referred pain

bluesky

I have osteo arthritis in my hip. My main concern is referred pain in my leg and below the knee. Doc says take pain killers & do leg raises - this really does not help. What can I do, some days I cant walk.

Brynmor

Hi @bluesky and welcome to the Online Community, lovely to see you here.

Osteoarthritis is the most common form of arthritis, and the hip is the second most commonly affected joint! There are some good general tips for exercising the hip joint on our website along with suggestions of reducing the strain on the joint which may reduce the referred pain in your leg:

https://www.versusarthritis.org/about-arthritis/conditions/osteoarthritis-oa-of-the-hip/

More specific exercise suggestions can be found here: Exercises for the hips | Versus Arthritis

Do join in across the community, ask questions, give advice or call in for a chat to say how you are getting on, you will be most welcome.

All best wishes

Brynmor

helpline_team

Hi @bluesky thanks for your post to the Helpline.

If you are feeling that the self-management advice may not quite be the answer, I wonder whether talking it all over with a physiotherapist might be helpful? There's a great deal of research evidence to back up the guidance on exercise and healthy eating. If you talk to a physio they may have some thoughts.

Keeping moving can be far more imaginative than leg raises alone - so talking things over with the health professional might enable you to add some other ideas to your routine, but also they may be able to make sense of the experience you are having - and that's where the benefit of their medical experience can show.

If you'd like a chat, of course do feel free to ring us on our freephone.

all the best

Guy - Helpline Team

bluesky

Thank you all for your input

RogerBill

@bluesky I have moderate to severe osteoarthritis in my left hip. Until six months ago I used to enjoy eight miles walks but then walking more than ten minutes became a real problem. I'm having a hip replacement operation in a few weeks time. For many years before my hip started playing up I've had lower back problems.

Like you over the past six months referred pain has been an increasing problem. Initially in the left thigh but now lower back and both knees which often crack loudly when standing up. All very confusing and somewhat concerning.

Because of my limping and lopsided posture I guess it's not surprising that other joints and muscles are complaining. After a friend of a friend had recovered from a hip replacement he was really pleased that many other back and knee problems had improved significantly. I'm hoping for a similarly good outcome but I expect the recovery process might take six months or more.

I'm trying to do pre op exercises [xxxxxxxx] Unfortunately I don't think they're helping with the referred pain but I'm hoping they will put me in better shape for the operation and maybe help recovery.

I'm sorry that all the above does is demonstrate that you're not alone in suffering from referred pain and doesn't offer any solutions. The only thing I find helps is taking paracetamol before, rather than waiting until the pain kicks in. As suggested by @helpline_team a physiotherapist might help. In my area you can self refer to Dynamichealth which is an NHS funded service: https://eoemskservice.nhs.uk/

Text edited because it promotes services and products which is contrary to our guidelines. Anna ( Mod)

Lilymary

Hi @bluesky , I can relate to this. The worse the OA in my hip became, the worse the referred pain got. In my case it was burning pains down my shin and sharp pains behind my knee cap, quite often when I was sitting or lying perfectly still. I’m afraid I never found a solution other than general pain management, primarily drugs ( cocodamol and naproxen), but even then the pills only knock the edge off it to make it bearable. I found a general backup of mindfulness and simply relaxing a breathing through the pain when random sharp jabs arrived from nowhere was helpful. The latter doesn’t work so well, I found, for persistent grinding pains in the hip, when distraction and relaxation techniques also helped (being tensed up made my pain worse, and doing something to take your focus away from the pain will also help you relax.. Some of the tips in this link may help

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

exercising to maintain muscle tone can help take the load off the hip joint, which can also help reduce referred pains. I’m now 4 months post THR and after an unusually long road to recovery, I can report both the joint pain and referred pain are gone, just some soft tissue niggles to sort out, which are gradually reducing. There is light at the end of the tunnel.

RogerBill

Hi @Lilymary glad that you're now pain free. Are you now also able to walk, bend, twist and do most normal things without too much concern?

@bluesky Like @Lilymary I've also found mindfulness to be useful in helping to manage and live with pain. It's something I first tried seven years ago when I was treated for prostate cancer. With the onset of osteoarthritis I restarted the practice. It's a technique which is promoted by the NHS https://www.nhs.uk/mental-health/self-help/tips-and-support/mindfulness/ Seven years ago I attended a series of training sessions funded by the NHS, I don't know whether these are still available or if they're available in your area but, if not, there are lots of online resources and books about mindfulness.

Lilymary

Hi @RogerBill , the pain in the joint went straight away, but unfortunately in my case it was surpassed by soft tissue pain for several weeks which is pretty much gone now (some of my hip muscles had a massive paddy post surgery). I get the odd niggle still but nothing I need to take any pain relief for. The main ongoing issue for me is getting those muscles working again, as the hip abductor muscles are still very weak, which at its worst made me lurch sideways over my operated hip. It’s relatively uncommon, but can be a temporary side effect of hip surgery (called Trendellenburg gait - not sure of spelling). Now being corrected with physio. I’m managing a lot more without my stick now, but still keep it with me for longer walks as the muscles tire quickly. I also had a lot of fatigue lost op, but that finally seems to be going, so now up to about 3 miles.

As for mobility, I saw stuff on the Internet eg “5 things you should NEVER do after hip surgery”. Crossing your legs is a bit of a no-no, as that’s how they dislocate it for replacement, and I also witnessed a hip dislocating during a pilates class when she was just on hands and knees. She had also had a dislocation by turning from the hip rather than from the waist, and another hippie friend had a few dislocations from falling “a lot”. while out walking on rough ground, so you can imagine how hypersensitive I am on this topic.

So I discussed it with my surgeon who said dislocations are very rare, I’m just unlucky that I met two of them. As for the other positions, apart from crossing legs he said eventually you should be able to lead a fairly normal life, although he did add that “not a lot of my patients take up running”. He said even horse riding would be a possibility eventually (although I’ve heard of some who were riding again in 7 weeks, but their thigh muscles were probably amazing to start with), which involves a huge amount of hip movement.

Now the muscles have firmed up around the new joint (which can feel oddly wobbly for a while), and having been very cautious, I’m now doing most “normal” movements, including hands and knees and twisting, without thinking about it, and without pain. My bending range is also improving. My hip always lets me know if I’ve pushed my luck, so I’m still being careful as I reintroduce more of the old routine.

RogerBill

Thank you @Lilymary I'm really glad that you've recovered well and it's very reassuring for me. Just hope I have a similarly good outcome. I've never been a runner but did enjoy a lot of walking and it would be wonderful to be able to do that again.

I am doing a lot of exercises in the hope that they'll help build up the leg and back muscles. Also having realised balance is a problem, I've just got a wobble board. The exercise I've seen advised is standing on it with one foot while tracing the other around in a semi circle for a minute or two taking care not to lock the knee of the supporting leg or toe gripping. Only got it yesterday and as yet can only manage it with support. Trying to balance is also quite challenging for the thigh muscles. But I will endeavour to persevere and I guess it might be OK to try two or three months post op.

Another recent purchase is a foam roller for rolling the front thigh muscles by lying on it supported by your forearms in a plank like position. Not sure whether it's helping to ease my muscle tightness yet, but interestingly on the leg with my bad hip I can feel it bumping up and down whereas the front of the hip on the other leg rolls smoothly. The roller I've got is firm and about 15cm diameter. The exercise is OK pre op but I don't know whether it would be safe post op.

Lilymary

@RogerBill , my physio is getting me to simply stand on one leg, that’s challenging enough for me atm. My balance has always been shocking anyway, so there’s no way I’d be safe on a wobble board. In addition to my outer thigh muscles switching off, (my surgeon doesn’t know why as he said he didn’t do anything to those), he also said that some of the muscles tighten up when the hip joint is in poor condition, including a small one at the front (did you know there are 22 hip muscles?!) which is another of those still being grumpy in my hip. I’m guessing it will sort itself eventually. I’m a keen walker too, and while it’s hard to imagine getting onto the summit of anything noteworthy, I’m looking forward to getting wet and muddy with the wind in my hair soon. We’re building up slowly, I’ll be happy with whatever we can reclaim.

sorry to hijack your thread @bluesky . I know you said the exercises don't help, but my physio told me you need to do them several times a day, everyday, for weeks to start noticing the benefit, but she assures me it does work if you keep at it. The exercises may feel pointlessly easy sometimes, but I’ve really had to persevere with mine this time as my hip muscles were in such a bad way I couldn’t walk upright, and she’s right, it has worked. She said it will probably take 2-3 months to really sort it, but I can see improvements every day now, so do keep it up. I found it helped to do them watching the telly or with the radio on to stop getting bored and giving up! Try to work it in at a scheduled time too, the discipline will turn into habit, and eventually you’ll miss it if you don’t do it. It might help you to go to a private physio for a proper assessment and exercises tailored for you. NHS physios are thin on the ground, and private physios aren’t as expensive as you’d think.

RogerBill

@bluesky Like @Lilymary the physio told me that it would take at least three months for the exercises to yield any improvement. I spent a lot of time doing the exercises but unfortunately walking or bending for any length of time didn't get any less painful. However, I don't consider the time spent doing the exercises was wasted as I'm sure they will help pave the way for the operation and recovery process.