Levels of pain

Robert10

Hello all. I have just joined. It's nice to be in touch with people with the same sort of issues.
I've got two questions.

1) I have osteo-arthritis in the right hip and am due to have a replacement on 14 August but I am having serious second thoughts. This is because, having spoken to people who have had the operation, I realise that my pain is not as bad as theirs. The only time I have pain is after walking five minutes. Sitting - nothing. Lying - nothing. So I am keen to explore all the alternative options - herbs, physio (I am already on paracetomol), supplements etc.
By the way, 12 months ago I couldn't sit down on those low seats on the Tube as the pain was excruciating. And lying down I sometimes had to apply an ice pack. All that has improved. But the walking has deteriorated - and I limp.

2) My pain has been better in recent weeks - could it be connected to the warm weather?

Thanks, in anticipation.
Robert

[Deleted User]

Good morning Robert
I am glad to here that your pain levels are better at the moment but I confess that I have given up trying to understand why it is sometimes better than others I am not sure that there is an answer to that. For some people heat helps and for others cold helps. You might find our booklet on pain management helpful to read through. https://www.arthritiscare.org.uk/living-with-arthritis/managing-pain It is also worth baring in mind that we all have a different tolerance to pain levels.
If your hip has been considered severe enough for a hip replacement this decisions will have been made for clinical reasons by your surgeon so it may be worth discussing your concerns with them. Otherwise you could discuss it with your GP but I would suggest it is not always a good idea to compare yourself to others. Also you have mentioned that you do have a limp so your walking pattern has already adapted.

Do you see a physiotherapist at all? They may well be able to advise you on exercise to keep your pain in your hip joint down but they will also be able to advise you on your present walking pattern. If you decide to not have the surgery at this time then the physiotherapist would be an important part of your maintenance. You also don't mention how old you are as if you are in the earlier years of life that may be another reason you decide to hang on for a bit. You may find our fact sheet on hip osteoarthritis useful as it includes a section on what you can do for yourself. https://www.arthritiscare.org.uk/do-i-have-arthritis/publications/233-osteoarthritis-of-the-hip
It is hard to make these decisions but I would certainly recommend you speak to a Dr about it first. Lets us know how you get on
Best Wishes
Sharon

stickywicket

Hello Robert and welcome from me, too.

What a dilemma! None of us relishes the thought of an operation and I speak as someone with both hip and knee replacements. However, if the pain is excruciating, the answer is fairly easy. It was for me every time but I've had RA for very many years which led to OA so most of my joints are affected. A simple decision for me.

Here's what I can tell you:

1. The NHS rarely offers replacement joints unless they are deemed essential. The more usual problems on here are that people are in bad pain and are being denied a replacement on the grounds of being too young. Anything under about 55yrs seems to be too young. This is probably because, for younger people, that replacement joint will itself need replacing later – a longer, more difficult operation. However, as I've now reached an age where my contemporaries' hips and knees are starting to go (I'm 71), I know that, for some, it seems that replacements are offered far more readily, presumably because it is felt that, at our age, they should 'last us out'.

2. Pain is an odd and personal thing. Some experience it more keenly than others regardless of damage done. I'm sure you will have been told of the importance of exercise. This is because exercising the affected joint(s) keeps the muscles strong, and strong muscles support the joint better. This means less pain and (I think) slower deterioration. Even so, it does seem a bit unusual that you have no pain until you have walked for five minutes and that you can get by on just paracetamol. I can't explain why this should be so now when things were clearly worse some time ago. Except to say that arthritis makes up its own rules. And / or maybe you are now fitter. Maybe you bought a new bed or mattress. Maybe you have stopped doing something that irritated it or started doing something that ameliorated it. Who knows?

3. I think what I'd do in your situation is have a chat with my GP. He / she should have the consultant's notes, if not the x-ray, and might have a better idea of what is, or isn't, going on. Bear in mind there can be, in some people, a lot of deterioration without undue pain and vice versa. Also bear in mind that, if the pain is affecting your gait, you might start to get a knock-on effect in other joints which would be best nipped in the bud.

4. As for the pain being better recently - yes, it could be the warmer weather. OA seems to prefer heat. Or, it might be something else. It likes to keep us guessing.

Please let us know how things go. I's a tough decision, isn't it?

dreamdaisy

Pain levels are so hard to judge: one man's agony is another's bothersome ache. If you have been offered a replacement joint then that indicates that someone-in-the-surgical-know feels you will benefit and that can only be a good thing. To my way of thinking a joint replacement (if you play your part in the recovery) can lead to improved mobility and reduced pain - what's not to like? I wish you well whatever you decide. DD

Robert10

Dear all
Thank you very much for all your comments. I am 66 by the way. It really is a 50-50 decision which has to be reached by 31 July! But I'm seeing my GP next week to discuss it.
There's also the question of after-care. I live alone and although my sister is going to be here for a week or so, the period after that could prove tricky. I have very steep stairs (like ladders - this is a Victorian terraced house).
If I leave it, maybe that'll give me enough time to find myself a partner!!
Robert

barbara12

Hello Robert and welcome to the forum..
I had the same dilemma with both my hips..and was told by my consultant that they don't get so bad that its not possible to operate..but the limp will effect your back and other hip..its such an hard decision to make but you will know when the time is right..good luck..

frogmorton

Robert10 wrote:

Dear all

If I leave it, maybe that'll give me enough time to find myself a partner!!
Robert

That made me laugh Robert!! Seriously though I just read the whole thread and have to back up those who say the NHS don't often offer THRs unless there is a need.

Also the affect of walking with a limp on other parts of your body mustn't be overlooked.

As for aftercare. The first week is likely to be the hardest after that your sister will probably stock you up with microwaveable food etc.

You should be able to 'borrow' a raised loo seat and maybe a shower seat too to make those aspects easier. There are other things which will help - Picker-upperers and sock putter-onerers (ok I can't remember the real words :oops: ). Ask you Dr about getting referred for these bits an pieces.

Let us know what you decide and how you get on.

Best wishes

Toni x

stickywicket

Robert10 wrote:

I have very steep stairs (like ladders - this is a Victorian terraced house).
If I leave it, maybe that'll give me enough time to find myself a partner!!

Or move house Seriously, maybe that would be a future consideration. None of us improve with keeping and many of us on here have had to make the decision to move for the sake of our joints.

Ladders apart we've had many people who have had a joint replacement while living alone. It takes more forethought (Cook meals in advance and freeze them / use online grocery deliveries for a while / move furniture for ease of access) but it can be done.

As for the aids that frogmorton mentioned - in my view these are essential and probably because they are essential most NHS hospitals provide you with them free of charge before sending you home but it would be worth checking. Also, in my all-too-vast experience, they won't let you out until they're sure you can cope at home but the steps they ask you to climb are very ordinary, non-Victorian, ones.

dreamdaisy

I used to live in a house with two flights of steep stairs to bedrooms but, when I had surgery, we would sleep on the ground floor in the dining room (we also had a ground floor bathroom so all needs were catered for). We have moved to a far more user-friendly house - a radical solution but it had to be done as my mobility is steadily decreasing and I am reliant on walking aids. I began my arthritic nonsense aged 37 and am now 58 so have a good few years behind me (and a good few ahead too ).

It is possible to manage post-surgery but flexible thinking about practical arrangements and much preparation is essential. There is a thread at the top of the Living with Arthritis board on here that covers this, it might be a good idea to read through and see if any of the suggestions and solutions are helpful. DD