I am hoping to get some answers regarding management of a newly diagnosed labrum tear.
I have been an ICU nurse for 15 years; I currently work for a large teaching hospital. I've suffered with chronic back pain, and had a non-work related ACL tear and repair 5 years ago, but have never had any hip issues at all. Walking has never been a problem for me. I am overweight and mostly sedentary at home with the exception of gardening and walking, but my job is very physical.
At the end of November, 2007, another nurse and I were cleaning a very large patient who was confused and kept trying to roll back over in the bed (while we were holding him on his side). After we were finished, my back was hurting, but since that is usual for me after situations like that, I didn't think too much of it. Later that evening my hip started to hurt in the groin area... and it got progressively worse over the next several days, to the point that it was waking me up at night, and I was unable to sit for longer than 5 minutes at a time.
I filed an incident report at work, and they sent me to see the Orthopedic Physician's Assistant who sees all the Workman's Comp employees. He diagnosed me with acute-on-chronic lumbar back pain and a left hip flexor strain. I was put on "light duty" (no prolonged walking, frequent position changes, 15 pound lifting limit) and sent to PT. The PT instructed me to get a cane and walk with that to take some of the weight load off of my left hip.
After 5 weeks of "light duty" (yeah, right... one ICU is almost a city block away from the other ICU, and I walked there and back at least twice a day) and PT, I returned to clinic and was still not feeling much better. My PT and I both thought that there was more going on with the hip than just a strain. The PA wanted to send me for diagnostic cortisone injections in my spine (he thought my back was the main issue and that the hip pain was referred), but I insisted on an MRI first. He was only going to do the back but I asked for the hip to be done as well since that is where my pain was originally. My "light duty" continued, but my lifting limit was increased to 20 pounds.
Three weeks later I went back to see him, he told me I had an acetabular labrum tear (and seemed in total shock of the diagnosis), and he referred me to one of the Ortho Surgeons at my facility. Of course the wait time to see the orthopod is just ridiculous, and my appointment isn't until the middle of this month.
Meanwhile, I have suffered at work with the walking and sitting, and yesterday called the PA to get some pain meds (had been taking Flexeril and tramadol for the "muscle strain"). He told me to walk over and see him. I was crying from pain by the time I got there (other side of the facility, which takes up a whole city block) and he wrote a note saying that I could not perform any duty that required ambulation. In other words, I could work from a wheelchair. Of course since sitting is also painful, this isn't an option. I went to my employee health nurse and insisted on being able to stay home until I see the Ortho Surgeon. The PA also referred me to get cortisone injections in my hip.
My job is extremely physical; for starters, I have to lift and move patients, push patients in their beds down to CT and MRI, etc, and overall it's just a very demanding job. I am very fearful that I will not be able to return to my duties. Also, Workman's Comp is not going to pay anything NEAR what I make as a nurse, and even with my short-term disability kicking in a bit extra, this is going to strap us financially - BIG time. I have been keeping meticulous records of everything since the injury occurred. My employee health nurse has been friendly about it all... but I have a nagging feeling that the niceness is not going to continue since it seems that I am not healing up quickly and nicely.
SO, I have done a bit of research on labrum tears and I'm not too encouraged. I am very stressed out with the way this has negatively impacted my life. I can't go on car trips. I can't walk with my husband. I can't lift anything or stand to bend over. I can't sit. I am IRRITATED!!! :mad: LOL!
Has anyone had pain relief success with cortisone injections into the hip?
What is the likelihood of me being able to return to a very physically demanding job, either with or without surgery?
Has anyone had success with conservative treatments such as rest and PT? (I have been walking with a cane for 8 weeks now, but I don't consider hauling my carcass all over the hospital to do paperwork to be "rest", LOL!)
Any opinions on the misdiagnosis of a hip flexor strain? I am wondering if my continued walking/sitting, all while thinking I had a muscle strain, has exacerbated the labrum tear?
Are all orthopods "created equally" when it comes to doing hip arthroscopies? (I know the answer to this but had to ask it anyway.) Who did your surgery, if you had it?
Thanks for reading my mini-novel... and I look forward to the responses.
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