Femoro-acetabular impingement anyone?

Apologies to everyone for not having been here much recently to support others - as I mentioned in another post my fiancé was diagnosed with a bladder tumour which was removed this week. They have given him a chemotherapy treatment to ensure they killed everything and were very happy that they removed it all in one hit. We have to wait 3 weeks to find out whether it was malignant (they seem pretty certain it is so expecting it to be) and what stage it is graded at. If it's the lowest level as we suspect then he's all done other than careful monitoring for the next 5 years and zapping it when it grows back. Anyway - all been incredibly stressful and exhausting and dealing with that, the flares it leads to due to me having to do more than i can really manage at the moment, and going through the whole PIP process at the same time has left me without the energy to be able to be much help to anyone else but once I catch up on my rest etc I'll be back reviewing the site again.

Anyway, just before all that happened I had seen my gp to start talking about my hip bursitis (as the rheumy thought it was) as I'd lost over 2 stone and it wasn't improving. She sent me for x rays over a month ago and I just got the results today ..

"The hip and sacroiliac joint spaces appear well preserved. There is a bilateral bony prominence at the femoral head/neck interface which may suggest femoro-acetabular impingement.

There is scoliosis in the lower lumber region"

I love how scoliosis is just mentioned as an aside! ;) Not had that show up before though so slightly concerned by it.

Based on doctor google it seems bone spurs have formed on my hips which are damaging the joint and cutting the cartlidge and nerve fibres hence the really sharp pain when I'm walking, or standing, or sleeping ... or doing anything really. The gp told me it's very painful ... ummm yeah I know lolololololol she is referring me to the local arthritis specialist hospital for physio. I can't see it helping as it's where I went privately but at the same time they were treating me for bursitis then and I guess the treatment might differ now they know what it is. I strongly suspect that this may end up with me either accepting the severely limited movement I already have or letting them operate to stop further damage - the info online doesn't say anything about whether this would help me get back to walking normally though.

Anyway is this something that anyone else has any experience of and any tips on what helps, what doesn't help, what makes it worse etc etc.? I don't even k ow what to make of the scoliosis bit either.

Funnily enough I had a call from the garage regarding my car today - it's on a 3 year pcp plan and I'm 2 years in so they are offering me an early upgrade. I have been thinking for a while that I am struggling with a manual car and really should consider switching to an automatic and this pretty much decides it. All good news for the PIP appeal I guess 🙈

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  • Hi mifford , wishing you and partner good luck with the treatment, I hope you get good news . I also have hip bursitis ,but no impingement , it has been a problem for a number of years now . Ive had a number of steroid injections , the last 2 weeks ago , they took an x-ray as the other hip is giving bother as well. Im still sore but trying to walk a bit more on the flat as im very unfit 🙁I had physio in the past with no success. Have they mentioned if they can remove the spur ?

    I have been discussing with husband when i next change my car that I'd get an auto matic as my hip gets sore using the clutch. Wish you good luck with that and your partners recovery xxx

  • Thank you.

    Had a steroid injection last year but it didn't clear it and only relieved it slightly for about a week. From what I've read I think this is different to bursitis though and means I don't have that but not 100% sure of that - would explain why the injections didn't work though. No idea about operation - she told me that the physio would now take over all decisions and referrals etc. They are in a specialist hospital and can sort injections etc so think they have responsibilities beyond the usual physio level. Fingers crossed they can do something to help though as I'm fed up with it disturbing my sleep so much. I wake up every 2 hours in absolute agony and as it's bilateral it doesn't matter which side I sleep on 😔

    Hope you get some answers and relief soon xx

  • I put on biofreeze in a roll on at night it can give to good relief as its easy to reapply xx

  • That's a new one on me ... off to see what is in it. I can't use any anti inflammatory creams so if it doesn't have any of that in it then here's hoping

  • It's worth trying, i like the roll on rather than the gel with no anti inflammatories 😀

  • Hello,

    I'm going to reply to you tomorrow when I have more time and can concentrate. I underwent a keyhole procedure on my left hip in April 2013 to repair a labral tear. I was 38 years old. I had lesions on my hip socket and they had torn through the lining of my hip socket. It was excruciating and by the time of my operation I could hardly walk. The procedure was done to try and preserve my hip for as long as possible. I was told I have advanced OA and have been told both hips will need replacing before my time. I'll dig out the letters and find the correct terminology. I changed my car before Xmas and have an automatic - aged 42 - as manual is so painful!! Old before my time. I also had bursitis last year and had steroid injection. I have daily hip pain, both sides. Never sure if it's all OA or lupus or a bit of both. Speak again tomorrow.

    Wendy x

  • I shall very much look forward to it thank you. The gp said there was no signs of arthritis so I'm guessing that's a good sign. And if it helps I'm 45 so I hear ya xx

  • Hello again. Sorry for the delay in getting back to you. I have finally had the chance to dig out the operation paperwork. I had my operation in April 2013. I had been training for a half marathon in October 2012 but had experienced increasing hip and groin pain on that side. In fact it was so bad, I haven't run since. Before the operation I was finding walking and standing painful. I was visibly hobbling. It was terrible. I went to my GP but the x-ray came back with no action required, all normal. But at 38 years old I knew that it wasn't normal to be experiencing so much pain in my hip! Luckily my husband's works health insurance agreed to cover an MR Arthrogram, which is an MRI with dye injected into the hip to show up in better detail what is happening in there. And thank goodness they did. I had lesions on the femoral head and they had torn through the lining of my hip, hence the pain. The running had been exacerbating the issue with the impact. The surgeon who I saw locally, wanted me to be referred to Cardiff for open hip surgery. I was terrified. I had 3 young children to consider and didn't want an open hip op at that age. But luckily for me my school friend is a nurse at Addenbrookes in Cambridge and has worked on Orthopeadics and Trauma for as long as I can remember. She told me about on of their Consultants who was performing this new operation, key hole to remove lesions and repair tears - 3 key holes and a much quicker recovery time. 6 weeks. He was training others in the procedure. My health insurance agreed that I could go to Cambridge and we just had to get me there. The fear had gone by now and I just wanted the pain to be gone!!!! The paperwork says Left hip arthroscopy, for partial acetabular labrectomy, chondroplasty & excision of impingement lesion. The surgery took 1.5 hours. I had one night in hospital after the op. I wasn't allowed to drive for 6 weeks and no hip rotation for 6 weeks. I had physio for 5 months which helped hugely. I can give you more info on how they perform the op if you want, don't know how squeamish you are. Anyway, it worked. I still have hip pain as that is the OA and probably lupus too. But that deep down excrutiating soreness and pain went. I have now heard of another friend in the Hereford area having this done on the NHS, so obviously, this has become a main stream operation now and no doubt has less risk of infection and a quicker recovery time, so good for the patient and NHS. I walk normally now by the way, however I think as the OA advances that will change. Anyway, for me the key hole op was a complete success and I am really grateful at having discovered the procedure and having it done.

    If I can help in any other way, please ask or PM message me.

    I wish you and your partner well, you have so much going on.

    Best wishes, Wendy x

  • Wendy thank you so much - it sounds incredibly similar to what I have had going on. It started with a deep ache that just wouldn't shift and now it's like a sharp tearing pain. It sometimes feels like my hip catches and then has to be clicked back into place. Lying on my side overnight is excruciating and such a sharp pain - even having the dog leaning against me hurts my hip and when the cat decides to jump on me I could scream. When I get up in the morning I can't do anything but shuffle and can barely lift my feet - it's like the soles of my feet are walking on concrete too and they hurt. And I can't sit with both feet flat on the floor - it's not painful as such but it's a really weird sensation and it makes me feel sick. Unfortunately it's on both hips although the left is considerably more painful.

    From what I've read the keyhole surgery is now standard where it's possible so that's good news. The 6 weeks recovery is scary if it's both sides but it's really good to see that it solved the problem. Everyone up to now had assumed it was the lupus and I couldn't see it ever ending so it's filled me with a lot of hope that it improved things so much for you - there's no OA changes showing up on X-ray yet but I'm prepared that if it does go as far as operating then it's inevitable eventually but at 45 at least I'd be able to walk now! The idea that my mobility at least could be improved even in the short term could be really good news. Once again thank you for sharing .. once I've heard from the physio with an appointment I'll update with whatever they say xx

  • I would definitely recommend the surgery. To be honest, all the physio and pain relief in the world is not going to correct the cause of this pain! The lesions are boning growths and they are rubbing the hip lining. They lessen the space between the ball and socket joint. Unless the growth is removed, the pain will continue and potentially tear your hip lining, with impact. Interestingly I have the same problem with my right hip. Lesions and a possible tear. Shown by normal MRI and I was offered the same procedure on that one, however I have NO symptoms on that side, well nothing like I had on my left. So I decided to leave the right alone for the time being. I'd be diagnosed with lupus between my left hip arthroscopy and the right hip MRI and same diagnosis, I couldn't cope with much more at that point. At least I know now what it feels like, and if that pain appears on the right I won't hesitate to opt for surgery. As I gave up running I have lessened the impact and risk. Also, no breast stroke. Anything that rotates your hip, as the lesion rubs!!! Plus, I was assured that once removed the lesions wouldn't come back. Apparently I was probably born with them. He asked if I'd ever been told I had clicky hips as a baby? I hadn't. But I am slightly flat footed and hypermobile. The hypermobilty doesn't help hips issues, especially OA, as the wider range of movements only increases the wear & tear on the socket. Good luck. Xx

  • The physio I saw when it first started asked me if I'd ever been diagnosed with hypermobilia. She picked up hypermobility in my hips, I know I have it in my spine and she suspects my shoulders as well. I can place my hands flat on the floor with my back staying totally straight ... I had no idea it was anything unusual! As a kid at primary school I used to complain of pains in my knees when I used to go swimming and could only ever swim breaststroke .. funnily enough I did swimming lessons as an adult to learn properly and we discovered then that my left leg just doesn't work. I think it's rotating up and kicking and the signal just wasn't going through to it and kind of dragged along. That was when I started seeing the physio to see why.

    Annoyingly I can't do any of the party tricks of bending my elbows inside out or anything like that .. I just get the painful can't see it type! Lol

    I used to run for a while too and when fitting for running shoes found that I over pronate with my ankles rolling in so should be flat footed but my knees rotate out giving me high arches - confused the life out of the running shop as I shouldn't have both.

    Operation might be interesting with the photosensitivity I have ... they'll have to coordinate it with Guys to see how they can do it. Nothing like doing things by halves!

  • Hi mifford

    So sorry to read what a tough time you and your fiancé have had. Fingers crossed you get good news re bladder treatment and outcome, keep us posted.

    I don't know if this might be helpful but I've got femoral nerve damage and impingement in my right leg and it is very painful!. I'm treated by my pain clinic with injections as pills don't cover the pain severity too well!. I'm waiting for injections now, hoping for a cancellation. If physio doesn't work out I'd strongly advise you asking for pain clinic referral, as they can treat it in different ways. I had physio with them and it was gentler than the usual physio. Good luck with it all and hope you get your PIP award. Keep us posted.X

  • Thank you.

    I think this is what she's got in mind with the ones she's sending me too ... she did mention they could do injections and refer for scans. They are very much a specialised hospital and not the physio they usually refer to. Do the injections help? The cocodamol she gave me did nothing last night so gave up trying to sleep at 5am again

  • Hi Mifford

    Does sound very similar. The injections do help. They do nerve block ones first as a diagnostic tool then if they work , they can repeat them and or do Radiofrequency ones which are newer and can give longer relief. They also look at your drugs as they can prescribe stronger ones than GP can. Sounds like you need that as well so I hope you don't wait too long to go. Good luck and keep us posted. X

  • Hi Milford

    iam not sure I can help with any tip however I to have been having issues with my lower back hips lumber area. It started about 3 years ago before anything eles happened to me sharp pains pinching I just thourght it was my hips playing up from having 2 babys. These day becoming more difficult to walk up right and when I do try to staighton up iam all over the place i also get a wet feeling on my legs the amount of times ive looked down to see if I'd wet myself lolol😕😳 the pain is hard to deal with some days. I had an MRI done last Sunday (still waiting to hear anything) so I hope they can come up with something x best wishes on ur journey through this difficult time x and hope u enjoy it new car 😊

  • The car didn't happen in the end ... the idiots said they had this awesome offer for me but then offered me such a stupid amount against my car despite admitting it was on mint condition and tried to get me to take on a car where my payments would double! Going to see how the PIP appeal goes or decide next year when my contract is up.

    Hope you get to the bottom of whatever is causing your back .. sounds like something "nerve" related

  • I'm sorry you have had such a stressful time recently. What kind of pain relief do you take? When I got to the point of both hips and lower spine hurting so much it was impossible to sleep, my GP started me on butrans patches which work 24/7. We gradually moved up in the strength of the patches. They help me a great deal.

    Nothing wrong with driving an automatic! Very common in the US, and most of the taxi drivers in Leeds prefer them!

  • Thanks. Believe it or not I've actually not been taking anything! I can't take anti inflammatories and things like paracetamol don't even take the edge off. Because I'm on methotrexate injections I'd been told to be careful what I take and as what I had didn't touch it it wasn't worth taking. I should have gone to the doc and asked for something earlier - she's now put me on low dose cocodamol and told me to take one and increase to two if needed. Took 2 last night and it helped me sleep for 4 hours or so then woke up in agony again. I've been doing more the last few weeks running around for OH so I think that's making it worse. Did just buy a lumbar roll from Lidl today so going to try sleeping on my back with that under my knees tonight and see if my back is ok like that and if it helps. I'm hoping the physio will sort pain relief soon though

  • Glad the co codamol helps. I can take paracetamol but it's not strong enough the pain, and my stomach objects strongly to any kind of anti inflamatories, hence my GP suggesting the butrans patch. Cautiously at first, because it doesn't suit everybody, but it's helped a great deal, and I get more sleep. I also have two memory foam mattres toppers and a duvet under me.

  • I'll certainly mention it to the physios and see if they can do anything as the cocodamol I can't use during the day etc and they are very limited in how well they work. Failed in sleeping on my back last night but found using the roll underneath whichever was my top leg when lying on my side helped last night as it seemed to stop my hips rolling in which seems to cause me more pain. Might try a pillow under the hip I'm lying on to see if that helps too - don't know why I've never thought to do that before

  • Yes, when I started getting hip pain we changed our mattress, in case that was contributing to my pain. I had always slept on my left side, which is my worse hip but i can't sleep on my right side! The new mattress did help a lot - memory foam, but obviously need more help than a new mattress to get rid of the pain in the end. Any kind of daily pain is difficult to deal with and its worth exploring all the ways to help relieve that. Wendy x

  • We have a memory foam topped mattress already that is about 2 years old - likewise it helped initially but not now. I tried sleeping with a pillow under my hip the other night but it was worse rather than better. I got a memory foam roll thing from Lidl the other day that can work as a neck support or lumbar roll etc which is supposed to go under my knees to see if I can sleep on my back. I just can't sleep like that I've found but if I lay it alongside me and use it to support whichever is my top leg (so my right leg if I'm lying on my left or my left leg if on my right) so it stops my hip rolling in so much and that has helped a lot. I'm still waking up every 2 or 3 hours in pain and having to move but it certainly feels better than it does when I don't use it and eases some of the pain going into my knees and ankles so I'm guessing that I'm over rotating inwards when I sleep. When I lie on my back or sit my hips tend to naturally rotate out as well (not very ladylike!) so it seems to be a more comfortable position for me. That and the double dose of cocodamol aren't fixing it but I'm at least getting more rest than I was.

    Plus I've been offered a mobility scooter by a friend - one of the little fold up ones that will fit in my car boot - I've fought against it for ages but I'm now thinking of taking them up on the offer as I don't want to become less mobile by walking less but if the x ray is right then walking isn't doing me any favours at the moment. It's very tempting

  • Hello mifford,

    Good to see you back here. I had only one thing to add on the scoliosis. Is this a new development? Or is it possible that it is long standing but never remarked upon before. Lots of people have mild scoliosis throughout life without its being discovered or causing any major problems.

    mx

  • Hiya. This I'm bemused by .. I've had facet joint injections and MRI scans of my back in my mid 20s and had pelvis x rays and scans in my 30s when looking for kidney stones on which they picked up pelvic phleboliths (not a clue!) and osteoarthritis in my lower spine. You'd think someone would have mentioned my hips and back things before?? I've also had a lot of physio where I was told that my back over arches and that I'm hypermobile in my lower back and hips ... apparently I hinge with a totally flat back or something. You'd think the physio would have noticed it? Because of this I'm thinking the scoliosis might be something new and my hips they probably just weren't looking as never been referred for that but not a clue. I know the last few years I've found it extremely uncomfortable to sit with both feet flat on the floor and it makes me feel kind of sick when I do, a bit like nails down a blackboard sick, but don't remember having that in the past.

    My nan had a very pronounced hump in her back and was pretty much always looking at the floor in the end but she was 92 and chairbound so not surprising. My uncle has started to develop the same but he's nearing 80 so no idea of it indicates a hereditary thing or not. My dad had the same bone spur thing on his shoulder and had to have it operated on to shave the bone too .. i keep getting impingement in both shoulders so beginning to wonder if they should be checked too

  • Hi Mifford so sorry to hear about your fiancée and your own health problems. I really do feel for you. And know how stress can make your own life hard with the flare ups it causes. I thought things were bad for me until I read your article. There really is always somebody alot worse off than ourselves. I think that everybody everywhere has their own problems in life to deal with and however large or small they seem to others they are such alot for the people concerned. It has helped me by reading your post today by showing me that there are many people out there with Lupus struggling with so many other problems in their lives too that aren't even related to the disease itself. Thankyou for sharing your experiences with us. And for allowing me to see that it's not just myself who is struggling with my disease as well as other issues in my life but there are many people out there doing exactly the same. Your post has made me realise that despite everything I should still feel grateful for what I do have in my life and that there will always be others alot worse off than myself. Which truly does make me feel a very selfish person going on about my own problems in my last post when they are nothing compared to some people's. Your post has definitely opened my eyes alot and Mifford I truly do wish both you and your fiancée all the best . And I hope that everything will improve and get much better for you both very soon. My thoughts and heartfelt feelings reach out to you both. And I send you both my love and very best wishes for the future. God knows you deserve some happiness and a break from so many hardships , bless you both. With all my love from Becca XXX

  • You certainly shouldn't feel selfish - I find this site great for being able to let off steam and have a good moan as everyone needs to let that frustration out somehow. When I write down everything going on this year I guess it does sound pretty awful but to be honest we're good and life goes on 😊 I have a friend who's life is always so awful and nobody understands what it's like etc etc (it's not and she really has no problems - she's just very dramatic) I always go and see her when I'm having a rough time as I always feel glad that no matter how bad it is at least it's not that bad 😂😂😂😂

  • Hi mifford,

    I am 29 and have FAI in both hips due to an egg shaped ball joint, and bony spurs.

    I had the labrum repair keyhole surgery on my right hip 4 years ago. I highly recommend it. I was in excruciating pain (although it is starting to return). With hard work and physio I managed to walk down the isle 3 months later.

    Have you tried gabapentin?? It takes the edge off my nerve pain. Allowing me to walk reasonably normally (along with plenty of hard work)

    Although at the moment it is all getting worse again.

    XOXOX

    Please check out my blog

    youngfreeanddisabled.wordpress.com

  • I've not been offered anything to help with it beyond cocodamol to help with sleeping at night. I did get a call today to book me in with a consultant next week so hopefully things will get moving then 👍🏻 Very useful to see someone else who has found the op to be a godsend as well - I think it's my preferred option if they offer it!

  • Update: saw the specialist today and although there is a very slight overgrowth on the thigh bone it's not what's causing me so much pain. He's confirmed it's definitely bursitis sitting right over the bony part of my bone on the outside of my thigh. He wants to do a steroid injection under ultrasound to ensure he gets it alsolutely spot on but wants clearance from my rheumy first as I said she's wary about giving me too many as had 4 general ones last year already. He's going to ring me when he gets back from holiday in 2 weeks for an update and has taped it in the meantime to see if it helps. I need to increase the size of the pillow I sleep with between my knees to make sure my hip stays totally in line with my leg and I have to start walking and sitting like John Wayne! No more skirts for me then! Lololol. My hips are over rotating in when I walk, stand, sit, transition to standing Etc Etc and it's causing excruciating pain. The biggest problem he's got is trying to find out how much is photosensitivity swelling, how much is lupus attacking and how much is mechanical and can be fixed without my back kicking off too. I wished him luck with that 😊👍🏻

  • Good to see things are moving forward for you and the cause isn't something that needs surgery. I'm surprised you need to wait for a guided injection though, I had bursitis last year, my GP injected there and then at my appointment. He asked where it hurt the most and stuck the needle in. The injections do seem to work though. I hope they don't make you wait too long because it's excruciating! I was in agony sitting down, standing, driving, lying in bed, nothing was comfortable or pain free. Not sure I could have coped another 2 weeks or more for treatment. I was silently crying, so kids didn't see, but tears rolling down my cheeks at time. Horrible. I wish you well. X

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