look for other solutions. There are risks and benefits to everything. Hope he is able to buy you some time.

Don

[Elmwood]

Thanks Don. I think part of it for me is that as a fire fighter and being aged 35, my surgeon is hesitant to give me a replacement that i'll most likely just need to get done some years down the line. I guess he feels its better to buy a little time with the FAI surgery and then get a replacement when this wears out. I had the surgery 4 weeks ago and have been able to walk pain free since about 3 days post op. Anyway, wait and see I guess. Glad to hear your hips are doing better and that you've managed to get the PN issues under control.

Yeah Karyn, like Don said it should be pretty easy with all the tools they have today to diagnose any hip problems you have. Seems like some people on this topic have had trouble convincing their doctors to buy into the fact that they have hip trouble. But other than that a diagnosis should be easy if you truly do have hip issues.

[Griff522]

Elmwood, have you had any pelvic floor PT? Because my PT found my source of pain and it's coming from my obturator internus muscle. This muscle is a hip rotator. She feels like its compensating with spasms to try to stabilize the hip. I believe this was Lernica's issue too.