I've been told I need Total Hip Replacement. How can I be sure it's not TMS?

Hi Everyone,

Several years ago I healed my back pain through Dr. Sarno's program. Though I had the usual issues of aging (3 bulging discs, stenosis, scoliosis, etc.) the 3 spine surgeons who each ordered MRIs couldn't find any basis for the catastrophic pain I was experiencing. One sent me to Sarno. After journaling and cognitive therapy with a therapist who understood the mind-body connection, my back is pain free. I also learned how to mentally make other stress-related pains go away.

However, a new pain has emerged in my hip, which has been progressing for years, and one that I can't vanquish. The head of the Hip Preservation Center at the Hospital for Special Surgery here in New York, who took x-rays and saw my MRI, has told me I need total hip replacement. He said that, due to an extra piece of bone on the ball of the joint, my labrum has almost completely worn away. There is no cushion for the bones and that is causing the severe arthritis and the resulting pain I am experiencing. This pain doesn't feel like the previous TMS issues in my back. It's constant and in the same place all the time -- and steadily getting worse. My previous TMS pains would come and go but didn’t prevent me from doing the physical activities I loved to do. The hip issue has put an end, for the time being, to almost all my activities and I now walk with a severe limp. The pain is so bad that it wakes me up at times through the night.

Though Dr. Sarno insisted that almost all chronic pain is psychogenic, even if there are coincidental structural issues at the site of the pain, I do believe there are some issues that are completely structural in nature and need to be treated orthopedically. But at the same time, I want to make sure my current hip problem is not a mind-body issue, that this bone protrusion and lack of a labrum in my hip is not simply coincidental. I don't want to go through hip replacement and a painful recovery period only to find out that the pain is still there because it’s TMS, not a decimated joint.

Does this sound like a non-TMS issue? Has anyone experienced this kind of dilemma and is there any advice you can give me on how to make sure before I decide to take the surgical plunge?

Many thanks!

 

Just out of curiosity, have them do an x-ray of the non-hurting hip. It would be weird to only have an "extra piece of bone" on one side.
If he sees the same on the other side, you can be certain it's TMS, because both hips would be equally painful, right?
That's what I would do. Much less stressful and costly to see if both hips match bone-wise.

 

Hi Marcia,

Thanks for responding! It's a great question, and yes, both hips were x-rayed. The left hip has normal bone structure. The right hip, which is the one giving me problems, has the congenital bone protrusion that the orthopedist says has worn away my labrum. This is why I'm leaning toward a structural explanation and treatment for my issue.

All my best, Ed

 

It's great you already had it done. I guess if the pain never comes and goes or becomes less, then you might have a structural problem. I would still try a more natural approach first. Try EarthClinic.com for hip pain. See if there's anything on there that people have success with before surgery.

I can tell you this. My sister's foot surgeon doctor told her many, many things about how, without surgery, her foot would always be in horrible pain because of structural abnormalities. They had her in a boot, and then extreme orthotics. She took tons of pain meds.

Then,...unfortunately she got cancer and went into treatment for that. Suddenly, she is walking fine, without the boot, doesn't wear the orthotics...and has no foot pain.
Sadly, it has taken something worse to let go of the foot pain symptoms, but...gone they are.

She can't see it because now she has her new worries. However, psychologically, it fascinates me.
Again, her foot surgeon told her she would never walk without pain, again, because of structural deformities.

 

That's really interesting. It sounds like an offshoot of the symptom imperative -- she didn't need the pain in her foot to distract her anymore; the cancer took over that role. I hope she beats her cancer and I wish her well. And thanks for the referral to Earthclinic.com. I will certainly check it out.

 

I am preoccupied with a similar fear as I await a pelvic MRI scan in two weeks' time. I've been struggling with sciatica for 6 months, which is now overlaid with severe hip pain. Maybe it's just a result of overcompensation/change in gait - stressed soft tissues around the hip that make it feel swollen and painful all the time. Or maybe it developed very slowly over time. But I'm worried it might be actual tissue damage. Heck, I'm not even 100% convinced my back/buttock/leg/foot pain is TMS. Doesn't mean I'm going to stop trying to 'unlearn' the pain, but still, it's rather frustrating.

Of course just because you have experience with TMS doesn't mean every pain is going to be TMS! Did you seek second and third opinion on your case?

 

Hi BK,

Sorry to hear you're going through a similar situation. I guess the only thing I can say is that it gets a little easier over the years to distinguish between TMS pain and structurally based pain, although it's never 100 percent clear.

I saw two rheumatologists before seeing an orthopedic hip specialist. One recommended physical therapy, the other said PT wouldn't help. Both recommended seeing an orthopedist. When I finally saw the hip specialist, he told me my only option was total hip replacement -- arthroscopic surgery wouldn't help because the labrum was completely decimated. I will get a second opinion from another orthopedic specialist shortly and then I'll have to go with my gut. Good luck resolving your issues...

 

Hey there,

This is definitely not the "typical" TMS diagnosis, so I understand how it can be hard to figure out what's really going on! TMS and hip issues haven't been as well studied/observed as low back. Certainly some things are structural and do require orthopedic treatment. I would consult with a good TMS doctor like Schubiner, or even get a recommendation from him for an orthopedic doc with a TMS outlook. I'd go that route for another opinion with a TMS perspective. Good luck!

 

Hi, thank you so much for your response. Contacting a TMS/orthopedist is an excellent idea! I will definitely do so to help me ensure that whatever decision I make is the correct one. Happy New Year and best regards, Ed

 

Yes, I'm exhausting every possibility that this is a TMS pain. So far, however, it doesn't have the same MO as TMS, which makes me lean in the direction of a structural issue. We are certainly on the same page though. I will see if I can wrap my head around the pain first to make every effort to avoid surgery. Who needs that?

 

I think we need to be careful to "blame" TMS for everything here too. Hip replacements are actually usually very successful - if those were always TMS, the surgeries would not help (like it is the case with a big % of back surgeries). I know several people who's had hip replacements and are doing great. Years of pain, gone. I think you are doing the right thing to be sure you need the surgery, but please don't exclude it as an option because it might just be what will fix you

 

I agree. Friend of mine had hip replacement. And he is feeling great again . No one here can say . "Yeah it's tms don't do surgery" if it's structural and they found this then yes they have have given you the best option.

 

As a "retired nurse" I saw many folks who had that 1st hip replacement ....then came back for the opposite hip. Then they came back for their knees or shoulders and so on...backs, necks. etc. Hey you're gonna do what you want to do to get comfortable. Believe me I totally understand. Just follow some of your friends for a few years and see if they go back for any other surgeries. Go to a cutter they will cut because that is their job. They aren't going to send you to a TMS doctor, but a TMS doctor will send you to a surgeon if they rule out TMS. No argument here. Even Sarno said his patients were screened.

 

Thanks for your input guys! I'm definitely going to find an orthopedist who understands the mind-body connection to see what they think. It was actually a very prominent spine surgeon who sent me to Dr. Sarno to resolve my back pain a decade ago. I should mention that the discomfort in my hip ramped up earlier this year when it appeared that my dad was dying. He ultimately recovered and my hip pain calmed down a bit but not completely. He began to go downhill this past fall and that's when I began walking with a limp. He passed away on New Years Eve at age 97. Since joining this forum as a member several days ago, my limp is not quite as pronounced. To me, that leaves open the possibility that my hip issue has at least a component of TMS. I don't believe that the TMS vs. Structural explanation are always mutually exclusive -- that is, there may well be a TMS component here, but I may also need hip replacement. It has certainly presented the need for me to do more exploration. Anyway, thanks for your insights! More food for thought...

 

I knew I read it somewhere...in TGPD by Ozanich on page 72 "...my left hip was severely wore out, but I had no pain there-yet. However, through this new knowledge that my hip was crumbling, this hip deformation would be back to haunt me later. After finding Sarno's work , I began getting more aggressive as per his recommendations regarding tms healing, and voila, my left hip began locking up on me badly. I had been made aware of these physiological changes to my hip; my mind wasn't clever enough to know they were there. One by one, during my healing, the pain sought out the locations of wear and tear in me, desperately seeking a site that would convince me that I had somehow reinjured myself. Anything, give me anything, to not have to face these resentful violent, guilt-ridden emotions!" Take it for what it's worth ppl per Steve Ozanich in his book TGPD.

 

Click, I so agree with you. After many years of pain in various parts of my body, my “remaining” pain is in my hip. There is damage that has been diagnosed, as was also diagnosed in other areas such as lower back. After several years of TMS processing this remaining pain and limping are dissipating. Sarnos books began my quest and Steve Os book TGPD Was defining for me.
Lainey

 

So yes, it's all very interesting. The orthopedic surgeon had convinced me that this was entirely structural and I was convinced that I needed hip replacement. However, just to make sure, I sought out the opinion of Dr. Ira Rashbaum this past week. He is a disciple of Dr. Sarno and after more than an hour of examination and reading my MRI and X-Ray, he felt very strongly that my hip pain is TMS and advised me against surgery. Yes, he saw the arthritis and some wearing of my labrum, but he deemed it moderate. He also checked an area on my buttocks (as Dr. Sarno did many years ago) and observed a hyperemic response to pressure. That, he said, was the autonomic nervous system's attempt to bring blood to an area of deprivation -- a significant indication of TMS. After accepting his diagnosis, the pain in my hip immediately receded by 30-40 percent and I have much more mobility in my right leg. I'm going to roll with this for a while and hold off on surgery. This truly is a strange and wondrous process...

 

I am so happy for you. I underwent a couple surgeries and it did nothing. I was convinced by the conventional doctors that they were right. Since working on TMS my pain is down, not completely gone but decreased. I received some advice from a TMS doctor yesterday and was told....you are doing great. Get any notion in your head that the pain is due to a structural problem because the slightest notion will get to the subconscious and the pain will continue....

 

Thanks Click#7! Yes indeed, it was a very surprising diagnosis from the TMS doc. I really thought he was going to tell me that the structural issue was real and recommend the surgery. I'm sorry you had to go through the surgeries, but I'm glad for your subsequent enlightenment! Cheers!

 

Hi there ... I was wondering if you would be kind enough to give an update on your situation? I have been recommended for THR also but I keep pushing the surgery date. However, my experience of hip issues is like yours ... I have successfully overcome many other forms of chronic pain even before I knew about TMS, but this one will just not completely go away and has curtailed a lot of the physical activity I could normally enjoy, even with pain before, as well as changed my range of motion and flexibility.