By Dr. Dana Myatt
I’m a better doctor now — and much more sympathetic — since I started having hip pain in March of 2014.
It started subtly at first, a little stitch in my right hip that I noticed after my morning walk. "Probably just more walking than I’m used to," I’d tell myself.
Over the next several months, the pain became much worse. Sometimes it was in my hip, other times my low back. Sometimes it was both. Sometimes it would radiate to my knee and even my ankle and foot.
At first, my beloved bromelain would help. When that stopped working, I tried my favorite NSAID, ibuprofen. Same thing — a little help, then nothing.
By now, the pain was getting severe. Instead of dogging me only after walks, it would wake me up in the middle of the night. No amount of changing positions seemed to help. The ache was deep and gnawing and interfered with my sleep.
I used my IRest “TENS” unit, did back and hip exercises and stretching, took all the right supplements, thought good thoughts. Nothing seemed to make much difference.
Deciding it was time to get help, I saw a naturopath who is one of the best spinal manipulators (kind of like chiropractic) I know. All naturpoaths are trained in spinal and visceral manipulation by the way.
He manipulated me two times a week for a few weeks and sent me home with back exercises (which I had already started on my own). I did them. His manipulations and exercises helped a little, but not for very long. The nightime deep ache continued. Driving my car became torture.
"Dr Nick" suggested I get a back and hip x-ray, which I agreed to. One of the signs of bone cancer or cancer that has metastasized to bone is a deep, unrelenting ache. I won’t say I feared for the worst (it’s not my style), but the pain had become so constant and relentless that the thought crossed my mind. So I wrote myself lab orders and had x-rays taken.
The results were good news and bad news. The good news? No evidence of bone disease like cancer or osteoporosis. My hip joints were fine. I have a slight anatomical "difference" from side-to-side, but this is so common that it’s the rule, not the exception. Nothing Big Bad wrong to explain my pain, and that was good. But nothing seen to help me know how to cure it, and that was disappointing. Still, I was relieved that this brutal pain wasn’t a cancer – which can also gnaw deeply. "No news was good news," sort of.
I all but stopped my daily walks since they only aggravated the condition. I found myself hobbling like some old people that I feel sorry for.
Nurse Mark is a Genius
I was lamenting my condition to Nurse Mark who has has worked everything from the emergency ward to hospice, with orthopedics in between. It was his orthopedic experience and his insistent genius that saved me.
Nurse Mark told me the story of when he admitted a little old lady who was scheduled to have first one, and then probably the other hip replaced. Mrs. Rossi (we’ll call her that) had been very active, walking everywhere: To the store for each day’s groceries, to attend Mass, to visit friends and family. That was "had been," because for the past year she had been crippled with hip pain that nothing — not drugs, not physiotherapy, not massage — had helped. This once active and independent lady was now barely able to shuffle using a walker for support. New hips seemed the only solution.
As Nurse Mark did her pre-operative assessment he noticed the shoes that Mrs. Rossi was wearing. He asked her if she was wearing those same shoes when she had seen her orthopedic surgeon, or when she had gone to her physiotherapy appointments. No she replied, looking at him as if he had two heads. Of course she would “dress up” to visit the physiotherapist and especially the doctor – these were her “everyday” shoes, not her “good” shoes.
Nurse Mark called the orthopedic surgeon (we’ll call him “Dr. Frank”) to discuss Mrs. Rossi’s admitting orders. He artfully asked if Dr. Frank had ever seen Mrs. Rossi in her “everyday” shoes?
Dr. Frank blustered that Mrs. Rossi’s shoes always looked fine to him, and “so what of it?” Nurse Mark explained that he was afraid if Mrs. Rossi were to walk on her “everyday” shoes post-operatively, she might undo all the fine work that Dr. Frank was about to put into her new hip.
Dr. Frank sputtered and grumbled, but that evening when he made pre-operative rounds he ordered Mrs. Rossi to put on her walking shoes and walk for him. Nurse Mark says his face went pale. He ordered her surgery delayed and he asked her family bring in her “good” shoes. When he saw her walk in her “good” shoes, he demanded that she throw away the “everyday” shoes. The old woman complained that “they look fine – lots of wear left!” but the Dr. insisted and ordered the physiotherapist to fit her with a new pair of “everyday” walking shoes. That did the trick and she never did come back for “new hips.”
As I listened to the story, I realized that I had increased my walking since taking up part-time residence in Phoenix. Most mornings I’d walk 3-4 miles on uneven desert ground. Still, my running/walking shoes looked fine. Good for another year at least.
At Nurse Mark’s insistence (I was an easy sell at this point because I was desperate), I went to a local running store that does "gait analysis." They filmed the back of my feet as I walked on a treadmill, then showed me the pictures.
Although my shoes look quite good by "eyeball," I was clearly lop-sided from the back while walking. Close inspection of my shoes (and it did take CLOSE inspection), showed an uneven wear pattern on the heels.
I tried on about twelve pairs of shoes. They had me walk in each to see which felt the best. I finally found one pair that felt good on my feet and almost immediately, my hip felt better. I hoped against hope it wasn’t just a placebo effect that would wear off.
Five Months Later…
After nine months of suffering, I have been pain-free for five months. I still walk; in fact I’m "back in the saddle" with daily walks or bike rides. No pain. No limp. Nada.
Those shoes cost me $123 which, for a simple pair of walkers, seemed a choke at first. In retrospect, it was one of the biggest health bargains of my life.
Two Reports from the Field
Yo, Joe! A friend of ours was limping when we saw his last month. He is obese, and said he "knew" his weight was the reason for his hip pain. It’s true that carrying excess weight puts a strain on joints, but we took a look at his shoes and advised him to get new ones. He did. I talked to him last week: his pain is gone and he no longer limps. Shoes: $158. Being pain-free: priceless.
Stranger in the hardware store. I wanted a picture of a far-advanced example of shoe-wear to show you, but such pics are hard to come by on the internet. Make that "impossible" to come by. Had I known that replacing my own shoes would work miracles, I would have saved the old ones for a photo. Alas, I decided to toss them right away because, as Nurse Mark rightly pointed out, if I kept them I would probably wear them again as "beaters." So out they went.
One day entering the hardware store I saw a man with a great example of a far-advanced case of shoe wear – he was literally falling off the sides of his shoes. I wanted a photo but didn’t quite know how to ask. (I’m so shy). The man cut in front of me for help, then apologized. I said I’d forgive him if I could have a picture of the back of his shoes. He looked befuddled but agreed. When he asked why we wanted them I showed him the pictures and explained about the back/hip pain.
"Oh my Gosh!" he exclaimed. He bent over and pulled his pants down to show me his lower back. (It’s OK, I’m a doctor). He had a long scar from the older style of low back surgery. I recognized it immediately.
"But," he explained, "I’m still in a lot of pain. I take pain-killers every day."
"I’d get a new pair of shoes," I recommended with full confidence.
"I have a new pair already, and now that I think of it, my back does feel better when I wear them. I just don’t wear them very often because they’re new and they were expensive and I was saving them for special occasions. And besides, these shoes look just fine from the top! I’m going to go home and throw these away and start wearing the new ones. Thank you so much. This was my lucky day to meet you like this!"
I haven’t heard from the fellow but I have a high confidence level that he is feeling much better. Now I’m left to wonder: how many people have gotten hip or knee replacement surgery when what they really needed was a pair of new shoes?
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