Osteoarthritis in hip Joint

dcdavies

Hi,

I recently got diagnosed with osteoarthritis in my hip joints. The worst affected is my right hip to the point that its painful to walk around and sleeping at night is very very difficult. I have gone through physio and seen a rheumatoid consultant and the general prognosis is that the x-rays show narrowing of my hip joints, but I am too young for surgery and I should therefore control it with painkillers. I was told in 10-15 years time I might be a candidate for surgery.

I am 37 years old, fit and I have always led a very active life style, however I find myself avoiding certain activities now due to the pain. I am finding it difficult to imagine another year of this, let alone living with it for another decade. The painkillers help, however even on full dosage I am still in discomfort. I have read through various web sites but still feel that I don't know what options are open to me, what questions I should ask doctors, etc. I feel that I am being palmed off by the NHS with pain killers on the basis that they don't consider the wear and tear to be that significant. However I am judging it more on the level of pain I am in and the effect it is having on daily life.

I have recently been referred to an orthopedic consultant after several trips to the doctor and I would like to be fully armed with questions when I go to see them. I am hoping that they might be more proactive... ?

I would appreciate any advice on this that people may have including whether it would be a benefit for me to push for surgery now as opposed to managing pain with pain killers for many more years.

Thank you in advance.

barbara12

Hello and welcome to the forum
I have OA in both hips but I am much older at 62...we have had quite afew people on here with knees and hips that have been told you are to young for a replacement,
We always say the same thing pain is pain whatever age, and if you cant enjoy being young because of this then they should look into doing it.
The reason they dont like to, is that in 10 to 15 years you may need another one..and the second one is much harder to do.So you can imagine having to have it done for a third time, all these have to be weighed up..has to how much pain you are in....I would keep a pain map and also wright down all the things you cant do....it all depends on the consultant you get...we have an help line at the top of the forum give them a ring maybe they will be able to offer more advice..I do wish you well with it all..and please come back to let us know how you get on..x

frogmorton

HI dcdavies

Lovely to meet you and wlecome you to our forums.

I am so sorry to hear of your early OA in your hips.

There are other options available from steroid jabs and physio to arthroscpies to actual surgery. YOur consultant will know all this. If you really feel (and I think you do) that this can't go on much longer you need to get taht accross to him/her.

I suggest you get armed. Write down a) all your symptoms how much pain - rate it from 1 - 10. b) how much you can't do now c) anything else like it 'giving way' etc.

Also try to take someone with you who knows you well and can support you. It is less easy to fob you off that way and anyway they can also remember stuff you forgot

Take care

Love

Toni xxx

dcdavies

Thanks for the advice. I hadn't actually considered that the second operation would be more difficult and it puts a whole new spin on it for me. I had heard that hip resurfacing was good for younger sufferers, however the consultant I saw said he didn't trust them as there had been a lot of issues with them.

Keeping a pain map is a good idea. I had been thinking along a similar lines in terms of writing down what aggravates things and also if what i am eating as someone suggested citrus foods cause inflammation.

I have to say though i can go through periods (such as yesterday and today) where the pain is probably a 1 out of 10 and I almost convince myself I am being silly about things. However I could wake up tomorrow and find it to be a 9 out of 10. I haven't managed to work out any pattern to it yet, but I think the diary will probably help

Thanks


David.

Stigger

Hi,
I have end stage Osteoarthritis in my left hip due to losing my right leg a few years ago (additional wear and tear)
I've had it since I was 40 and am now 53. I take 30/500 codeine and paracetemol and 50mg Diclofenac 4 times a day. Which no longer really work.
Sleeping is difficult as the pain wakes me quite often, however I still work and enjoy life.
Like you, some days I am ok and others I crawl about like an injured cat. It is weather dependent I think and how tired you are and sometimes it hurts just because it can.
If it is not too bad i.e. no cartilage left, you can have an injection of steroid and local anaesthetic in every 6 months or so. My cartilage had all gone by the time I went to see the Dr., so I can't have the injection.
The consultant will look at your suitability for a THR using this http://www.orthopaedicscore.com/scorepages/oxford_hip_score.html and there is good information here http://www.arthritisresearchuk.org/arthritis-information.aspx
Good luck and let us know how you get on.

nearlybionic

Hi
I have had hip pain for years due to congenital hip dysplasia, which then caused secondary OA in my hips. My left hip became very painful when I was 39, and I was advised that I needed a hip replacement due to pain, loss of mobility and quality of life. I had my first hip replaced aged 40, and my other hip has now deteriorated to the same level 4 years later and I am waiting for a date for that one replacing. Yes, I will need revisions in the future, but I wanted to enjoy life whilst I am still quite young, and made the decision to have them done now rather than suffer for years in pain etc...
It is not an easy decision, but you can talk it through with the orthopaedic surgeon and make an informed decision on what you feel is right for you.
Some surgeons are not doing resurfacing now due the metal on metal issue, but again, see what your surgeon advises.
Good luck
NB

daffy2

Hello and welcome - and sorry you had to find us as we often say!
As you are fairly young, and facing a potentially long wait for surgery I think that the thought of coping with pain and limitations to your active lifestyle for that long is probably causing you a lot of difficulty, which ironically can make the pain worse. There is an Acceptance thread on here which you might find interesting - it's something many of us struggle with, but also if there is an AC course being run that you can get to you might find that helpful - follow the links from the AC homepage.
Don't get me wrong - the pain is real and thinking happy thoughts won't make it go away, but how you approach the problem can make a difference to how well you cope with it. There will always be support on here for when things get you down, and to share the good times as well(- and they will happen, but perhaps not in the way you have been used to!)
Wishing you well.

sallyann14

hi david
sorry to hear all this, flipping painful eh? BUT...i have to say that the drs are talking tosh. i had my first THR aged 36, my second aged 37 (as i had an alergic reaction to the metal on metal), my third aged 39 (because it kept dislocating and all on my right hip) and have had the letter today for my fourth THR which will be on my left hip and i am now 43. you may need to push them or ask for another drs opinion, but as for you being too young, nahh !! Mine is all due to OA too. just remember this is YOUR pain and YOUR hip, don't tell them that you can "manage" or that you are "happy to be on painkillers" for the next decade...no you're not. the drs are not the ones in pain, YOU are and let them know about it, tell them how much of an effect it has had on your life, the changes you have had to make, the sacrifices made... this may sound dramatic but its true isn't it? i hope this helps david. keep us all informed, this site is a wealth of info and support all of which you will need. just remember we, on here, have all been there and we are all here for each other.
all the best
Sally.

dcdavies

Thanks again for all the replies. Hearing other peoples stories really gives me a perspective on things. The doctor put me on 50mg dicloflex which i am taking 3 times a day with paracetamol in between, and 200mg slow release tramadol for the nights. My pain levels seem to be much better. Hopefully it can continue.

Reading some of your experiences here makes me suspect that it will be a number of years before I am considered for surgery, but I will discuss with the orthopedic consultant. Basically the x-rays suggest that I still have some joint space in the right joint and the left, although narrowed is still pretty good, so its not as bad as it could be. Having said that, my right joint is pretty much always grinding and catches 7 out of 10 times when i stand up so I am guessing that there must be something in there making contact which is probably leading to inflammation etc?

Stigger, thank you for the links. I filled in the chart which scored me at 26 which suggests consulting an orthopedic surgeon which seems to be spot on as it reflects exactly where i am with things. It may be a number of weeks before I even get an appointment but we shall see where that leads.

Thank you again for all the posts. I am finding them very helpful.

David.

hileena111

Hi David
Welcome.....I'm another one with OA in hips......Generally you are too young for surgery......although you should be able to enjoy your younger years. Like Barbara I'm older than you and have had one THR.
As you are reading these posts, replying to them.....have your notebook beside you and scribble down bullet points that you want to mention to the consultant. Like the rest of us ....when you get there you will probably forget We all make lists. Also like someone said take someone else with you.
I find that I'm so busy remembering what to ask that what he says doesn't completely sink in so my hubby comes.....he's my memory
love
Hileena

dcdavies

Thanks Hileena,

Taking notes / bullet points is definitely a good idea as I have been finding I forget to mention things. I've been Ill this week and spent most of it lying on the couch. As such the pain in my hip is probably only a 2/10 at most (although my back and knee which I think is related to the hip is up at 5/6!). What I find is I forget what the pain is like and start to wonder what I was bothering about. The danger is that I see the consultant when I am going through a good patch. So I think taking my other half with me to the consultation to chip in when required would definitely be good.

Is it normal for the pain in the hip to go through good and bad phases. When i get asked about the pain I tend to say I don't have good or bad days, it tends to be good or bad weeks.

Thanks,


David.

dcdavies

Thanks Hileena,

Taking notes / bullet points is definitely a good idea as I have been finding I forget to mention things. I've been Ill this week and spent most of it lying on the couch. As such the pain in my hip is probably only a 2/10 at most (although my back and knee which I think is related to the hip is up at 5/6!). What I find is I forget what the pain is like and start to wonder what I was bothering about. The danger is that I see the consultant when I am going through a good patch. So I think taking my other half with me to the consultation to chip in when required would definitely be good.

Is it normal for the pain in the hip to go through good and bad phases. When i get asked about the pain I tend to say I don't have good or bad days, it tends to be good or bad weeks.

Thanks,


David.

dreamdaisy

I have an auto-immune arthritis plus OA in both ankles, both knees, my right hip and now it's starting in my neck. I don't have good days pain-wise, only bad ones but that is the nature of the beast as I am now starting my seventeenth year of my life with arthritis.

It sounds as though you are not bad enough as yet for surgery but, when your joint is replaced, there is no reason why it shouldn't last you a good long time if you take care of it. Artificial joints are totally different to the natural ones and they need some degree of cossetting - one lady on here has a knee joint that is around 35 years old. Good luck with it all. DD

elainebadknee

David

If you have only seen a GP at this stage then they will try various pain relief's for you to see if it will work...You said at the moment the mix of paracetmol and tramadol is working for you, I do however hope you get offered stomach protectors as when you use paracetmol and brufen on a regular basis its not good for the stomach lining....I hope this however continues to give you some long term relief..
As others have said its not about age, its about how its afffecting your quality of life, its yours and you need to live it to the max, otherwise you become so restricted. Do not let anyone tell you that you have to wait for replacement surgery or that they will not do revision surgery either - WRONG!!! I am one of the I say younger ones, but others on here are younger than me when they had joint replacement surgery. I had athritis since my teens and had various arthroscopies till it reached a creciendo back in 2009 when I had just turned 41. I got told by an unhelpful consultant that I was too young and carrying a bit of weight. I could do something about one of those things but the others well I aint Dr Who!! So I lodged a complaint and sought 2nd opinion which took me 90 miles away but my new consultant said if i lost weight he would consider me for surgery...I lost over 3 stone and got my new knee last october...It was major surgery and I probably will need another one later in life but if I don't well what the heck? It can be done and I will cross that bridge when it come...
Good luck with your orthopedic consultant they will offer physio and steroid injections i suspect but see how you get on and update us eh?

Elainexx

dcdavies

Hi All,

Sorry for not posting a reply sooner than this. I was waiting until I saw the consultant and I had a bit more information to put forward.

Well I saw two consultants in the end. The first one specialises in full hip replacement and advised me that I was too young and that my joint was not all that bad and that i should persevere with the pain medications. He did however refer me to another consultant who specialises in young patients and hip resurfacing. He took fresh x-rays and told me i had lost 75% of the joint space and that he felt I was suitable for the resurfacing. He did however explain the enormity of the procedure and the risks involved and that he would only do surgery on me if I was 100% decided on it.

I have to admit that I am somewhat undecided as to what to do. My quality of life is suffering in that I have to suffer moderate pain & discomfort to remain active and to keep doing my hobbies (e.g. I could hardly play golf yesterday and I am suffering today for even trying). On the other hand I have this offer of surgery which may improve things. I am uncertain whether I should be waiting until the pain is unbearable, or alternatively, taking the approach that I only have one life so why should I continue in pain - I guess that is something that only I can decide. I've also heard a lot of negative feedback regarding hip resurfacing and the risks associated with it.

I've a couple of questions which I would really appreciate any thoughts on:

1. If I delay surgery as long as possible, is it possible that I may be doing irreversible damage to my knee or back? My right knee is really painful these days;
2. Does anyone have any feedback on hip resurfacing and experience of the risks (good or bad)?

Many Thanks,


David.

hileena111

Hi David
It's good to hear you again.....it is hard when they throw things like that at you isn't it?
Sorry I know nothing about resurfacing but others on here do. I've had 1 replacement and am due another one ...haven't got a date yet.
As far as exercise and doing things {eg hobbies} you have to be prepared for "payback" the next day. With me {its my back as well as hips} if I'm having a good day and do too much housework I suffer the next day....to me THAT IS NOT WORTH IT but if its something I enjoy I'm prepared to be a bit sore the next day.
Have you seen a physio yet? They will be able to tell you things to do and movements you maybe shouldn't be doing. We do need to keep moving and exercise is good but it needs to be the right kind.

Love
Hileena

dreamdaisy

Hello again, long time no hear! This is a dilemma isn't it? I think I would be feeling damned if I do and damned if I don't and none of us, alas, has a crystal ball.

I was told (aged 52) to contact orthopaedics again when 55 about new knees, this to meet their age criteria. I am now 54 and life is considerably worse mobility-wise than two years ago. I am in a different boat with my arthritises but I do feel that the ankles and the hip are so much worse because my knees are. My Mr Ortho may be squirrelling up further work for himself and I am paying the physical price. I don't know anything about resurfacing but hopefully those who do will spot your update and come along with some help and information. DD

dcdavies

Yes it's a difficult one when someone says they can provide you a solution albeit with catches :roll:

The main temptation is to be more active again which is good for sports and running around after my little girl. But what's in the back of my mind is that no matter how good the replacement is it can't be as good as my joint (if that makes sense).

*sigh!

D

dreamdaisy

Becoming more active is a possibility but the degree of activity will come with some limitations - OA is a progressive and degenerative condition and there are always catches with the solutions. A replacement is a good substitute but it is just that, a substitute. As I said I don't know anything about resurfacing (my joints are beyond that) but I do hope that someone who does will reply at some point. DD

dcdavies

Hi Hileena,

Good to hear back from you too.

It sounds like you and dd have to put up with a lot with your arthritis and I just want to say that i am so grateful to you, Dd and everyone else want to share their experiences.

In answer to your post, yes I have seen a physio and have stretches and exercises to do. They have helped however I tend to find they can also aggrevate things. The physio has provided me some do' s and don't s in terms of exercise. a bit restricting considering what I used to do.

D.

dreamdaisy

It's one of the toughest things, learning not to think about we used to do. I am now in my seventeenth year of this malarkey and I have finally learned not to think about my past because it doesn't help the present. In my view arthritis takes a great deal and gives precious little in return. Learning to accept that and live with it is one of the harder challenges, and one of those challenges is measuring how much effort we put in with exercise etc before things begin to rebel. We all have our personal tolerance levels and discovering them is a matter of trial and error. DD

dcdavies

Thanks DD. I think your right. Getting the right mind set is important as is setting realistic goals for ourselves.

dreamdaisy

Acquiring the mindset is easier said than done - and every now and again it slips. It is sometimes easier to be resentful than to be accepting but you'll get there, we all do. Good luck with your endeavours and yes, keep those goals realistic - trying to do too much only leads to frustration and disappointment which isn't helpful. DD

hileena111

HI
Yes...keep the goals realistic.....what is the saying? REST?

R REALISTIC {not too high a goal or you set yourself up for a fall}
E ENJOYABLE { you're more likely to do it}

S SPECIFIC {not just I want to lose weight. How??}
T TIMED. {time it and stop when you feel you can still do a bit

more}

That's what I was told anyway LOL

Love
Hileena