Did any of you have lower back pain/spasms prior to your surgery?

[Nilidar]

I'm a 46yr old male and I've recently found out I will need a new hip soon.  I'm not bone on bone but I'm down to 3mm on my bad hip and its definitely limiting my activity levels.  I used to be very active, including running/triathlons when I was a little younger.  That morphed into longer walking and swimming and now I'm stuck on the bike trainer.

Anyways, one of the things I've had happen over the last 2.5yrs is recurring and more severe lower back pain.  I've had several back spasms which have literally knocked the air out of me and left me on the floor for days at a time.  My back MRIs show nothing out of the ordinary but I can no longer walk more than 20-30mins without needing to stretch out my lower back, which doing sometimes leads to its own spasms.

In chatting with the surgeons I've met so far, several feel that the two are likely connected and that repairing my hip will likely help my lower back pain.  I happen to live in Seattle and I've met with Dr. Pritchett who happened to be the only surgeon who didnt feel they were related.  I know he gets high praise here on the forums but I didnt get a good vibe in my interactions with him.  I'm considering another local surgeon (Chris Boone), who does BHR but only on certain patients (of which I fall into).  He doesnt do nearly as many resurfacings as total hips though (~5% of his overall procedure count is resurfacings).  That concerns me but I know someone whos worked with him and they say he's an excellent surgeon.

My question for the group is: did any of you have similar problems prior to your surgeries?  Did getting your hip fixed help your lower back pain in any meaningful way? 

I'm worried that while they seem correlated, they're not and replacing my hip will have no real effect.  I'm also worried that since my hip isnt "that bad", I might be prematurely stepping into a major operation too early.  I've done all sorts of different things for my back at this point and nothing has really worked well.  So if getting my hip fixed does work, I'd be ready and willing.

Thanks in advance for everything this forum offers, its been excellent to read all of the different posts here.

[Mouse Potato]

Hi Nilidar,

I used to get lower back spasms that took my breath away.  They only lasted for a few seconds at a time though so they were not to the levels you are experiencing.

I haven't had one since I had my hip resurfaced in March this year so in my case, they seem to have been related.

Russ

[Pat Walter]

Hi Nilidar
I am sorry to hear you have hip/back problems.  It is often very difficult to separate the two and figure out what is going on. Have you been to a doctor that specializes in backs? Try to find a specialist not an ortho that does a little this and a little that. Ask around, search the internet reading ratings for the doctor.  I would at least try to get a couple opinions from back specialists.
As far as the hip, why don't you get some more opinions from other experienced hip surgeons.  The top surgeons all do free email consultations.  Just send them an email and attach your x-rays in a digital format.  That way you can have more opinions from some of the top surgeons. Be sure to explain your whole situation.  If you need a hip resurfacing, you might have to travel.  It is always best to use the surgeons who have done 4000, 5000 or more. You want someone that does them day in and day out.  It is a much more difficult surgery than a THR. An experienced surgeon is like a musician or athlete. If they don't practice every day, they get rusty and are not at the top of their game. Experience is very important in hip resurfacing.
Here is a list of surgeons, you can see you does free email consultations - almost all the top surgeons do:
https://surfacehippy.info/doctors-with-1000-hip-resurfacings/
https://surfacehippy.info/hip-resurfacing-doctors/
I wish you the best.
Pat

Here

[Nilidar]

Thanks for the replies Pat and Russ.

Russ, I'm glad to hear your back is feeling better post surgery.  Thats great!

Pat, I've been to several back specialists over the last year and they all cant find anything clinically wrong with my back (which I guess I should be happy about).  But they also cant offer me any real relief other than pain killers.  I recently saw someone who suggested a cortisone shot into my hip as a diagnostic tool for my back.  The theory being that my hip is bad enough that it is constantly guarding and thus pulling on my lower back.  If the shot helps resolve the back pain, then I know its likely the two are correlated.

[Saddlepal3]

I just want to reiterate Pat's point that you should only consider resurfacing with a surgeon who specializes in them. Another surgeon may, in fact, be excellent, but unless he/she primarily does resurfacing, you would be taking an unnecessary risk. I have had two procedures with Dr. Pritchett, and I believe he is outstanding. That being said, if you prefer someone else, consider traveling to another resurfacing specialist. Good luck!

[einreb]

Pat, I've been to several back specialists over the last year and they all cant find anything clinically wrong with my back (which I guess I should be happy about).  But they also cant offer me any real relief other than pain killers.  I recently saw someone who suggested a cortisone shot into my hip as a diagnostic tool for my back.  The theory being that my hip is bad enough that it is constantly guarding and thus pulling on my lower back.  If the shot helps resolve the back pain, then I know its likely the two are correlated.

Have you been to anyone other than a surgeon regarding your back?  My back pain experience was resolved working with a good Physical Therapist for core/strength/stretching. 

For me, I'd attribute some of the back pain root cause to my bad hip and doing things to favor it.  I also have a mostly office job that has me sitting and my main athletic activity is cycling with is notorious for poor posture and asymmetric exercise. 

[Nilidar]

Thanks.  Yes, I've been in PT for over a year now for both my hip and my back.  I've also seen two different physiatrists.  It gets a little better and then I have a set back and the clock simply resets.  I now barely do anything since I know any amount of walking will lead to a very tight lower back and that eventually leads to the nasty spasms.  I do a lot of movements to help loosen it up, ice/heat, etc but it still persists. 

[chuckm]

Yes, Nilidar, I had debilitating lower back pain for two years before I had my hip resurfaced. My back issues resolved 100% within a month after surgery.
If you are a back sleeper put a pillow under your knees at night for some relief. The problem is that as your hip continues to lose range of motion, your back makes up for that loss of motion. The hip flexors go into a state called contracture. You are unaware of any of this except you feel the pain. Try lying down on your back on a firm surface like the floor and see if your legs will like flat without back pain. If you can't get your knees flat down on the floor without straining your back, especially on the worse side, then your hip is the problem.

Chuckm

[Nilidar]

Thanks Chuckm, I appreciate your comment (and congrats on the hip and resolved back pain).  I just tried lying on my back and while I can still get my knee almost to the floor, I definitely feel a strong pull through the front of my bad hip.  Sounds like they might be related for sure.

Did you ever get a cortisone shot in your bad hip before your surgery?  It was recommended to me by a physio as a way to "test" if its my hip or something else.  It makes sense to me in some ways but it also will cause me to delay surgery for another three months if I get it.  I like the idea it may help and could give me a little more time on my natural hip but I also dont want to waste more time if it wont help.

[chuckm]

Yes, Nilidar. I did get a cortisone shot in the hip. It did work for a very short period of a couple of weeks at most. In my case I think it actually hastened my need for the surgery. When the muscles of the hip tighten or shorten (contracture), that is the body's mechanism to keep you from moving the hip too much and aggravating the cartilage lesions in the joint. When the cortisone shot removed some of the pain, I noticed a small improvement in my range of motion. Little did I know that this was paving the way for grinding away more quickly. Once the cortisone wore off I was in much worse shape than before. But, I did not opt for the cortisone until quite late when there was no doubt that my hip was the problem.

Chuckm 

[jimbone]

Nilidar

During my first consultation with Dr. Pritchett I asked about referred back pain and disc degeneration- I had been referred to Dr. Pritchett by one of the leading back surgeons in Seattle who'd performed successful scoliosis surgery on a friend.  Dr. Pritchett said the back surgeon would insist the hip issues be resolved first.  As Chuck explained above, when the hip joint is that badly compromised the other muscle and tissue groups react with contracting response to stabilize the hip joint.  One of the primary muscles is the psoas which runs from the lower back around to the frontal attachment at the illium of the hip.  When the hip is compromised the psoas will contract to help stabilize and in doing so will create pain issues in the lower back.  As my OA progressed the deep tissue massage I relied on to relieve the back pain eventually failed to provide relief.  By the time I was able to get the 1st hip done it was an unusual day I did not need to rely on crutches for some period of the morning and needed to lean on surfaces continually during the rest of the day.   Back, hip, glute and quad pain were constant and debilitating.  I am now 17/15 months post bilateral HR with Dr. Pritchett, at 64 I can walk for hours, hike mountain trails, do full days of work in steel fabrication [really ready to give that up] work out intensely, do light trail/treadmill jogging [was never a runner], and feel I have been given my life back.  As long as I stretch and exercise regularly, back pain is a thing of the past, nothing but occasional bruises or mild strains someone my age in my profession wouldn't expect and they resolve quickly.  The HR surgeries made this possible.  Whatever your reservations might be personally with Dr. Pritchett keep two things in mind- you are seeking surgical treatment not a social interaction and that surgical treatment is a highly challenging, technically difficult one you are best served having done by someone of demonstrated success and experience.  Dr. Pritchett has done thousands of successful HR surgeries and is one of the leading and most recognized HR surgeons in the world.  If you got a "bad vibe" might ask yourself, "Wonder what kind of day he was having?  Did he just save someones life who'd been run over by a bus and had their hip crushed and was still concerned with their outcome"?  I researched long and hard to locate a surgeon with enough experience for me to trust them to put the knife to me.  Having had that done I would never consider a surgeon of lesser experience.  High volume, experienced, successful, recognized HR surgeons are who you need to be consulting with.  Best of luck.

[Nilidar]

Thanks Chuckm and jimbone, I really appreciate the insight.

As for Dr. Pritchett,I realize that he has many successful surgeries and is well respected here on the forum and elsewhere.  My interactions with him personally have all been fine, and I found him to be personable and considerate.  That said, my "bad vibe" feeling is something thats been somewhat validated in a few ways:

1. When I asked Dr. Pritchett if my back pain was related to my hip, he gave me an emphatic "no".  He's literally the only surgeon I've interviewed who said they werent related
2. Someone I work with had their hip resurfaced by Dr. Pritchett 4yrs ago and had a horrible experience with his surgery and post operative care.  In the end he required an extensive revision and end up with a THR as a result
3.  The patient in #2 referred me to a PT in the area that works with THR and HR patients.  They've told me that his patients tend to have a lot of problems post operatively and didnt seem to have a high opinion of his work

So while I'm glad others have had a good experience and outcome with his operations, my gut feeling and these three factors led me to rule him out of contention for my hip.  Its just too large of an operation to not feel good about the person performing it.  FWIW, I dont think surgeons need to be personable, I think they need to be competent.  I'm not inferring that Dr. Pritchett isnt competent but all combined factors have led me to pursue other options, even if less experienced.

As to my original topic, I really appreciate the help and advice you've all provided thus far.  Its nice to know there might be some relief from my back pain once my hip is resolved.  My back has bothered me a lot more than my hip ever did so I'll keep my fingers crossed.