Did labral tear surgery reduce your PN/pelvic/perineal pain?

[Jax87]

I don't know anything about tilted pelvises, but I do know that groin pain is a symptom of a labral tear. I have this on my right side, which is the side where my hip is worse. This symptom didn't develop until over a year into my PN pain. Julia, I think you should try to get an MRI of your hips to see if your groin pain might really be a hip tear. It would also make sense why it would worsen after ESWT since that loosens muscles which may be holding damaged joints together. How are your other symptoms after Cornwall?

Hugs,
Jackie

[Julia]

Thanks Faith and Jackie.

I had the groin pain before the ESWT, especially after standing too long. For the last year or so I have had a part-time retail job just a few hours per week and the groin pain would start coming on during my shift. I get a pulling, tightening, achy feeling that makes me want to sit down. I try to avoid sitting of course so I usually just keep standing and leaning when possible, then collapse on the couch when I get home! The more I push through and continue to work despite the groin pain, at work or at home doing chores, the more PN burning pain I seem to get at night.

I am now 2 weeks and 2 days post ESWT and I have not posted my update because I don't really have anything concrete to report yet. In the last few days I have noticed more groin pain, but LESS of the deep, intense burning pain. I am also more "reactive" in the sense that I can't get away with doing as many things without a flare up. This is to be expected though as Dr. Andrew said I would likely be flared up for a while after treatment. I don't feel worse, and I don't have any new symptoms. Just sort of in "wait and see" mode. I am trying to do the exercises Dr. Andrew recommended twice daily, and also had daily baths for the first week. Now I use a heating pad in the evening when I feel like everything in my pelvis is very tense. During treatment and post treatment I have had really restless legs. I had this before the ESWT, but it seems a bit worse now - so I guess that is one negative side effect of the treatment. I always felt that I had "twitchy" legs in the response to the pelvic pain, you know, like my toes curl and I''m kind of wiggling around. Dr. Andrew advised me to take calcium/magnesium to help with this. I should have thought of this already as I work at a natural food store! He also said that tensing up can actually be a side effect of the shockwave, since I was literally tensing up my whole body in response to the pain during treatment.

Back to the hip question!

Jackie and others with confirmed hip tears, I have never had any hip pain, how likely is it that I could have a hip tear if groin pain and pn pain are my chief symptoms?

Sorry Faith that you have new symptoms, I guess we never know how these things will turn out but all we can do is make the decision that seems right for us at the time. You should be proud of yourself that you took the leap and tried it and I pray that things will calm down for you and you will find something that helps you.

[Jax87]

I'm not a hip specialist, but from my experience and what I have read, you can definitely have a hip tear without having classic hip joint pain. I mainly have some groin pain and clicking in my joints. I was pretty surprised to find the hip pathology. The PT for PN aggravates my hips. Evidently a lot of injuries that were previously classified as "groin pulls" are actually labral tears. I think that there's info on the HSS website about that. There's a lot more attention to it in sports medicine. The fact that you have had more groin pain after ESWT could just be from the treatment itself, but it could also be from the fact that the ESWT tries to loosen your muscles and your muscles don't want to let go of unstable hips! Also, you had related groin/PN pain from standing. Just a thought. Dr. Andrew wanted me to get my hips looked at before I came to Cornwall, so that is how I ended up with my diagnoses. He told me in Canada it is much cheaper to get the MRI you need to find the tears, it is just a regualr MRI. In addition to Dr. Andrew, my regular ob/gyn who conducted the study with HSS on vulvodynia/labral tears also wanted me to get the MRI. She says she now sends all PN patients for MRIs of their hips because she has seen so many women with that issue. Something to think about.

I am glad that you have less of the deep, intense burning pain! It's so awful, I would love to have less of it. Are you doing physcial therapy too? You are so brave to gone to Cornwall!

Hugs,
Jackie

[Julia]

Thanks for the information Jackie, I have been following your experience with interest! I had an MRI of my whole pelvis early on in my PN investigations, Dr. Andrew said that he thought this would have picked up any hip issues. But isn't it true that I need an MRI with contrast? Or, someone who knows what they are looking for? I will definitely try to have the proper MRI done, just not sure who can order it. My regular physician, or does it need to be a specialist? Lernica is also from Canada and is recovering from her 2nd hip surgery now from what I understand, so when she is back on the board I will ask for her advice.

[Julia]

I am going to ask my physician if he can order the MRI with contrast to check for hip tears. Does anyone know of an article that I could bring him that explains the connection between pelvic pain and hip tears? He always looks at me like I'm crazy so the more information I am armed with the better!

[Jax87]

No problem Julia, I have been following your ESWT experience with interest! I had the Potter MRI of my pelvis and it did not pick up my hip tears because they were not looking at my hips specifically. I had to go back and have a hip MRI specifically looking for labral tears/impingements. So, no, even "the best" pelvic MRI does not necessarily show your hips.

My ob/gyn ordered it, which is a little unorthodox in the US, and I'm not sure how it works in Canada. Mine was not with contrast, per Dr. Potters' request. You might want to ask Dr. Andrew about where you could go, he gave me a place in Ottawa when I was planning to have it done in Canada. Would that be convenient for you? Good idea to ask Lernica as well, she will be more familiar with Canada. I think the MRI is definitely worth it to check out the groin pain, the scan is painless, and if its covered by insurance you have nothing to lose.

Hugs,
Jackie

[Jax87]

If you look back through the boards, I think that Beverley has posted them a few times. I will try to repost them when I get a chance, I'm technically supposed to be working, haha.

Delinquently,
Jackie

[Julia]

Thanks Jackie, I found these two. If anyone else has more to share, please do!

http://healthyfocuspt.com/wp-content/up ... rticle.pdf

http://webdoc.nyumc.org/nyumc/files/obg ... ooklet.pdf

[Skylar]

Hi Julia,
I had two MRI's done. First was a pelvic scan with a 1.5T machine which is the level most hospitals have and those results specifically said my hips were fine. Any doctor however can write a req for an MRI but I don't know which hospital closest to you has the 3T capability. There was no contrast used in either of mine, we didn't mention hips specifically in the requisition.
I hope your doctor doesn't need convincing, it shouldn't be outside his comfort zone to rule out hip pathology for any groin/pelvic pain. Guess I'm lucky that my doctor is very open to discussing any new avenues...... Normally we go to them for suggestions but for PN patients it's usually the reverse.
Wishing everyone progress in their pn journey.
Fall Girl

[Julia]

Thanks Fall Girl for all the helpful information you shared! I see Dr. Gordon also so I will ask him for the referral at my next visit. The hospital in Oakville told me that they will not do a hip MRI without xrays first. Was that also the case at Mt. Sinai? Just trying to figure out what order I need to do things in. Did it take long to get an appt. for the 3T MRI at Mt Sinai? I hate that whenever I finally feel like I'm on to something, there's always so much more waiting involved! I've had this pain for 3 years and everyday waiting for tests feels like 100!