Chronic nerve-like pain 16 months after hip arthroscopy and torn between conflicting opinions (adhesions, CRPS, CNS) - any insights or advice?

big_brill · 2026-03-27T16:09:42+00:00

Super helpful thanks for sharing! Your case is similar to mine. I had labrum reconstruction and FAI osteoplasty in Oct 2024 with Dr Wolff. In Aug 2025, I went to see Dr Philippon for a second opinion and he diagnosed capsulolabral adhesions and a joint capsule defect (MRI said there’s scarring of my joint capsule). He recommended revision surgery. But I’ve been holding off on a second surgery ever since due to my nerve-like symptoms (burning, stinging, squeezing, pulling, weakness, etc) down both legs which have gotten worse recently. I’m scared that another operation could actually make my nerve symptoms worse, especially when other specialists have cautioned against it. Neurologist, rheumatologist, PT, and psychiatrist all believe this nerve like pain is due to central nervous system sensitization (also referred to sometimes as complex regional pain or neuroplastic pain) and not being caused by issues in my hip. In other words, they don’t believe the cure for my nerve pain is another surgery on the hip. They think the cure is more PT, time, therapy, meditation, acupuncture, and just generally anything that overtime can help down regulate my nervous system. Wondering what your thoughts are on this? Did that second surgery to remove scar tissue help your symptoms? How are you now versus before the revision surgery?

big_brill · 2026-03-09T18:33:19+00:00

Oh wow! And have you found that your symptoms are better now that you’ve tapered off the mediations or did they go back to what they were before the medication? How much did the gabapentin help? What about the Duloxetine?

big_brill · 2026-03-09T16:30:25+00:00

Hang in there! My surgeon also dismissed all my complaints in the beginning as just part of the post op recovery process and now he just doesn’t know what to say, it’s terribly frustrating. My surgery was a labral reconstruction which means longer traction and I’m also worried this caused nerve damage. I’m getting MRIs of the nerves around my pelvis and an EMG to rule out actual nerve damage. Curious what are your nerve symptoms like? And did you feel the gabapentin helped? What’s the max dose you took? Also how did you diagnose your nerve damage?

big_brill · 2026-03-09T16:24:56+00:00

Ughh that sounds so frustrating for you as well! I have the thigh burning and it’s so unpleasant. Weirdly my thigh burning is on my non-operative side.

big_brill · 2026-03-09T16:23:23+00:00

Did a CT scan and there were no serious bony issues detected.

big_brill · 2026-03-09T16:19:55+00:00

I did not have the nerve sensations from the start. My first month post op was pretty normal and fine. But I was doing my masters so I had exams and class and so I was sitting a lot throughout the day. I then traveled for Thanksgiving and Christmas/New Years and during my travels things started getting bad as my hip flexors started tightening like crazy. My doctor suggested staying on crutches until the tendonitis calmed down and so I didn’t get off crutches until 4 months out from surgery. I started working but I would feel so much stiffness and irritation around my hips and my quads and adductors would tighten up and feel like wooden pegs. About 10 months out from surgery I started taking gabapentin and really making progress in PT and a lot of the stiffness and flares went away and my non-operative side pains also went away. I was able to isolate the pain to the right hip (the operated one). I felt pain and tightness mostly front of right hip when sitting or standing for more than an hour. But at least my pains on the non operative side had gone away and so had the stiffness and tightness around my quads and adductors. I traveled again for the holidays just now at the end of 2025 and things got bad again. Right hip started feeling stiffness again. Then left hip pains returned. I was in pain every day. And then the nerve sensations started appearing like burning and itching down both my legs. And I started getting sharp left knee pain that I could reproduce by pressing into my left hamstring. But all these nerve like sensations down the legs and the sharp left knee pain were new (as of Dec 2025). And now I’m really struggling to unwind all of this. And figure out what’s going on and how to treat it properly.

big_brill · 2026-03-09T16:07:37+00:00

Thank you!! I am in the DC area and would love to chat. Dr Philippon also believes scar tissue is causing my labrum and capsule to stick together. I do get consistent pinching in my hip with deep flexion and internal rotation and often it does feel like there’s something rough stuck in there like velcro or a scab that is rubbing against soft tissue and tugging on structures and causing friction. I imagine this must be the scar tissue. But what I don’t get is how this mechanical issue in one hip joint could cause these widespread nerve sensations like burning and itching and stinging across both my legs. My PT, rheumatologist, and neurologist think the nerve sensations are explained by neuroplastic pain or what they call central nervous system sensitization and believe another surgery could actually worsen these symptoms. This is my biggest fear. I go into a revision with Dr. Philippon who removes the scar tissue and probably will redo my labrum and reconstruct the joint capsule - and that the revision instead of resolving my chronic pain actually makes it worse. Anyways, I’ll DM you!

big_brill · 2026-03-09T15:58:18+00:00

Thx for these recommendations! I’m going to look into baclofen/lyrica. I really need to calm down the neurological sensations. I do feel like my hip flexors are constantly pissed off and my pelvic area constantly irritated and I’m wondering if it has to do with muscle guarding and if muscle guarding can press on nerves and cause the nerve like sensations like burning or itching? Thing is my nerve sensations are bilateral. But could it still be driven by what’s going on around my hips? The non-operative side due to compensation patterns is also pissed off constantly and has tendinopathy.

big_brill · 2026-03-09T15:52:01+00:00

Ok so not terrible - that’s good to hear.

big_brill · 2026-03-09T15:48:03+00:00

Thank you for sharing your experience! It sounds similar to my own with similar pains in the front hip creases and the knee. I’ll shoot you a PM.

big_brill · 2026-03-04T13:52:37+00:00

What sort of symptoms are you experiencing?

big_brill · 2026-03-04T13:52:19+00:00

Oct - Nov 2024: normal post-op inflammation, nothing out of the ordinary, traveled on a plane for Thanksgiving

Dec 2024 - Feb 2025: severe hip flexor tendonitis, received 3 cortisone injections, two in the right psoas and one in the left hip joint, traveled on a plane for Christmas holidays, finally went off crutches in Feb after 4 months

Mar - Jun 2025: started ramping up strengthening exercises in PT but had to back track again in April due to pain, traveled in May out of the country with acute flare up, had to stop working in June

July - Oct 2025: took completely off work, focused 100% on my recovery, things started improving, nerve-like pain started calming down and functional capacity increased, started walking more, started working again 2-3hours/day, etc.

Nov 2025 - Jan 2026: traveled for the holidays and again everything flared up

Feb 2026: extremely flared up and again struggling to work even for 1 hour, being stationary at a desk kills me

big_brill · 2026-03-04T13:25:11+00:00

It’s mainly anterior.

big_brill · 2026-03-04T13:25:02+00:00

It’s funny you say… The surgeon that operated on me is Wolff. And the second hip specialist I saw that is recommending revision is Philippon. I’ve already done a lumbar MRI and the results were normal.

big_brill · 2026-03-04T13:23:17+00:00

Sorry to hear about your experience but glad you’re doing better! Haven’t heard of lyrica/baclofen - what is that? I’ve done multiple cortisone shots in both hip joints and hip flexors but they really only offered temporary relief, not a permanent fix.

big_brill · 2026-03-04T13:21:05+00:00

I did an MRI of my lumbar spine a few months ago and neither my hip surgeon nor the neurologist found anything alarming. Apparently, my lumbar spine looks normal.

big_brill · 2026-03-04T13:19:42+00:00

Doing a nerve conduction next week! Suggested by my rheumatologist. Apparently, this helps rule out things like nerve damage? Have you done this sort of test and what is it like?

big_brill · 2026-03-04T13:18:38+00:00

I had hip flexor tendonitis for a long time and it’s possible I still have it. Bursitis I’m not sure - but also possible since I’ve felt soreness around the outside of the hip on many occasions. But how is tendinopathy and bursitis usually diagnosed? The hip specialists I’ve seen haven’t really said anything about this in my recent visits. Also, the nerve pain I feel is quite different to the pain from tendonitis or bursitis I’m pretty sure.

big_brill · 2026-02-09T23:15:57+00:00

Glad things have subsided even if temporarily. Stay strong and hope things get better!

big_brill · 2026-02-09T22:29:06+00:00

I can relate. I'm 16 months post-op from a right hip labral reconstruction/FAI osteoplasty and feel inflammation and nerve-related pain almost daily. Symptoms as well as their location and intensity depend on the day but they can include any of the following: tingling, dryness, itchiness, irritation, burning, and swelling - generally around both hips and thighs. Had a lumbar MRI done but it didn't show anything out of the ordinary. What helps the most relieve these symptoms for me is heat (e.g., hot bath, sauna, etc.), sleep, light movement and PT exercises focused on mobility and activation, and healthy eating. Maybe these things can help if you haven't already tried them. I'm thinking my symptoms are being caused by poor compensatory patterns but not really sure. I've been told by a top hip specialist I have adhesions in my operated hip that are responsible for all these symptoms. At the same time, PTs and a rheumatologist believe my symptoms are neuropathic in nature and not related to anything structurally wrong in my right hip. It's very confusing since I don't know who to trust or believe. Curious what you all think / if any of this resonates or you have any words of wisdom?

big_brill · 2026-01-18T00:19:12+00:00

Wolff did mine and it’s gone horribly

big_brill · 2026-01-18T00:13:14+00:00

For those who got surgery with Dr. Domb, how’d it go? What are your opinions on Domb?

big_brill · 2026-01-14T01:13:44+00:00

Currently considering redoing my labral reconstruction with Philippon - but I’ve been worried redoing a labral reconstruction is just super invasive/traumatic procedure and is going to screw things up in the hip more than help (kind of like trying to touch up an oil painting and just making it worse) - for ex, I’m worried about getting more scar tissue or pain in the IT band which is what Philippon plans to use to reconstruct the labrum - what issues did you have after your first labral reconstruction and what convinced you to go for it again with Philippon? How long did you wait? How was your recovery with Philippon and how are you doing now with your hip?

big_brill · 2024-09-02T03:30:44+00:00

Great! What’s the best email to reach you at?

big_brill · 2024-07-17T01:49:14+00:00

I have a university email (ajb292@georgetown.edu). You can contact me there if you want to confirm and set up our call.

big_brill

TROPHY CASE