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The Question or Help

Hi, my name is Mel, I am a 22 year old female.

A year ago I started noticing lower back pain from sitting at the computer for periods at a time. I had started a new full time desk job at the start of the year and half way through the year it began to become chronic and hard to sit at a chair for hours at a time. I had developed pain in my lower right back around the SI Joint (buttocks area) and lower right side of my hip.

- I had visited the General Practitioner in July to seek help and answers, who then referred me to obtain an x-ray of my "lumbar pain". The findings were that the lumbar vertebral bodies appear normal in height and alignment. No compression fractures were seen. The disks spaces and pedicles appear normal, with no evidence of spondylolisthesis noted and no significant abnormaility was detected. After obtaining this information the General Practitioner did not persue to seek answers.

- I later visited the physio therapist who performed an FAI test, to find then observe pain from the right hip region. He hinted that instead of the back being the issue, the pain could be coming from my right hip and noted the pain could be due to the psoas/hip flexor. The physio incorporated stretching exercises, (three-four times a day) for back and abdominal muscle strengthening and pursued me to obtain an x-ray of pelvis and both hips, as he questioned possible FAI impingement.
The examination demonstrated over coverage of both hips, particularly on the left side, with evidence of ace-tabular retro-vision and cross over signs seen. This was most pronounced once again on the left side. In addition, the Dunn view demonstrates small pits of the femoral head/neck junction bilaterally. No bony bump was seen, and femoral head/neck junction offset was satisfactory. The findings suggested underlying pincer type femoracetabular impingement. The changes are noted bilaterally, but are worse on the left.

I went back to the physio, would went through the results with me, and referred me to a surgeon who specialises in hip arthroscopy. I then went to to obtain an MRI of my right hip. The findings demonstarted a small cam lesion with mild fibrocystic change. Anterior superior labral tear. No chrondrolabral junction injury. Small effusion. Ligament teres normal. Gluteus minimus and medius tendons appear normal. Trochanteric bursa normal. Rectus femoris origin, iliopsoas complex and hamstring origin normal. Posterior labral recess noted. The conclusion was that there was moderate cam lesion with minor fibrocyctic changes with associated anterior superior labral tear. No chrondrolabral junction injury.

The initial consultation with the surgeon lead to getting a cortisone and anesthetic injection to see whether the pain was coming from my hip. I explained to the surgeon that it was hard to obtain an accurate result due to needing to obtain a result in a controlled environment where i am forced to sit hours after the injection for the test. To time my pain threshold before the injection for maximum pain and book a time for the injection was quite impossible. I recorded the results for a month, and noted the most important time to document the test was the hours straight after. The anesthetic minimized the pain within the first few hours around my hip, but was still very inconclusive.

The surgeon was not confident in my explanation of pain relief that he had sent me back for a second injection which only contained the anesthetic for my right hip. During this time, he said I should got seek help and answers from a sports physician, and obtain an MRI of my brain because I had cramping sensation of my right arm and right leg. No tumour was found.

Basically the physician observed my condition, noted my pain and sporting history. He noted that the surgeon's "decision was made to manage the hip condition conservately", which however was not the case, because I had not gone back to see the surgeon after my second injection to let him know that there was a decrease in pain around my hip, but the SI pain had developed two hours after. The physition's conclusion was that he would send me back to the physio for functional assessment and lumbopelvic and cervical spine strengthening. He stated that gradually establishing a posture-maintaining spinal strengthening program it may be able to take the edge of the pain.

Mean while the physician told me to obtain a MRI of my lumbar spine and sacroiliac joints which demonstrated alignment was normal. No abnormality seen. No spinal canal or foraminal narrowing.

I went back to the physio, and the sports physician had told me, and the physio changed up my exercises, as my whole right side of my body was xxxx. Aches in my right arm and legs. Tight lower right back. Pain in my right SI joint and hip. The physio, was still uncertain about the surgeons advice, so he made a call. The next time I visited the physio was when I had started my health care plan and he suggested that I seek a second opinion for hip arthroscopy. Can you see where this is going?

The system is absolutely xxxx. I believe in my physio, I truly believe that I can strengthen my posture to help with some of my aches and tight muscles, however I think that all these things are happening to me for a reason, and its clearly because of my labral tear and hip is making my pelvis unstable, which is attributing the the sacroiliac pain and tight muscles around my psoas major. I do not believe that these "exercises" will be the cure to my pain, because the labrum is what needs to be repaired, and without it being surgically fixed I will never get better. I have limited my activities to a minimal, where I feel like I am not functional in society anymore, ie cant sit down on a bus etc.

So my final question is, if you actually got through this xxxx essay is: how the xxxx do I convince the second opinion surgeon to get surgery, because they basically want you to tell them what they should be doing to your body because diagnosing is not a great trait of surgeons?



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