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Author Topic: Back pain after Bi lateral THR  (Read 3205 times)

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jamie b

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Back pain after Bi lateral THR
« on: March 31, 2011, 09:40:52 PM »
Hi
  I have had bi lateral THR in the last six months. First operation on Sept 20 and the second one on January 10th. My Hips are really coming on well, i do about two hours work in the pool and gym every day, and i am also doing pilates once a week. My problem is with my back, ive had an MRI done, and everything was normal, its just that my core muscles are really weak after years of poor posture due to bad hips.   

    Before the operations i had a big curve in my back, which is not as pronounced now, as i am  standing much straighter . The problem is that i am still getting a lot of back pain!! It is worse in the morning, but i also have it during the day. It is preventing me from walking more than a few 100 metres at a time. I have to sit down and rest it quite often.

   Did anyone here suffer with this curve in the back? And if so how long did it take for the pain to go away? Its a bit frustrating as the hips feel really good now, i know it is only ten weeks since my last operation, but its the back that seems to be causing me the most problems!
I would love to hear how other people got on with similar problems to mine!
         
             James

FlbrkMike

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Re: Back pain after Bi lateral THR
« Reply #1 on: March 31, 2011, 10:26:49 PM »
Hi James,

Which way did your back curve before your hip replacement?  I have recently had bi-lateral BHR (2/11/11 and 3/11/11 - 11 seems to be my lucky number).  Limited range of motion, due to the hip arthritis, caused me to walk with a bent-forward gait, and I am sure has also affected my core muscles.  I am also standing much straighter now, but I think I also need some work on the affected muscles, especially stretching my quads, before my posture is completely straight again.

I used to have lower back pain that I am sure was exacerbated by my bad posture, as the bent over gait had to be straining those muscles.  I've also been diagnosed with "severe degenerative disc desease", which just means that my lumbar discs are compressed, as happens to a lot of us as we get to middle age.  I'm completely free of back pain right now, since my second operation, but I also haven't been walking much because I have been told by my doctor to restrict the weight on my right hip and must use crutches at least until my follow-up appointment next Wednesday.  I'm hoping at that time to be able to throw away the crutches and start walking again.  Then I'll really know how my back is doing.  I'll let you know how it goes.

Mike
Dr. Ball
56 years old
LBHR 2/11/11
RBHR 3/11/11

jamie b

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Re: Back pain after Bi lateral THR
« Reply #2 on: March 31, 2011, 10:42:17 PM »
Hi Mike
  Thx for you reply. My posture was a bent forward gait, with my backside sticking out, i am a little straighter now. My quads are really short, and my physio has be doing lots of exercises to stretch those. If i bend down both knees crack, and my hip sometimes due to the shortness of the quads. There is no pain in this cracking, and i have no pain in the knees , just my lower back. I am hoping that the pain is due to my improved posture, as my body learns to adjust after the operations.
                 James

eperk

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Re: Back pain after Bi lateral THR
« Reply #3 on: October 11, 2011, 07:38:29 PM »
Hi James,
I am hoping that you feel better, and this info. is TOO LATE for you! 
But--my experience clinically is that often hip pain and low back pain go hand-in-hand, and so I am hopeful that someone may find this of use.
I'm a P.T., and this year had both a (failed) arthoscopy on my hip and about 2 weeks ago a (hopefully wonderful) resurfacing.  I have a history of low back pain (have had two low back surgeries).  My experience following both the arthroscopy and the (anterior approach) resurfacing was of increased low back pain, new sacroiliac pain, and increased sciatica.  It all makes sense to me given the mechanics:  After both hip procedures, I initially had decreased hip extension (my leg doesn't go as far behind me--this means that the low back will arch to compensate while walking), as well as post-operative swelling in the iliopsoas muscle, which attaches at one end to the low back, and at the other end inside the pelvis.  So, when this muscle is impacted, it pulls on your low back, increasing the ''arch'' in it.   This muscle is also the major muscle for bending the hip (as in bringing your knee towards your chest).  Following the reduction in swelling from the arthroscopy, I was able to diminish much of the low back and sacroiliac pain by doing self-release of the iliopsoas muscle--not fun!  Basically you dig your thumbs inside the iliac crest (the front part of the hips that you can feel on either side of the belly button), holding pressure on the sore tissues until it ''softens'', and then you follow it a bit deeper with your thumb.  A skilled masseuse or P.T. can do more effective iliopsoas release than you can do on yourself.  The other component that was very helpful to me following the arthroscopy was a LOT of self massage of the I-T, or iliotibilal band (long tendon on the side of the leg that runs from a small muscle at the side of the thigh to the knee).

DGossack

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Re: Back pain after Bi lateral THR
« Reply #4 on: October 11, 2011, 07:51:51 PM »
eperk-

After ten weeks the lower back is really the only problem location.  It gets very tight and sore.  There isn't severe pain but it can definitely ache.

I have thought it was because I am no longer arching my back and sticking my butt out to walk.  I am also able to sit and ride normally on the exercise bike.

I will try the iliopsoas release as you describe.  I am already doing some work with Triggerpoint tools (tptherapy.com) to work the IT band and related muscles.

Best wishes on your recovery and rehab.
Dan
LBHR, Dr. Pritchett, 8/1/2011
fullmetalhip.wordpress.com

Ross

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Re: Back pain after Bi lateral THR
« Reply #5 on: December 16, 2012, 01:33:40 PM »
I know this is an old thread but I was going to give it life again as I have experienced similar complaints.  I have a big s curve in my low back and in my younger years squatted weekly with heavy weight.  My hips do not hurt so much as my low back and only the sacral illiac area.  This prevents me from walking further than either hips.  I guess really focusing on good posture may help.  Time will tell but I am open to suggestions.
Cordially,
Ross

hernanu

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Re: Back pain after Bi lateral THR
« Reply #6 on: December 16, 2012, 03:24:50 PM »
I'd give it a little time, Ross  - your body was under siege for a long time with the OA, it needs to readjust to the new, better reality.

Working on good posture probably will help, and working on your core when it's time to do that will also help.
Hernan, LHR 8/24/2010, RHR 11/29/2010 - Cormet, Dr. Snyder

Ross

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Re: Back pain after Bi lateral THR
« Reply #7 on: December 18, 2012, 01:11:06 PM »
Thanks Hern.  Trying to be patient with it not my strong point but I do have a good work ethic so I will keep pushing.
Cordially,
Ross

lycraman

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Re: Back pain after Bi lateral THR
« Reply #8 on: December 21, 2012, 09:27:52 PM »
Hi Ross

I'm nearly 4 months post op now and recovery has been good but the last week or so I've had a sore lower back, mainly over the right sacro illiac joint, which is unusual for me because if I ever get a sore back it is almost always over my left sacro illiac joint.  Fortunately I bumped into my physio on Wednesday and she managed to fit me in for a quick sess (I haven't been to see her since the op - Mr Treacy's orders!)
My lovely physio did a 60 second assessment of my gait and mobility and said that my problem was simply caused by tissue adhesions under the scar on my left hip, which was pulling my left hip back and tilting the pelvis. After 15 minutes of manipulating the scar tissue and underlying fascia and some work on the hip flexors i felt like a new man.

Just goes to show that the knowledge and hands of a good physio are essential.

Good luck Ross.
Left Birmingham Hip Resurfacing
11th September 2012
Mr Ronan Treacy 54mm head 60mm cup

 

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