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What is hip pain, and what else could it be?
Bal M Rajagopalan, MD posted:
Frequently hip pain is mistaken for another diagnosis and vice versa. In my practice, I have seen people have hip replacements from various other doctors and their issue ended up being spine related, and not related to their hip. Not all diagnosis' are concrete. It is good for a patient to know that typically hip pain is not in the buttocks area. Hip pain from arthritis is usually in the groin, which radiates down the inner aspect of the leg to the knee. This pain is usually in conjunction to weight bearing. Hip pain is also associated with stiffness in the morning, due to being immobilized throughout the night. It is very important for your doctor to establish a correct diagnosis. Many entities such as disc herniations, hernias, abdominal or pelvis issues can mimic hip pain.

Sometimes even when the diagnosis looks simple on a XRAY, your doctor still needs to look and confirm that your pains are in fact, due to your hip. Personally, is I have even a small percentage of doubt, I will perform a hip injection under XRAY guidance. Within this injection is lidocaine and steroids. If my patient's pain goes away with the numbing agent right away, this confirms hip pathology 100% - as the cause of pain. So, as a patient, before you undergo a procedure such as a hip replacement, if you sense any doubt of the diagnosis make sure that your doctor has cleared all other options that the pains could be from.
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An_206526 responded:
I have had a hip replacment six months ago because i did have the groin pain and stiffness. I am walking much better now and i do not have the groin pain but I have puffiness on my hip. The doctor found calcium deposits on the x-rays. Will the calcium be absorbed by my body and the discomfort and puffiness go away in time or will I have this long term. Right now I am taking Alleve for the discomfort. Have you ever heard of other cases like this?
_swank_ replied to An_206526's response:
I had bone spurs on my hip and a calcified labrum. Have not had a replacement yet but did have arthroscopic surgery to remove the spurs and part of the labrum.

It takes a long time for joint replacements to heal, up to a year or more in some cases. Nobody here can tell you if/when it will go away. Your doctor is your best source of information.
Bal M Rajagopalan, MD replied to An_206526's response:

This is common and is called HETEROTOPIC OSSIFICATION. Essentially the surrounding tissues in their desire to heal form calicification. This calcification usually leads to stiffness once this calcium matures to bone. Some people have a genetic predisposition to form this. In our training we were always told that debris in the tissue can incite this. For this keep following up with your surgeon and keep active. Worse case scenarios the calcium will have to be removed surgically .So definately followup with your surgeon to get serial xrays to moniter the progress of this bone formation. This will not affect your implant negatively..
georgia888 responded:
Hello Dr. Raj,
Mostly we read about patients who are dealing with only problems related to the joint to be replaced. I will soon be scheduling hip replacement surgery as my condition is bone-on-bone however, in addition to this problem, I also have fibromyalgia secondary to osteoarthritis in various other joints. MRI's of a few years ago showed moderate to severe lumbar stenosis. I am 55 years old.

Assuming all goes well with surgery, will these other problems interfere with recovery? Do you think that perhaps my lower back pain felt mostly on my left side may be relieved somewhat in that the left hip is the bad one?

I realize you can't predict outcomes but thought you might be able to comment on this.

Thank you,
Bal M Rajagopalan, MD replied to georgia888's response:
Hi Georgia,

We all should hope for the best. The lumbar spine issue may be improved in the fact that you can walk better and are not loading your back more. Fibromyalgia is a tough one. If you are bone on bone, you need surgery done for sure, but the fibromyalgia won't improve. This and the stenosis will interfere to a degree, but not to the point you should hold off. Your doctors should be cognizant of such with pain meds as well.

- Dr. Raj
Keenebd responded:
By coincidence, I just responded to someone about to have a big toe fusion, then I saw this. To come directly to the point, about 20 years ago, in fact right after running the Boston Marathon (my last one), I developed hip pain that was quite disabling. After trying many non-surgical alternatives, including orthopedic shoes, my doctor determined the that the pain caused in the hip was caused by arthritis in the big toe that affected the way I walked, and that the aberration in walking was affecting the hip! The toe joint was removed and replaced with a stainless steel joint. During that 20 years, I have had no pain in either the hip or the big toe. I hate to think that I might have had an unnecessary hip replacement.

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