Question
Sharon,  My Mother still requires a walker for mobility after 18 months post-op.  She received a partial hip replacement as a result of a fall.  She has not been without pain since the operation.  She has general pain down the outside of the leg and occasionally in the groin, but the main problem seems to be sharp pain apparently coming from the bone, and often when releasing weight from the operated leg.  Because of the pain, she cannot walk without assistance for fear of severe pain and falling.  The pain sometimes causes her to scream, and while it only lasts a moment, it is unbearable.  The surgeon and a second opinion doctor are at a loss of what to do.  They discourage repeat surgery.  She is 79 but otherwise in excellent health.  She continues to work diligently with the physio.  Any help would be much appreciated.  Thank you.

Answer
Hello Scott

I can hear the frustration in your email for your mom.  I wish with all my heart I could give you an answer, but I'm not a doctor.  I do have some feelings though and you might want to ask your mom's orthopod to investigate these things.

If your mom's surgeon feels that the hip is in place, is in place and solid, it may be nerve damage.  I had some nerve damage which sometimes causes both tingling and pain.  It started after msy surgery, and my doctor told me if it did not get better in 18 months, the damage would be permanent.  My problem though does not seem as bad as your mom's and I am truly sorry for that.

You might want to ask the doctor if nerve damage could be the cause of her pain and if a drug like neurontin might help.  It's non narcotic which also is a good thing.

The other thing that sticks in my mind is that you said she is afraid of falling.  It may be that because of her fear of falling, she tightens up her muscles when she walks and that can cause muscle spasms.  Muscle spasms hurt badly and sometimes that pain can mimic bone pain.  Maybe a muscle relaxer can help that part of her pain too.

My concern is that after 18 months, she is still on a walker.  That doesn't sit right with me.  Why has her PT not worked with her to get her off that walker?  

Ask her doctor to also take her leg length.  If her legs are not even, that can cause pain while walking.  

The last thing I want to mention is something she may "poo-poo", but give this a try.  Ask her physical therapist if she knows Trigger Point massage.  It's not a massage technique that is a normal massage technique.  It's a type of bodywork where the therapist puts pressure on certain points of the body and just presses.  (the patient is fully clothed), and by putting pressure on certain points, pressure and pain in areas of the body lessens.

I truly feel empathy for your mom and her pain.  I hope I have given you food for thought and I hope your mom gets the help and assistance she needs.

Sharon