Groin Pain resolved + Pain Medication

Bones, joints and muscles
1

Four weeks + 2 days opst op THR right hip.

I took a different appraoch than most. My first week was very traumatizing with not getting pain medication the day after surgery and then having a bad reaction to morphine, then Tramadol, until I came home on day 7 and my Primary Care doctor prescribed a pill with Codeine (25mg) + paractamol (400mg).  I had issues figuring out the right amount of pills to take, not to much not to little.

Initially I had deep pain deep inside my right butt cheek (I had the surgery from the side) but little by little that has healed. A week ago I woke up and walking from the bedroom to the living room, only about 15 meters left me shaking and sweating and camy. I figured it was either my heart or the codeine, it was really bad. Stopped taking the 2 codeine pills at night and the next day was like a new woman. Okay the codeine is good doens't take you donw as long as you ahve pain, with decreased pain taking the codeine wiped me out.

Having tremedous problems sleeping at night, pain is just enough that the naproxen doesn't quite stop it but the pills with 25mg codeine seems to be to much. I'm only sleeping 3 to 4 hours a day, which obviously is quite fatiguing. Next week I'm going to ask my doctor for a pill with Codeine with only 10 mg of codeine in it, I bet that is going to be the ticket.

GROIN PAIN- that has resolved itself. I realized quite early on that I had, Iliopsoas tendonitis and I stopped doing anything that aggravated that. During surgery the surgeon dislocates your hip and manipulates the leg in unatural positions and this tendon obviously got stretched. With tendonitis the treatment is REST the tendon. It can have micro tears in it, just stay off it and let the tendon heal, exercizing is only going to further tear the tendon and leave scar tissue. That is what I did, I stayed off of it and did not do any execrizes that hurt that tendon.

One exercize was to lay flat on the bed and with using your hip raise your leg off the bed, in other words lift your heel off the bed. That exercize was impossible for me to do, the pain was excruciating. So I dind't do it. I only did exercizes that didn't hurt and honestly I didn't even really do the exercizes very much. My theory was to simply wait and let everything heal up. I did have a physical therapist come 3 times a week and massage my leg and manipulate the leg, but when doing these manipulations he completely supported the leg, I wasn't using my muscles.

I'm happy to say that exactly 4 weeks after my surgery I am walking without any crutches or aids and I am carefully going up and down the stairs. I am 60 years old and only suffered about a year with severe hip pain so maybe I wans't as disformed as people who had suffered longer. I feel fotunate to not have any back pain, that has got to be tough for people who do. Yesterday I took my first shower which went very well. I have a jetted tub with a pretty high wall but had no problems lifting my leg up with my muscles to get into and out of the tub. I was stable in the shower and know my new hip supports me. If 10mg of codeine at night works for me that will resolve my new issue since stopping the full strenth codeine pills, lack of sleep.

I want to offer hope and support to people who are experiencing groin pain. My groin pain presented after I sat in a chair for a while, once I stood up I got the groin pain in my Iliopsoas tendon. Also as stated above when I tried to raise my leg while laying flat. I want to offer you hope and support if you are experiencing groin pain.

Iliopsoas tendon presents as a pain in one small area of the groin, in the crease where your leg joins your torso. It does not shoot up and down your leg of give tingly pain. It hurts, it is sore. Just like if you get punched in the arm and have a bruise, it only hurts right on the bruise, your whole arm isn't sore, it's is only sore where it has been injured.

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Glad to hear every thing is improveing. As far as the codene is concerned 2x25mg tablets is a very high dose when I had an accident with extreme trauma to the tibia , tibia plateau reconstruction the strongest dose I was given was 15mg tablets . I cant take morphine, tramadol or strong codene without taking anti sickness tablets. they can have nasty withdrawl symptoms so reduce slowly .

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I'm glad you're doing well. My iliosoas Tendonitis is improving for the same reason. When my 5mg Percocet became too much I cut the pills in half and still take those as needed. I had the same reaction when I took a whole one but the pain wasn't bad enough to need it (sweaty, clammy, just awful). 

I hope things continue to go well for you!

4

Hi, I am 7 weeks on from left hip replacement and everything I thought was on track to make a complete recovery. However I have developed excruciating groin pain which happened after my first bath!  Have you experienced this? did I climb into my bath tub too soon? (even though the nurse said it was ok). I have been diligently doing my exercises but today the pain is so bad that I  have not! I would be so pleased to hear from you or anyone else who has or is experiencing this pain. I feel very disappointed and also feel my recovery has gone backwards!

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Very glad you are doing better and thank you for the groin pain details.  I am guessing you had posterior approach, i had posterior too for my right hip and 11 weeks ago had anterior for the left hip.  I too developed groin pain at week 7 recently and my doctor said to stretch the iliopsoas tendon with exercises, i did and it did not help much so i stopped doing the exercises and the groin pain went away soon after that.  Unfortunately, it looks like pain as now moved to the front and side of the thigh, i have pain when i put pressure on the leg when i try to walk without support, so after 11 weeks, i had to go back using a cane.  This anterior recovery so far has been very disappointing to me.  It also left me with numbness and left over swelling of the thigh that possibly will never go away.  None of this i have experienced with the posterior right hip.  Does anyone out there experience numbness of the thigh after anterior?

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I can't answer your question directly because I'm 7 weeks post op from a posterior thr but I have damage to the same nerve that's causing your numbness. It's the lateral femoral cutaneous nerve and is at the most risk for injury from an anterior approach. Mine was injured from the seatbelt in a car accident almost 3 years ago. It has improved but will never fully recover because of the way it was damaged. However, in an anterior thr, the injuries are less severe and usually recover in time. Unfortunately, nerves heal considerably slower than bones and soft tissue so it can take several months for the nerve to heal. Mine went through phases such as numbness, tingling, extreme sensitivity, itching, etc. but not all at the same time. 

The good news is that there's a very good chance that the nerve will fully recover. The bad news is that it may take a while. I've also had nerve blocks and radio frequency ablation so there's hope even if it doesn't fully recover on its own. 

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Sounds like it could be tendonitis in the iliosoas. If it hurts every time you try to lift your leg, it's probably the iliosoas. The best solution is rest. Ice helps some too. Tell your therapist and stop doing exercises that use that muscle. I rested it for about two weeks and it feels much better. I kept doing other exercises and just started on the iliosoas again yesterday. 

Try not to worry. It sounds like you just did a little more than your body was ready for. Rest and ice will help. 

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Thank you for that, it gives me hope. I shall contact a therapist for help. 

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Lynn, geeze I feel so sorry for you. This is the best test I can think of to self diagnose iliosoas Tendonitis. (My physical therapist onfirmed that was my issue)

Test 1-

Lay flat on your back in bed with the covers off.

Legs extended.

Gradually bend your knee and drag your heel (keeping it in contact with the bed), drag your heal up close to your butt by bending the knee more and pulling the heel towards your butt wth your leg muscles.

Result should be no groin pain.

Test 2-

Lay flat on your back on your bed with your legs ully etended. Try and lift your oeprated leg up from the bed. Specifically try to raise up your heel, keeping your knee straight not bent.

Result will be pain.

If you get No Pain on Test 1 -AND- Pain on Test 2 it is most likely iliosoas Tendonitis.

For all tendonitis, first rest the tendon, let it heal, then slowly do stretches. I am just starting stretches, easy peasy ones, I don't want to re-injure. I am hanging onto a table and kind of squatting jsut a little bit and sticking that lg behind, and lowering my body. (sorry hard to describe)

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Jodi, I think I had groin pain doing heel slides (your test 1) when my iliosoas tendonitis flared up. I know my therapist told me not to do those when I was resting it. I can't remember for sure but I think it was any movement that required me to lift the leg at all. Maybe I was compensating but I know she stopped me from doing those for a while. Test 2 definitely caused pain for me and still does. 

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Experiment done and you are quite right! Will attempt squatting as you describe and meanwhile rest. I am seeking a physical therapist got help. Thanks for your advise. 

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Lynn, it pleases me enourmously that I was able to help you. I would add that I do not recomend you exercize that tndon AT ALL until you have rested it 3 weeks or so. AFTER it has healed up, nd it will moslty heal then you can do gentle stretches to bring it back. But heal it first.

I am an expert on tendonitis, having had it in both legs from my hip to my knee, for 3 years. In fact it turned from tendonitis to a permenet condition tendonosis.  When I got it in my legs I did the wrong thing and just suffreed and did not go to the doctor for 6 weeks. by that time it was to late. I had a really severr, severr case of it. Thi is how I know that the proper treatment is to stay completely off the tendon and let it heal. I can feel the tendon on the outside of my legs that runs from my hip to my knee, I can actually feel the scar tissue in the tendon. It was like a miracle for me that after my THR, it releveved about 95% of my tendonosis on my worst leg. My tendonosis was actually mote debilitationg to me than my hip.

I have just the very smallest amount of pain in my iliosoas now, and only now do I feel comfortable doing any stretching. Think of the tendon as getting little tears in it, all up and down the tendon. In the THR if we are lucky t simply got stretched beyond what it could handle, and no tears. If there are any tears they are micor tears and if we give it a cance will heal back with no scar tissue.

Best of luck to you Lynn. I am so happy I could help you as I sure have gotten a TON of great advice on this forum.

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basically this but shorter. Do NOT wotk th tendon until it has healed itself, approx 3 weeks where you do more laying than siting. After healing when you have just a tiny bit of pain then can begin easy stretching. I apologize for my typos, don't have my glasses on.

14

Lynn you wrote, "However I have developed excruciating groin pain which happened after my first bath! "

I bet you got the iliosoas Tendonitis because you were *sitting* in the bath. That particular sitting position with your legs out probably triggered it.  Sitting, for me anyway, is what really aggrivated my iliosoas Tendonitis. I bet it was the sitting position in the bath that did it. Please throw out my theory if you took a shower, LOL!

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Thanks Jodie, I appreciate your help and advise, a lthough more laying than sitting is a bit daunting! Apart from the dilibating pain the distressing part is not being able to straighten my leg. It is very rigid! I look forward.to healing and being able start easy stretching. 

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You've got it! I did sit in the bath as I wanted to soak all over. I did awa y with the stool Doh! Timing proves you right as it was that night the pain started! I've also been exercising too much, each time I would think how painful it was when all the time I was overdoing the stretching! I wish the nurses had warned me about this but feel goPod now I know I am not the only one who is suffering and am not bring a n wimp! 

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If you can't straighten your leg, something else may have happened. Tendonitis hurts when you try to lift your leg from a straight position. It doesn't prevent you from straightening it. I think you would know if you dislocated the joint but if the pain is excruciating and you're not getting relief, I would call the doctor, therapist or even go to the hospital if the pain is really bad. Tendonitis doesnt hurt enough to feel like you have to go to the hospital. You can also get relief from tendonitis when you rest. If you can't, I would call someone right away. 

 

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Thanks!  I got more positive results from my posterior surgery.   The only negative i remember (and it is only 11 months old so my memory is not failing me) was the weight bearing 50% with the walker for over 4 weeks, i had to make the doctor repeat '4 weeks', i thought it was crazy and unecessay, but guess what, this is what gave me the best end results.  If i had a third hip to do i would definitely go posterior again, but thank G..d we only have two, so amen...

 

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I feel a lot of people do that. Feel a pain and think, oh boy I really BETTER get ON these excercizes. But if you think about it, that tendon was already over stretched during surgery so why do excercizes to keep on a stretching it?

I took a completely different approach, I waited first for healing from the surgery before pushing myself. It was in a matter of maybe 5 days I went from using a walker to walking crutch free. Today I even drove the care around the driveway for a little bit. Went up the stairs without a crutch and the nromal way of walking up the stairs.

I still have some slight pain in the hip socket when I walk or try to go to sleep at night so I know I'm not completely healed yet. I had a LOT of pain in my right butt cheek when I got home form the hospital after a week.  I think because I did to much walking the first 2 days that hip socket was simply not ready. After the frirst 2 days I went down hill. I stopped, and simply laid around and waited to heal. Once the healing took place it ws remarkable how lighting fast I improved. I used the walker because I felt safer with it. Then I think I spent maybe 2 days on 2 crutches then 2 days on one crutch then no crutches.

Lynn, if you stay off the physical positions and activities that aggrivate the iliosoas tendon it won't be that long until it heals. If it is hurting to walk, maybe go back on at least one crutch for 2 weeks to take some wight off of it. It is really a good thing you read the forum becuse exercizing it could have given you a perment tendonosis in that tendon, just like I have in my legs. This forum is great people are so nice. smile

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I think I agree with Cindy. The thigh is the quadraplex muscle, a big huge muscle, it would seem odd to me to have a pain going "down" your thigh if it was a tendon. it would seem to me that practically the whole quadraplex muscle would be reacting. As Cindy says, it sounds more like a nerve issue (but I am not a doctor). I have never had quadraplex tendonitis nor nerve damage so I am probably not the best one to try and help.

My surgery was from the side (I think this is what you call anterior) an had no swelling at all. I did have a drain and in the first 24 hours they drained off about 3 cups of blood. On the second day there was maybe a tabelspoon of blood so they took it out. Maybe that was a factor?