Dr. Timothy K. Durnin - 10/24/2008

Question
I was born with bilateral CHD with dislocation. The right hip developed but even with casting and braces the left never did. I required "experimental" surgery in 1962 at age five in order to keep the hip in place. I was in a body cast for four months post op and then braced and non weight bearing for a few more months after that. Although the surgery was a success I never had normal range of motion. Despite that I was active, danced and even learned to ski.  Over the years the joint deteriorated. One day it partially dislocated when simply throwing a basketball. It never went back in place, I was unable to weight bear and six weeks later at age 47 had a THR. That was four years ago. As a result of the surgery my leg that was once 1.5 inches shorter is now even with the other. I had ITB syndrome post op along with balance problems and back pain as my body tried to adjust to being even for the first time ever.  I continue to have chronic hip and thigh pain. It feels like muscle pain and not joint pain. I have had seven cortisone injections for "bursitis" with little to no relief of symptoms. In fact initially the pain is much worse. I even have nights I am unable to sleep due to the pain. My hip and thigh are always tender to touch. Many times I am unable to lie on that side. I have worsening pain with sitting. I am thin and often wonder if I had more padding if I would have less pain in the hip where the prosthesis is. A feather pillow tucked under my hip/butt actually helps some. I also use a heating pad for most of the evening and night. I have recently realized that when I walk up the stairs I can feel a tendon(?) clicking over my hip. It is at the point where I am most tender to touch. My pain does extend from my hip into the buttocks area and sometimes as high as just below my waist. It also goes all the way down the side of my leg to just below the knee. I always feel better after being in bed all night. As the day goes on the pain gets worse. My x-rays are fine and a recent nerve conduction study was normal. I have traded my joint pain for other pain. It is by far worse then any pain I had prior to my THR. I take 1/2 Loritab about four times a day to help manage the pain. I have tried Lidoderm patches with no relief. I am open to ANY suggestions and would be willing to travel for a second opinion. Your assistance in this matter would be greatly appreciated. Thank you for your time.

Answer
Hi Peggy,

Your situation is exactly what Chiropractors are trained for; make sure they are "mixers" and not straight Chiro's since you will need modalities to attenuate the chronic tendonosis you have developed in the hip. Your history and reasoning for your current problems is spot on and couldn't agree more. This is all due to a compensatory change in leg length. See a top recommended D.C. in your area and get it resolved.

Good Luck!

Dr. Timothy Durnin