Well it’s been a while since I’ve had hip pain this severe, the two years that I was on Morphine, had masked the severity of my hip conditions. I have a Labral Tear on my right hip, sustained from a fall in 2008, for four years it went undiagnosed it was wrongly diagnosed as soft tissue damage, I’d seen multiple Physiotherapists and two Orthopaedic Specialists who had all missed the signs. It wasn’t until 2012 that it was finally diagnosed as a Labral Tear, at Southport & Formby DGH by a Physiotherapy Clinical Specialist. I was referred to Professor Board at Wrightington Hospital’s Hip Centre of Excellence, they discovered that I also have a Hip Impingement.
The Acetabular Labrum is a ridge of cartilage that runs around the rim of your hip joint socket. Its purpose is to make the hip socket deeper and more stable. The Labrum can be torn from its attachment and cause pain, clicking or catching.
The hip is a ball-and-socket joint. The socket is formed by a part of the large pelvis bone (Acetabulum). The ball (Femoral Head) is the upper end of the thighbone (Femur). A slippery tissue (Articular Cartilage) covers the ball and socket, providing a smooth, low-friction surface that allows the bones to glide easily across each other.
A strong Fibrocartilage (Labrum) rings the Acetabulum and forms a gasket around the socket, creating a tight seal and helping to provide stability to the joint. When bones of the hip are abnormally shaped and do not fit together perfectly, the hip bones may rub against each other and cause damage to the joint. The resulting condition is Femoroacetabular Impingement (FAI), which is frequently seen along with a Tear of the Labrum.
One of Professor Board’s Consultants discussed my options with me, a Hip Arthroscopy was recommended. A Hip Arthroscopy is a minimally invasive surgical procedure used to diagnose and treat problems of the hip joint and surrounding soft tissues. Hip Arthroscopy is same-day surgery and is generally performed under general anaesthesia. I was advised that following a Hip Arthroscopy, an average of 6-8 weeks of bed rest is recommended and that was something that I couldn’t manage because at that time, I had a baby and 5 year old and I was and I still am, a single mother.
We decided that an Injection of Corticosteroids into my right hip, was the best way forward. Corticosteroids are powerful anti-inflammatory medications that can provide pain relief when injected directly into the hip joint. Reduced swelling in the hip joint allows the Acetabulum and Femoral Head to move more smoothly and without pain.
In addition to the Corticosteroid, Doctors typically inject a small amount of Anaesthetic, which provides short-lasting but immediate pain relief. This medicine wears off a few hours after the injection, at which time hip pain may return temporarily. The Corticosteroid solution begins to work approximately two to three days later.
For some people, a Corticosteroid Injection can provide pain relief that lasts for months or years. Others may find the injection relieves pain only for a short time.
I had three Corticosteroid Injections over a period of three years, unfortunately, the third injection only lasted a few weeks, before intense pain returned. I arranged an appointment at Professor Board’s Clinic to discuss surgery. A month prior to our meeting, I was diagnosed with Fibromyalgia and Hypermobility Syndrome by a Rheumatologist at Southport Hospital and when I mentioned this to the Consultant, he said that having Hypermobile Joints, makes me too high risk for a Hip Arthroscopy and I was devastated, in my mind, having a Hip Arthroscopy would’ve given me a more active lifestyle with my children.
I wasn’t diagnosed with Hypermobile Ehlers-Danlos Syndrome until a year later, by Dr Shipley, a Specialist at University College London Hospital’s Hypermobility Clinic.
Because of the hypermobility of the all joints in patients with EDS, there is increased stress on these joints. For hips in particular, patients with EDS can put increased stress on the Labrum (the cartilage rimming the outside of the socket), and be more prone to Labral Tears of the hip. The abnormal motion of the hip can also predispose a patient to earlier onset arthritis of the hip.
Dr Shipley was surprised to discover that Professor Board’s Team at Wrightington Hospital, declined to perform a Hip Arthroscopy due to risk, because UCLH perform these procedures on patients with EDS. Although Hip Arthroscopy was now on the cards, my circumstances at home, made it impossible. That’s not to say, that I won’t be able to have the procedure in years to come. Although, the deterioration of having these injuries, could result in having a Total Hip Replacement.
Hip Replacement (Total Hip Arthroplasty) is surgery to replace a worn out or damaged hip joint. The surgeon replaces the old joint with an artificial joint (prosthesis).
I did make a complaint to Professor Board’s Clinic and asked how my very hypermobile joints were missed during my assessment and it was stated that I had ‘slipped through the net’. The Consultant who had initially assessed me, no longer worked at Wrightington Hospital and his assessment method, missed my over extending joints.
There has definitely been deterioration of my right hip since 2015, Corticosteroid Injections are no longer an option since the last one only lasted a few weeks. My mobility has massively reduced since then and I have to use my Smart Crutches from time to time, to help me get from A to B. I can only walk short distances, so I also use my crutches if I know I’ll be on my feet for an extended period of time. I have a very mild limp, so people can’t really see that I’m injured or in pain, this however, causes people to assume that my health problems don’t exist or that I exaggerate my symptoms.
Invisible illnesses are very real, we don’t want people to see our illness, we desperately want to live normal lives, we will always try to act as well as possible. When people ask how we are, usually we will say that we’re okay, but our okay is very different to a healthy person’s okay.
I found these very accurate quotes on invisible illness