Way forward

Henrietta

Hi, after a year of working and hobbling throughout lockdown and exhausting self help routes at great expense, I now have a referral for consultant. Pain in right hip with referred pain in groin and lower spine area. Keeps me awake after 2.00 PM when pain killers have worn off and stops me working full time and walking dogs not to mention just general "stuff"

I'm being advised by different knowledgable people to do totally different things, my experienced social care manager saysgo for hip replacement,skip any useless injections and get it out the way and move on. Another friend, consultant radiolagist says self help all the way and skip the medics. Totally confused.

Unsure how I will cope at home with dogs, lodgers, huge garden and no supportive family. Any advice welcome on anything!!!

 

Lilymary

Hi Henrietta, would you ask a dentist about problems with your feet? In the same way, why listen to a radiologist about musculoskeletal problems? I’ve never heard such daft advice as a solution to a crumbling joint.

Self help has its place, and there are some things you can do to help your body cope with the effects of arthritis, but my understanding is that the arthritis itself is irreversible and progressive, and there comes a time for many when the only solution is surgery, however many non-pharmaceutical pills, potions, diets, exercises and self help books you get through. You have already followed that expensive route and it’s still brought you to the same destination.

It sounds like you had a similar lockdown to me, where the pandemic was a mild inconvenience compared to what my hip did to me. I’be just had hip replacement and am in the painful recovery phase atm. But from my experience, you’ll get referred to a consultant rheumatologist or orthopaedic surgeon (in my case the latter, via a musculoskeletal consultant) who will arrange for X-rays and review the best options for you given the level of damage at present and your personal circumstances. The goal is to minimise pain and get you moving again.

First stage is pain relief drugs and specific exercises to strengthen the muscles around the worn joint. If and when this is no longer enough (I was already past that stage when I was referred) they may try a steroid injection into the hip. Your colleague’s comment about this is unhelpful in my view, a lot of people do get benefit from this to varying degrees and the surgeon will keep offering this until they don’t work any more. In that respect it’s not a waste of time. They aim to defer replacement surgery as long as poss because the new joints eventually wear out and can only be replaced a limited number of times, which is why they seek to find alternatives for as long as possible.

However, for many (myself included) there is little or no benefit from steroid injections if the joint is down to bone on bone (but they usually give it a try anyway). After this the treatment is escalated to hip replacement. Resurfacing is rarely offered (I understand) since it’s an invasive procedure with not great long term outcomes.

i can really relate to the symptoms you describe, and the effect it has on your life. It’s really tough going. There are a couple of links on this site (I’ll try to find them) specific to hip conditions, surgery and pain management that you may find useful. While it’s great that your friends are supportive, if misguided, I hope your consultation gives you a clearer way forward.

Lilymary

https://www.versusarthritis.org/about-arthritis/treatments/surgery/hip-replacement-surgery/

https://www.versusarthritis.org/about-arthritis/managing-symptoms/

helpline_team

Hi @Henrietta  

Thank you for posting on the helpline forum. I'm sorry you are in so much pain that is keeping you awake at night and impacting so much on your work and general quality of life. Things sound like they have been very tough for quite some time, so I’m pleased to learn that you now have a referral to see a consultant.

I can see from previous posts on other threads that, although you have been diagnosed with OA of the knee, you needed clarity from a medic around the diagnosis of underlying cause of the pain and stiffness you have in the other joints. I’m guessing from what you say here, it has been diagnosed as OA and that your appointment is with an orthopaedic surgeon for a discussion around hip replacement surgery. If that’s not the case, do contact us on the helpline so we can provide more tailored advice.

Thanks to Lilymary for providing the links to hip replacement surgery and managing your symptoms. I have provided a further one to OA which may be worth revisiting.

You are right to reach out for evidence-based information. The hip replacement surgery link addresses your most pressing concerns I think, and could help with questions you could ask your consultant. Most people with osteoarthritis won’t need surgery. It’s usually only considered once you’ve tried all other suitable treatments. It is important to find out what you can expect from surgery, what the possible risks are, and how you can best prepare for your operation and plan ahead for your recovery. You're already thinking through how you will manage your situation without family support and with your dogs, your lodgers, the house and garden to manage.

I appreciate you have exhausted all of the self-help routes, but it may still be useful to talk things through with one of our helpline advisors prior to your appointment, just to make sure you’re not missing out on information around possible self-help and treatment options.  

Either way, you are very welcome to call us on our freephone helpline: 0800 5200 520 so you can talk things through with one of our helpline team. 

I hope this is helpful.

Best wishes

Mags

Helpline Team

https://www.versusarthritis.org/about-arthritis/conditions/osteoarthritis/

Henrietta

Hi Mags

Thanks so much and yes you have assumed correctly about my path so far in getting here, I couldn't find my earlier posts and knew they must have been some time ago.

The self help methods I've tried include supplements-Turmeric, MSM, Calcium, Magnesium, Zinc, Glucosamine Chondtrite, Colagen Type 2, Green Lipped Mussels, Marine Chondrite, Boswelia, Green snail slime from Helix.

I've had 5 or 5 chiropractor sessions including deep tissue massage and bespoke fitted orthotics, I've got 2 show boxes full of numerous orthotics some bespoke and many varieties, cupboards full of varieties of trainers from Asda to very expensive ones nearly £200 a pop.

More recently I've private physio for 5 sessions including accupuncture.

Ive had private gym trainer, followed those exercises, on line numerous versions of hip exercise, physio exercises

I've had knee supports, a hip support, a back support

I've been on Naproxen and CoCodaamol for 16 months

Limping on working my way through lockdown and avoiding anywhere medical due to covid.

Hip xray I had week before covid outbreak said "Moderate superior joint narrowing, subacetabular schlerosis within right hip. Minimal osteophystosis from lateral aspect of right femoral head. Minimal osteophystosis on right lateral aspect of L4/L5. The Dr said from my most recent xray a couple of weeks back there was "advanced wear and tear in right hip"

Henrietta

Hi Lilymary

Thank you so much for taking the time to reply with a balanced and informative view. No one can understand unless you are there or trodden that path. I realise none of my friends get it at all because I tend to suffer in silence a great deal and when I do moan they think I'm being a hypercondriac I think.

Yes my referral is to an orthopaedic surgeon and I have been reading about the hip steroid injections which is what I requested when I last saw my GP, she went on to refer me for hip x ray and then to specialist having viewed the results.

I wish you a very swift and painless recovery. You must be so relieved to be through the other end now.

Some of my reservations besides covid in the past year have been that thought that hip joints don't last forever and I'm only in my early 50s and also wondering how on earth I will cope with the recovery side of things.

Lilymary

I'm sorry to hear it's hit you so young. With me I was 60 when it all kicked off. My new hip has a ceramic head and plastic socket, and my surgeon said it should give 15 years or more, and he knows I intend to be very active once my body is ready for it. So assuming you get through two of these, and in your later years you will (probably) be less active, so that could see you well into your 80s? You do hear of people of your age having replacement surgery, when there are no other options. Let's hope the steroid injections can buy you a few more years.

Meanwhile I'm impressed by your efforts to stave this off! I can see that would have cost you a forture. Not all of that will have been wasted, certainly the various orthotics I had in my shoes probably bought me more time, and OA in any joint will make your body adapt round it leading to soft tissue/nerve issues, so the physio may also have helped. So not all of that will have been a lost cause. I've had a few medical conditions in the past where I decided to just throw money at the problem. In retrospect it's hard to know which, if any, made the difference, as I just hit it with everything at once, but I did recover eventually, and at least I felt I'd tried my best.

I had bespoke orthotics for my walking boots (some more comfortable than others) but I found the Superfeet orthotics worked well in my every day "sensible" shoes - they fit well in Hotter and Gabor shoes too! The Superfeet inserts were recommended to me by a consultant rheumatologist years ago, who was a desert marathon runner, so she'd tried and tested them.

I hope the consultation with your orthopod goes well.

Henrietta

Hi Lilymary

Thanks so much for your reply. Interesting to hear your recommendation about superfeet. I've been using those for about the last 6 months in my work shoes. Recently I've taken one of them out on the right side as I feel it is my left knee that needs the support and I feel I walk with less of a dip without it on the right side. Early stages of experimentation. I had gait analyses at a running shop and they recommended them to me.

Thanks for the encouragement about the 15 year lifespan of your replacement. I think the prospect of all this is so galling as I've just spent the last 10 years of my life caring for my father through his 80s and into his 90s with negliglible help from brother who has spent last 10 years jet setting his way through retirement. Life isn't fair sometimes. Sorry needed a good moan.

Lilymary

Hi @Henrietta . Caring for someone is real life. It’s what humans are made for. It’s what makes people, families, communities, societies, tick. Jet setting is just fluff. You’re the one who’s had a real life, however hard it seems at the time, your brother has just been pretending. Some people, of either gender, just aren’t instinctively good at that sort of thing, yes, they can learn, they can try, but it takes something special to be able to do it well. Sounds to me that you’ve got what it takes. Anyone can jetset, it takes someone special to do what you did for your dad. X

Henrietta

Thanks, it sounds very much like you've been there to ❤️

Lilymary

True, but not to your extent, and I wish I was better at it. I’m in awe of those who make it their life. While there’s nothing wrong with wanting to have fun, see good stuff and build exciting memories, (which helps with mental health), I don’t subscribe to competing for the best photos on social media. It’s a modern artifice. One reason Homo sapiens have thrived, apart from opposable thumbs and big brains, is because we support each other. If the human race had been all about bungee jumping out of our cliff top caves, we wouldn’t have lasted long! 😅