Hip-Spine Syndrome: Eliminating Pain in New Ways

Did you know? Your back pain might be a result of your hip arthritis. New medical research found a relationship between disorders of the hip and spine, meaning that there is a connection between conditions like degenerative lumbar spinal stenosis (DLSS) and degenerative osteoarthritis. Why is it important that we’ve discovered such a connection? Well, research has shown that treating one condition works toward resolving the other.

Hip-Spine Syndrome (HiSS) was discovered by researchers who noticed that many patients with symptomatic osteoarthritis also experienced back pain. Hip-spine syndrome can be confusing for clinicians because it can be difficult to determine what is causing the patient’s pain and other symptoms. Studies show that about 20 percent of people with back pain also have hip arthritis or hip pain. Recent literature shows that the spine and hip are more connected than we might think.

“The last 10 years, we’ve come to learn that evaluating the patient’s spine and their hip at the same time can better define what patients need surgically,” said Joint Replacement and Arthritis Specialist, Dr. Kalain Workman of TPMG Orthopedics.

The hip and the spine are connected through the pelvis, the large bony structure that attaches our hind legs to our spine. Some of the strongest ligaments in the body connect the sacrum spine (shield-shaped bony structure) to the pelvis and the pelvis to the hip. Meaning, that what affects the biomechanics of the spine (spinal surgery, arthritis, etc.) often also affects the biomechanics of the hip and vice versa. The good news is that correcting hip problems could decrease your back pain. For some, undergoing hip replacement surgery not only improved their hip function but also decreased back pain.

What should I do if I think I have Hip-Spine Syndrome?
If you suspect you may have HiSS, contact an orthopedic specialist to discuss your case. Your provider will begin by taking a detailed history, narrowing down where and when you have experienced the most pain. Isolating the exact areas of the body in which you’re experiencing pain will tell your doctor a lot about your condition. Radiating pain from the hip to the low back is usually a result of something different than pain radiating into the groin area. Additionally, your doctor will want to know when you experience pain. Do you notice pain when changing position? Do you have trouble when lying on your side or while walking long distances?

After your doctor takes a detailed history, they might want to complete a physical exam and imaging. Most exams involve maneuvering the body in ways to isolate the exact area in which you’re experiencing pain. You might also undergo a neuro exam, which will determine if there is any weakness in the nerves that elicits a reaction from your lower extremities. Imaging also accompanies the exam. X-rays will give your doctor a look at any arthritis in the low back or hip. After completing these tests, your doctor might continue with further testing depending on your results.

Once your doctor understands what is causing your pain, they can move forward with treatment for whatever region of the body that is contributing to the pain. Treatment differs depending on the issue that has caused the pain. It can involve a series of injections over time, partnering with pain interventional specialists to perform epidural injections, physical therapy, or surgery to correct any deficits found.

If you believe you might be suffering from HiSS, don’t be discouraged. Over recent years, arthritis specialists have become much more attuned to examining the spine, expediting the diagnosis of HiSS, identifying the actual source of the issue, and treating them appropriately to decrease pain and improve function. Talk to a TPMG provider today about how you can find relief from your back or hip pain.

kalain workman, do

About Kalain Workman, DO

Kalain Workman, DO is a board certified Surgeon with TPMG Orthopedics in Newport News, Gloucester, and Williamsburg. Dr. Workman treats patients 18 years and older for a variety of joint-related conditions including osteoarthritis, rheumatoid arthritis, avascular necrosis, and fractures. He has a particular focus on osteoarthritis of the hip and knee.

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