It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Knee & Hip Problems Message Board
Post New Thread   Closed Thread
LinkBack Thread Tools
Old 04-27-2012, 11:30 AM   #1
Newbie
(male)
 
Join Date: Apr 2012
Location: Cerritos, CA
Posts: 3
jason793 HB User
Slipped Capital Femoral Epiphysis/Chronic Back Pain/Stiffness

[FONT="Georgia"]Hi, I'd love to get feedback from anyone who has had a similar condition/problem.

I had bi-lateral slipped capital femoral epiphysis at age 13. Subsequently, I had both hips pinned. My left hip was a mild slip; my right hip was a moderate/severe slip.

I was very active following my hip surgeries, but my legs (hips) never felt normal. I was an avid cyclist, weight lifter, and sometimes runner/jogger.

I always suffered intermittent leg pain (never hip pain) and always had residual stiffness in my hips.

Basically, I was able to do anything physically, but I had to put up with the awkwardness and clumsiness that my hips caused.

My right leg (the bad side) was always 1/2" shorter than the left, and my right thigh was always atrophied compared to the left (my right foot is/was a size smaller than my left foot as well).

Over the years, my main complaint has always been hip stiffness and a lack of internal rotation. I never really had much of any actual hip pain. I used to get a lot of shin/knee pain over the years, but that has all but faded.

I am now 37, and believe it or not, my hips still don't hurt. But I have been suffering from chronic muscle/soft tissue pain in my lower back and trunk area for the last 8 years or so.

I was involved in a major rear-end collision in 2004, and from roughly a month or so after the accident, I've had CHRONIC low back stiffness, low back pain, and the inability to engage in exercise (weight lifting especially) without rebound pain and stiffness.

Also, I tried intensive stretching regimens, including various yoga poses, core stretches, and hip stretches, and the stretching always improves my symptoms in the SHORT-TERM; however, it feels like the stretching routines might exacerbate my problems in the LONG-TERM.

I'm convinced that my pain/stiffness problems are soft tissue/muscle related, but it's chronic and downright disabling at times.

The fact that I have a residual hip problem makes me wonder how much (if any) my hips play in my problems.

I just had fresh hip x-rays taken in January of this year, and I, of course, have degenerative changes in both hips along with residual deformities of both proximal femurs. My right femoral head is significantly deformed; the left head much less so.

However, I have no pain in my hips joints. I can stand on either leg and jump up and down with no pain. I can do leg presses/hack squats at the gym with no hip pain. At hip examinations, my ortho would push/pull directly on my leg and I would have no hip pain. He always suspected a muscle strain/pull.

But my lower back and core pain are driving me insane. I'm only 37, but most days I feel like I'm a well-worn and battle scarred 75 year old.

Back in 2004 following my accident, I had a lumbar MRI and lumbar x-rays, and the doc's could find nothing wrong!

I had a nerve conduction test in my legs a few years later, and again, nothing wrong.

I even went through a pain management phase, whereby I had several lumbar epidural injections and a sacro-illiac injection, all to no avail!

Bottom line is this: being in chronic pain sucks to the highest level. And I know the difference between true joint pain and muscle/soft tissues pain, so I am almost certain that my pre-existing hip condition is not causing my chronic soft tissue pain/stiffness.

Anyone have any ideas or advice? Sorry this post was so long, but I am going insane from having to deal with this for the last 8 years. I wake up every morning with severe back stiffness. I had to resign from a good job a few years ago because of this as well.

 
Sponsors Lightbulb
   
Old 04-30-2012, 06:08 AM   #2
Senior Member
(female)
 
swimbunnie's Avatar
 
Join Date: Mar 2011
Location: Central NJ
Posts: 165
swimbunnie HB Userswimbunnie HB Userswimbunnie HB Userswimbunnie HB Userswimbunnie HB Userswimbunnie HB Userswimbunnie HB User
Re: Slipped Capital Femoral Epiphysis/Chronic Back Pain/Stiffness

I was just diagnosed with femoral acetabular impingement syndrome. This came to light after several months weightbearing on the affected hip due to foot surgery on the opposite side. I experienced pain that led to mri which showed cartilage tear, fai deformity and mild OA. For years I have had lower back issues, piriformis syndrome and the like with no real answers...now finding it all could be related to this fai. The belief is this develops during the growth years and slipped capital epiphysis is believed to play a role. Sometimes our bodies compensate to deal with a problem but unfortunately it causes other problems from what I've been told. Perhaps this is true in your case. Good luck.
Bunnie

 
Old 05-01-2012, 01:20 AM   #3
Senior Veteran
(female)
 
Join Date: Jan 2012
Location: San Francisco, California, United States
Posts: 737
SweetPeainSF HB UserSweetPeainSF HB UserSweetPeainSF HB UserSweetPeainSF HB UserSweetPeainSF HB UserSweetPeainSF HB UserSweetPeainSF HB UserSweetPeainSF HB UserSweetPeainSF HB UserSweetPeainSF HB UserSweetPeainSF HB User
Re: Slipped Capital Femoral Epiphysis/Chronic Back Pain/Stiffness

Hi there -- welcome!

I tore the cartilage in my labrum at age 14, and went completely undiagnosed until age 29, finally diagnosed with FAI at 31. During my third hip scope, my surgeon found that a little more than half of the cartilage had delaminated from the acetabulum. He wrote a really interesting article regarding how most joint pain is sensed through the muscles, tendons, and ligaments that pass through the joint, rather than in the joint itself. By tracing the pain back to where the soft tissue attaches to the joint, you can determine where joint pain originates. I'll look for the name of the article, if you think it would be of benefit. I also had lumbar central stenosis, and underwent a fusion in late 2011. So, not the same condition, but I am also full of hip and back pain.

I suspect that your entire body is compensating for your limited range of motion, weakness within the hip stabilizers, and possibly damage within the joint that your body has learned to ignore. (If you want to test out the hip pain, there were two things that made my hip pain completely unbearable. The first was doing a plank (9 on a scale of 10). The other was being in a frog leg position and the doctor pushed my legs together with me resisting (12 on a scale of 10).) I would recommend a couple measures that might not "fix" you, but might make you feel better.

I would definitely make sure to get a proper orthotic lift for your shorter leg, if you don't have one already. I would make an appointment with a physiatrist, as they tend to have more of a whole-body approach, whereas orthopedic surgeons look for an isolated problem to fix. I would ask the physiatrist for physical therapy, too. There may be some exercises and stretches that would be beneficial, even in the long-term. I will post if I come up with more suggestions.

 
Old 05-01-2012, 10:45 PM   #4
Newbie
(male)
 
Join Date: Apr 2012
Location: Cerritos, CA
Posts: 3
jason793 HB User
Re: Slipped Capital Femoral Epiphysis/Chronic Back Pain/Stiffness

Quote:
Originally Posted by swimbunnie View Post
I was just diagnosed with femoral acetabular impingement syndrome. This came to light after several months weightbearing on the affected hip due to foot surgery on the opposite side. I experienced pain that led to mri which showed cartilage tear, fai deformity and mild OA. For years I have had lower back issues, piriformis syndrome and the like with no real answers...now finding it all could be related to this fai. The belief is this develops during the growth years and slipped capital epiphysis is believed to play a role. Sometimes our bodies compensate to deal with a problem but unfortunately it causes other problems from what I've been told. Perhaps this is true in your case. Good luck.
Bunnie
Hi Bunnie,

Thank you for your reply. Yeah, I have read a lot about FAI, which seemed to be an overlooked condition until somewhat recently. I have no doubt that my hip deformity is causing some impingement/soft tissue issues, but my back stiffness/pain seem to be of a different nature. But one never knows. Good luck with managing your condition. Since you only have mild OA, you should still be able to get a lot of useful years out of your hip.

 
Old 05-01-2012, 11:02 PM   #5
Newbie
(male)
 
Join Date: Apr 2012
Location: Cerritos, CA
Posts: 3
jason793 HB User
Re: Slipped Capital Femoral Epiphysis/Chronic Back Pain/Stiffness

SweetPeainSF:

Thank you for your informative post. You raise some interesting points regarding joint/muscle pain.

One positive aspect that has arisen from my hip/back troubles is that I have developed a keen interest in all things orthopedic; in fact, I spend hours over the course of a week simply reading journals/articles regarding many orthopedic condition, specifically ones relating to hip joint disease. I consider myself a minor expert on various hip joint pathologies.

As for my problems, I still remember my main ortho doctor, a hip/knee replacement specialist (highly recommended one) giving me an examination in his office roughly 4-5 years ago. I had the exact same symptoms then as I do now. And, after pushing/pulling on my hip, he believed that most of my symptoms were NOT from the hip joint itself; rather, he felt that I either pulled a muscle somewhere around the hip/lower trunk area, or that I might simply be suffering pain from chronic overuse.

Granted, I never have really stopped working out (even with all my pain and stiffness), so it's possible that I have some sort of chronic soft tissue malady that is being exacerbated by physical activity.

Just tonight, after having a lot of lower back stiffness and weakness/pain radiating into my legs, I went to the gym and did a pretty intense back workout (all back-related weight training) including plenty of lower back stretching. As a result, since leaving the gym, I feel ALMOST normal with no pain and virtually no stiffness.

But the problem is, tomorrow morning when I wake up I know I am going to awake with severe back stiffness and pretty severe (muscle?) pain throughout my back and torso. So, I already know that my brief respite is not going to last.

And thanks for the recommendation for an orthotic. I have been using a 1/2" heel lift for several years now, and it does seem to help my short leg feel better and not so dysfunctional. I have even purchased a few specialized types of shoes with extra soft soles and even small springs in the soles from a specialized footwear shop that have helped a lot.

So, as you can see, it's been a long-term struggle.

And good luck to you with your fight against FAI. Are you planning on having any sort of reconstructive hip surgery?





<Please do not name public figures. Discuss your own issues>




.

 
Old 05-03-2012, 01:03 AM   #6
Senior Veteran
(female)
 
Join Date: Jan 2012
Location: San Francisco, California, United States
Posts: 737
SweetPeainSF HB UserSweetPeainSF HB UserSweetPeainSF HB UserSweetPeainSF HB UserSweetPeainSF HB UserSweetPeainSF HB UserSweetPeainSF HB UserSweetPeainSF HB UserSweetPeainSF HB UserSweetPeainSF HB UserSweetPeainSF HB User
Re: Slipped Capital Femoral Epiphysis/Chronic Back Pain/Stiffness

Hmmm... if you've been tested for hip pain by the best expert you could locate, your limited range of motion may still be causing you to modify your behavior/gait. My problem is actually the opposite: hypermobility (a little in many joints, but particularly right hip, elbows, and knees). I've read that FAI with labral tears and hypermobility are a bad combination, because they are hard to treat and prone to unpreventable reinjury.

My most recent hip scope involved micro-fracture and curettage under my delaminated cartilage, with pop-lock anchors at the edges. Done by Dr. Sampson in San Francisco, who was the best expert I could locate. The goal is for the cartilage to reaffix itself, and he advised I should feel better around 16 months post-op and hopefully pain-free at 30 months. So, waiting. I still have painful, loud, clicking, which is not snapping hip (ruled out during surgery). I feel like a hip resurfacing is somewhere in my future, but is contra-indicated in females during child-bearing years. Dr. Sampson indicated that a fourth scope would be futile, and I trust his judgement.

Have you done any physical therapy for your back itself? The exercises I was given for core work were targeted to certain muscles, and very different from gym work ("Ab lab" for example). If you are interested at all in Pilates, a couple of physical therapists had me do "The Hundred", which is a Pilates warm-up and a good way to engage the core.

Try to remember that when you are exercising, your endorphins (oh those addictive endorphins!), kick in and you are unaware of pain. This is part of why you don't feel the over-exertion until the next day. If you were running away from a bear, this is a great biological reaction. Not so much if you are trying to stabilize your body and get it into a pain-free state.

I don't know what your fitness goals are, but if your primary goal is to get improvement with your pain levels, then you might want to cut back from heavy-duty targeted work-outs, and aim more toward something more integrated, like the yoga you were doing before. Also, folks with back pain tend to have tight hamstrings, so be sure to stretch those regularly, in a way that doesn't aggravate the back pain. I usually lie on the ground and use a strap around the back of the thigh.

You might also think about chiropractic care. I'm not real excited about chiropractic adjustments, but I went to one chiropractor who used only nerve activation techniques to reactivate muscles that had gone lazy or into spasm. I felt fantastic after each session, but couldn't afford the out-of-network bills long-term. Something like this might be helpful for you, but I would definitely coordinate with your doctor before seeking chiropractic care of any type.

I am starting acupuncture on Saturday for a complication from my lumbar fusion. If the process helps with my hip/back pain, I will definitely post results.

 
Closed Thread




Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off




Sign Up Today!

Ask our community of thousands of members your health questions, and learn from others experiences. Join the conversation!

I want my free account

All times are GMT -7. The time now is 06:19 PM.



Site owned and operated by HealthBoards.comô
Terms of Use © 1998-2014 HealthBoards.comô All rights reserved.
Do not copy or redistribute in any form!