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  • Hip Pain - but worse at night

    Hi
    I'm a newie to this site and thank God I found it! I'm in Australia. I've had an MRI with an arthrogram (needle). Painful when it went in but felt like a new woman afterwards. No dramas at all. Outcome: osteoarthritis with mild to moderate arthritis in the hip and a labral tear quite significant. I'm 45, ride horses and walk a lot. Then over Christmas what with camping and driving around touring, the hip pain became worse. The pain is heaps worse at night. During the day I can walk around ok with slight pain and a limp, then at night time the pain in excrutiating, right when I go to bed! So I take the pain killers and have a few bourbons to try and get some sleep. Went to specialist today and he is going to do a hip arthroscopy on Tuesday to see what's going on as pain is only excrutiating at night he is perplexed as to what is happening. Sitting is fine just when I get up from the chair does the pain start and when I lay down in bed at night. The pain shoots into my groin and down the leg to my knee with pins and needles in my foot sometimes. When I went to specialist today no pain until he took my leg to the outside like a squat position, and then I felt like thumping him, very bad pain.:
    So its a mystery as to where the pain is coming from, the tear or what I don't know. Feels like pinching and grinding and pressure when I stand up from a sitting position and when I lay down. I suppose all will be revealed from the arthroscope on Tuesday.
    Does anyone else have the symtpoms I describe, especially at night?
    Any info any has would be greatly appreciated.

  • #2
    Trochanteric Bursitis

    Hi Ali,
    I have had pain in my hips for 30 years. It started with my first pregnancy and then went away after my baby was born, this happend with my other two pregnancies as well. About 12-15 years ago I started gaining weight and the pain returned. I have tried to diet to lose the weight but it was brought on by medication and thyroid disease and have been unsuccessful in reducing my weight enough to affect the pain. Initially the pain was only at night when I laid on that side and I used pillows to try to make sleep more comfortable. The pain increased over the years and I have tried physical therapy and water therapy. I was unable to tolerate the water therapy because the water was just too cold for my comfort. I have tried Lidocaine pain patches, injections, both blind and ultra sound assisted. I saw two rhumatologist that both disgnosed bursitis. My GP thinks it is fibromyalgia and has started me on Lyrica, which has some wild side effects and I am going to try to give it a fair trial, but not sure if I can tolerate the side effects. The pain is now intollerable and some days I have burning all day long from my waist to my knees. It is starting to hurt even when I sit on soft surfaces, it feels like I am sitting on a very hard rod. I am going to see a Orthopedic for the second time to ask for a bursectomy. I have the pain in both hips, but my left hip is much worse than the right. I do have days that are pain free, but never have nights that are not filled with pain. I have purchased a new mattress, have a 4 inch memory foam pad, sleep on bed pillow with a fiber mattress pad doubled over that and it is very comfortable sort of like sleeping on a cloud, but it does not stop the pain. Have tried extra deep sheepskin and other pillows with no relief. Hope you find an answer to your pain.
    Kay

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    • #3
      Hi Ali

      Did the surgeon say what had caused the labral tear? ie do you have an underlying issue like FAI or hip dysplasia?
      I have FAI and have stabbing pains in the groin area when sitting for extensive periods of time and it's gets extremely worse at night. I have found painkillers and anti-inflammatories don't help either but the less I sit/walk during the day, the less pain I have at night.
      Ice packs on the hips help slightly.


      Hi mamakay

      The fact that you have it in both hips may mean there is some underlying hip issue. Ask your surgeon about FAI and hip dysplasia. Find a surgeon that does hip arthroscopies, they may be able to identify what the underlying cause is.

      Comment


      • #4
        Hi there
        What's FAI? If its impingement I think that's what I have. The surgeon says the labral tear is wear and tear as I ride horses although the MRI says that I have osteoarthritis with arthritic changes in the hip as well as a tear in the ligamentum teres. The pain is better although it feels like its tight in the groin so makes me walk with a slight limp and after sitting for a while the pain is worse. Last night pain wasn't too bad at all. I guess that the arthroscope will reveal all. I've already spoken to my physio about a rehab plan, in the pool with exercises and with this hot weather, that suits me fine.

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        • #5
          Hi Ali

          FAI is Femoral Acetabular Impingement. A useful website is www.fai.com
          Do you know if your surgeon will be treating you for the FAI as well as the labral tear?
          With FAI they sometimes shave a small bit of the femur off to stop the impingement.

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          • #6
            Hi there
            He's not sure as the MRI I last had didn't show impingement but as there's more damage since the MRI in early December, he doesn't quite know what's going on and he said that MRI doesn't always show exactly what the problem is, so I guess its a bit of a waiting game to see afer my arthroscopy on Tuesday. Thanks for the site info, much appreciated. I'll have a good look at it.

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            • #7
              Me again. After reading the FAI and reading the MRI report again, the MRI report says there is 'a strong suspicion of Pincer type femoral acetabular iimpingement.' Also I have 'mild to moderate superior compartment degenerate change with extensive labral tearing'. Also I have 'focal signal abnormality on the femoral insertion of the ligamentum teres consistent with a high grade partial thickness tear of uncertain age.' I also have 'mild to moderate insertional tendinosis at the gluteus minimus'. I guess this isn't too good?
              And from what I can make out its a long slow process back to good health. So my horses are going to have a good rest and I'll get fat and that will be that!

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              • #8
                Hi Ali

                I have both CAM and Pincer type impingement. I believe the Pincer type has a longer recovery after surgery. Whilst I understand that CAM is treated by shaving off some of the thigh bone, I'm unsure as to how exactly pincer is fixed. Has anyone else had arthroscopy for pincer impingement who could shed some light on the process and recovery period????

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                • #9
                  Ok thanks for that. Are you in Melbourne. Me too? Andrew Shimmin is my specialist but his sidekick Jonathan Bare is doing the arthrscope. I now have back pain which is excrutiating in the mornings. I have a history. I had back surgery 10 years ago and every morning now my back is in spasm. I take a diazepam to stop the spasms. I'm over the pain! I don't want more back problems as well! This site is so good to let off steam! I believe pincer impingement is approximately 4-6 months.

                  Comment


                  • #10
                    Sorry to hear about the back pain. Dealing with chronic pain is hard. Friends and family don't always understand what we are going thru so it's good to be able to vent on this site with others with similar problems.

                    I've been misdiagnosed for 10 years with bursitis/tendonitis/IT band. Over the years I've endured many cortisone injections into the bursae and tendons which haven't helped.
                    My latest diagnoses is FAI but no labral tears, so I'm not that keen on surgery yet.

                    I wish you all the best with your arthroscopy, pls keep us updated with your progress.

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                    • #11
                      Hi
                      Yes it is certainly good to compare notes. Thanks for that I will post a new thread once I've had the arthroscopy.

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                      • #12
                        Hey Ali

                        I had an arthroscope to repair a torn labrum in my hip about 3 and half weeks ago. Before my surgery i experienced nearly exactly the pain you described for over 2 years. My pain was always worse at night and often got to the point where i needed to take pain killers just to get to sleep. Other activities that upset it were sitting or standing for long periods of time. The grating or the catching sensation you experience is from the torn labrum. My physio said my pain was worse at night due to inflammation from the day. Sitting especially inflames the area apparently because it makes the space in between the labrum and the bone smaller meaning there is more rubbing. I used to find that bringing my knee up into my chest often alleviated some of this pain...

                        The good news is that since my surgery, while i have had post operative pain i have not had a single night with pain The bad news is that i've had to give up all my sports because the tear was caused by my hip dysplasia meaning that my weight travels through the labrum when it shouldn't- making it easier to tear. Maybe because of your arthritis and the tear giving horse riding a miss for a while is a good idea...

                        Another thing... a lot of people are on crutches after they have an arthroscope depending on what they have done. I'm not sure if you've been on crutches before but lower back pain is really common with hip pain and apparently most people who are on crutches have problems with their lower back as a result so take care

                        Goodluck with your scope on Tuesday!

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                        • #13
                          I really relate to you guys with the night pain. I suffered for 2 and a half years until diagnosed with labral tear. I ended up flying to Melbourne to get an experienced surgeon in this area. I had a morning consult, then arthroscopic surgery in late afternoon same day! The surgeon also diagnosed FAI, so shaved some osteophytes off the femoral head to improve clearance. He could see this "FAI" on the MRI.
                          In retrospect, I truly believe that had I had just a labral repair, my buttock/groin/hip/leg/knee/feet pains wouldn't have improved so dramatically!! First pain to go was buttock (what a relief!!). But to be honest, I still don't understand how a few bone spurs on the femur can cause so much referred pain!!
                          By the way, I'm still left with some residual trochanteric bursitis in my leg, but the pain is much diminished. I only feel it at night when lying on it.
                          Thank God for traditional, western medicine (I tried all kinds of modalities along the road to finding a "cure" - very expensive, time-consuming, at times painful BUT UNABLE TO REDUCE MT PAIN LEVELS).

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                          • #14
                            Hi Legless and Jean M
                            Very informative replies thank you. Yes I will not be riding for a while but the thought that eventually I will ride will assist in my recovery and make me more determined to heal and be a good patient, patient!
                            I'll let you know how I go on Tuesday.

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                            • #15
                              Dear Legless,
                              As you're located in Melbourne, I'd be seeing the best hip surgeon around who's in Richmond (Dr. John O'Donnell). Lucky you.
                              I'd also let pain guide me. Like, if you're getting heaps of disrupted sleep, or your usual daily activities have to be curtailed, why not get the hip scoped? Dr. O will know if you need to get the femoral head shaved, and what's more he can do the procedure arthroscopically! I credit this particular procedure with a huge reduction in my pain levels. An maybe your labrum IS torn, but doesn't show up in tests. This could be fixed at the same time.
                              All depends on your pain tolerance. For me, the decision was easy: I just couldn't live anymore the way I was going........................

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