ONE NURSE'S FIGHT WITH CHRONIC PAIN

Femoral acetabular impingement
 

I've been a nurse for many years and am now in my forties.  I've also been pretty healthy all my life and danced when I was younger.  I did a lot of ballet, tap, modern and jazz.  I try to stay fit by walking my dogs daily and doing yoga.  So, I guess to sum it up, I've considered myself pretty healthy for most of my life.

I have suffered from back problems most of my adult life, The pain can be quite severe at times, but I try not to allow it to interfere with my life too much.  

2 years ago I was diagnosed with endometriosis and had a hysterectomy.  I felt better after the surgery but noticed that the pain in my sacral iliac joints was still alive and well.  Since  my gynecologist couldn't find a cause for the pain, she summed it up to referral pain from the endometriosis and sent me to a pain clinic to have steroid injections.  I had a series of three and found there to be no relief, so I learned to live with it, not wanting to take narcotics for the rest of my life. 

About a year ago, I noticed some pain in my groin area after doing yoga and I assumed I had pulled a muscle during one of the poses.  The pain was moderate and went on for about a month, then disappeared and I was quite relieved, until about 7 months ago when the pain returned.  Once again, I figured I'd pulled a muscle and maybe that particular muscle was just weak and that was why I pulled it again.  I did notice the pain was more severe this time and nothing I did seemed to help.  

A few days after I felt the groin pain, I noticed something much more concerning.  I was unable to externally rotate my leg. My daughter came to visit and I showed her how I was unable to open my leg and she rolled her eyes at me.  "Mom, You're trying to tell me you can't open your leg more than that?"  It did seem crazy, my range of motion was practically gone in my right leg.  

When I spoke to my husband about it, he suggested that I make an appointment with an orthopedic specialist and I agreed.  

Off I went to see the specialist who examined me and sent me for x-rays.  When he looked at the x-rays, he told me I had spinal stenosis, kyphosis, scoliosis and all my discs where bulging....All of them!  I asked him if this would cause the pain in my sacral-iliac joints and he said: "it could".  As far as the pain in my groin, he said I probably pulled a muscle. The x-rays of my hip revealed some osteoarthritis, but other than that, he said my hips were fine. 

I explained to him that I knew there was something else going on because It wasn't normal to be unable to externally rotate my hip.  He shook his head and said, "Well, if you want me to send you for an MRI, I will, but I doubt there will be anything wrong."  I told him adamantly that I wanted an MRI as soon as possible because I knew damn well there was something wrong. 

I had another appointment with him after the MRI was completed and his whole demeanor changed. He was no longer looking at me like I was crazy.  The radiologist had read the MRI and sent the report to him.  He said, "Well, it looks like you have what's called femoral-acetabular impingement, which is a congenital deformity of the hip." I asked him to elaborate on it and he said that I could try steroid injections and if those don't work then I can try arthroscopy, "to clean out the joints and buy you some more time. But regardless of what you do, you will still need bilateral hip replacements in about ten years."  I was completely devastated and couldn't believe what I was hearing. I asked him if exercise would help and he told me it would actually make it worse.  I asked him if the deformity could have been passed on to my kids and he said: "Only if they are female". I have two daughters.

Apparently acetabular-impingement is a chronic condition that can either be caused by a deformity of the hip, or by overgrowth during the growing years.  It's a condition in which the bone of the acetabulum overgrows and interferes with the joint's normal ability to move in full range.  

I feel terrible that I have probably passed this on to my daughters and hope they never have to experience this.  I know there are people much worse off than me, but I am still in shock that I have been diagnosed with something that is so chronic and nothing can be done about it. I do now realize that all this time, I was blaming the endometriosis for the pain in my sacral-iliac joints and even went so far as to have steroid injections in both joints, all the while it was my hips that were causing the pain there.  

This has caused me to experience a lot of depression because I know I will be in pain for a lot of my life now.  It's not the pain that really concerns me as much as the loss of function in my hips and knowing nothing can be done. Already, I am unable to tie my shoe, cut my toenails or put my pants on with out a lot of struggling and pain. 

But I also believe that attitude is everything and I will get through this. I plan on going through with the steroid injections and hope they will help. If not, I will move forward with the arthroscopy. But, I pray my daughters are not cursed with this.

I will continue to exercise even though they say it will make things worse. 

I would like to raise awareness about this disorder. More and more people are being diagnosed with this and it can be overlooked for years.  Most doctors aren't trained to spot this on x-ray.  You must go to a hip specialist.  Don't discount any pain you have that you think may be groin pain and go see a specialist if you are ever unable to externally rotate your hip.

If you have pain in your sacral-iliac joints, don't blame it on your back, endometriosis, or anything else until you know for sure what's causing the pain.  SI joint pain is a common symptom of  femoral acetabular impingement. 

Always  questions doctors. They're people too and they don't know everything.   Get a second opinion if you have to and insist that they dig deeper, till they find out what's wrong.   

I will continue my nursing career as long as I can. Nursing is my calling and I will never give it up. 

 

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