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Hip Labral tear surgery & glute pain(piriformis)

So I am starting a thread that will possibly help you decide whether you should get hip surgery to correct a Labral tear and possible secondary pain such as, glute pain, hip pain, groin pain, and coccyx pain. Now initially the pain started around the lower back/deep upper glute and started to spread towards the side of the hip, back of the hip, under the knee/above the ankle(sciatica), and finally in the end, the groin and coccyx areas. I was taking ibuprofen, gabapentin, methocarbamol, prednisone(for 3 months), amitriptyline hcl, norcatics, mophine shots, and cortisone shots(in piriformis). I was a giant mess going to the ER 2-3 a week. Initially they thought that I had an impingement of the sciatica nerve in the spine, the MRI showed to be negative, PT did very little, so finally since I had snapping and locking of the hip, we had MRI done on the left hip, which showed an anterior condrolabral separation(a Labrador tear for simplicity) and a  piriformis muscle which was narrowing the foramin of the sciatica nerve( the piriformis was pinching the sciatica nerve). At this point the pain lvl's I was experiencing was 9-10 on a daily basis, many times suicide crossed my mind, finally got a steroid shot in piriformis which helped tremendously, but wore off quickly. I went to see an ortho when my pain lvl was back to 8-9(around this time, about 6 months since the pain began, my groin pain just had started) The nurse told me she had piriformis syndrome and the only thing that cured it was vitamin d, it took her a while to get her v-d lvl's back to normal, over a year, she also said the labral tear and glute pain are two separate things, my physical therapist said the same.( I find out later on this was false). The ortho said that I'll be referred to a sports medicine doctor for my labral tear. So I went home that day, very depressed and decided to try a multi vitamin pill. I kid you not, rather I swear to god, 2 hours after taking that multi vitamin pill, everything just flipped around, my pain went down extremely fast. I found strong research claiming that certain vitamins such as b-12 can help when muscle pain. I also read the there is actually a connection between piriformis and near by structures such as si joint or the hip. The pain I was in was around 6-5 at this point, I finally got to see the sports medicine Doctor from USC and he said labral tears most common symptom is groin, however, it is not limited to that, a labral tear could cause havoc to other structures as well, si joint, thigh pain, glute pain, etc. So I had the surgery done and he said the tear was small, only 2 sutures were used and he did some shaving. It's been 7 weeks since the surgery and I'm doing so much better. A lot of the pain in the side hip went away and even the glute, the doctor said labrum should fully heal in 3 months since the tear was small, however, it will take a year to fully recover. I read an authentic 216 page research paper on hip labral tears and it's said 36% of patients will feel pain in the glute, 67% the side hip and 90% in the groin. Right now I am taking 1500 gabapentin/day, 2400 ibuprofen, 25mg amitriptyline hcl, multivitamin pill, 5000iu vitamin-d, blood work showed a decencies in vitamin-d.
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1

Comments

  • jocko1jjocko1 New York Posts: 10
    Similar symptoms but labral tear (large tear) surgery did not fix my symptoms
  • itsautonomicitsautonomic LouisianaPosts: 2,561
    edited 09/30/2016 - 10:42 AM
    I was running 4 days after surgery for tear, never looked back. 2 years of pain ended that day.
    What sticks out to me is the amount of pain you were having, that isn't consistent with a labrum tear to have that level of pain.  And B vitamins from my knowledge is known to help nerve issues more than muscle, I could be wrong but it's go to for nerve pain.
    My gut tells me something is being overlooked , but I don't know the levels of pin pisiform syndrome can cause.  I had sciatica and while terrible never needed pain meds other than nerve medications.  We are all different , but it just seems something in the picture is missing reading this.
    Labrum tears can cause chain type issues due to compensation if goes on to long.
    Do your due dilegence, trust you know your body and question everything if it does not fit. Advocate for yourself and you will be suprised what will be revealed trusting your body and instinct.
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  • jocko1jjocko1 New York Posts: 10
    To expand upon my first post the pain in my groin (from the labrum tear) got better after the surgery.  However the glute pain and sciatica stayed without improvement.  I'm still searching for an answer. It could be pelvic floor muscles are in spasm or something from the lower back that an mri didn't pick up.  I had a discogram done and it picked up a leaking disc at L-5 S-1.  I'm getting shots next week Ill let you know how it goes.  Pain sucks.
  • mashaif00mmashaif00 BakersfieldPosts: 5
    Its been 8 weeks post surgery and my symptoms starting to get worse, and yes I also believe if a tear is not fixed early the pain tends to spread to other areas. The surgeon did tell me that if the nerve pain, because of the piriformis, doesn't improve, he'll send me to a nerve specialist who does the piriformis release (surgery). So I seen the surgeon yesterday and he will be sending me to the nerve specialist. There is a few things I haven't mentioned, I've had an MRI of the spine which came out negative, and EMG of the left leg and spine, which also came out normal, I am negative for SI joint dysfunction, have seen a rheumatologist and test came back negative. The only thing that's left is piriformis syndrome and a labrum tear. All these test were used to rule things out before confirming piriformis syndrome. I do want to mention there are people who have had the piriformis surgery and there MRI showed a normal piriformis some however show it to be bulky by the MRI. An EMG test only sometimes will show an impinchment of the nerve in the piriformis if it is extremely impinchment. 
    When my pain started around 10 months ago, it started around the glute and hip side it was only 6 months later that I started experiencing groin pain because of the labral tear. Although for over a year I have had locking of the hip because of the tear, but no pain. The one thing the gets me through the nights, I have a heat pad the turns off after an hour, I place it under the glute pain and fall asleep, it does wonders, cold however will worsen the pain in the long run, in my experience.
    lastly I am actually excited to see the nerve specialist, just waiting for the insurance to authorize, I am very excited because everything has been ruled out and the only thing that's left is the piriformis surgery and the research that has been done on this surgery looks very promising.
  • mashaif00mmashaif00 BakersfieldPosts: 5
    @jocko1 why not try an EMG, ask a neurosurgeon to order it, btw, do you have pain below your knee.
    @itsautonomic I laughed when I read you ran 4 days after your surgery because I remembered my surgeon saying no running for 6 months.
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  • itsautonomicitsautonomic LouisianaPosts: 2,561
    Haha, I didn't even have to do PT.  My dr may have been mad at me , but I was in good shape so when tear gone so were issues
    Do your due dilegence, trust you know your body and question everything if it does not fit. Advocate for yourself and you will be suprised what will be revealed trusting your body and instinct.
  • jocko1jjocko1 New York Posts: 10
    I would try a botox injection into your piriformis before surgery.  You can't undo that surgery. If the cause of your pain is not from the piriformis and you get the surgery that could cause major problems.  Botox temporarily deadens the muscle.  I had them in the past and have had success.  Its worth a shot before you commit to surgery.  There are many muscles in the pelvis that can cause pain, cutting the piriformis may add additional strain to a muscle that is already damaged.  
  • jocko1jjocko1 New York Posts: 10
    I have pain in my feet.  EMG came back clean.  I have no tenderness along piriformis but I do have sacrum a low back pain too.  
  • mashaif00mmashaif00 BakersfieldPosts: 5
    I've been thinking about the Botox injection, I'm also desperate, I have 4 surgerys being postponed because of this problem and the more I postpone them the more damage occurs and haven't worked for a year, we're very confident it's the piriformis, though a Botox wouldn't hurt.
    My chiropractor found scar tissue in the piriformis area using a technique called graston, just waiting for my insurance to approve the referral to the new surgeon , I should know by tomorrow.
    I seen my neurosurgeon today and he thinks the piriformis is the right direction. I am sure the Botox will help but it won't be permanent because of the scar tissue. I read about an individual that had the piriformis surgery, he's EMG came back normal but when he did a provocative EMG it showed an impinchment in the piriformis. Here's a link https://piriformissyndrome.me/piriformis-syndrome-diagnosis/
  • mashaif00mmashaif00 BakersfieldPosts: 5
    The insurance just approved to see the surgeon, he seems to be a top surgeon from what I'm reading.
    This graston technique that my chripractor is doing has help a great deal. I believe what it does is breaks down fibrous scar tissue slowly over time.
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