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Suggest Treatment For Lower Back Pain Post Hip Replacement Surgery

Posted on Tue, 20 Oct 2015

Question: Hi. 7 weeks ago I had a hip replacement. I was good for a couple of weeks then I started getting pain in lower back. I think it started from physical therapy. I have degeneration disc in my lower back. the pain seems to be around SI joint. Bothers me when I sit and hurts when walking at times. I am so disappointed. I had cortisone shot last week didn't do anything. I had ultrasound machine on today. I still don't feel the difference. Would I have a to do it a few times? Any other ideas? I am at my wits end. thanks

Answered by Dr. Aashish Raghu (53 minutes later)

Brief Answer:
Kindly get an MRI done. Apply heat to the painful areas to relieve muscle s

Detailed Answer:
Hi there.

Welcome to Healthcare Magic.

Thanks for the query.

Usually after hip replacement, the muscles around the hip are very weak and hence you teens to use your spine to move the trunk around in communication with hip movements. This can lead to pain of you already have an arthritic spine and can aggravate slip disc as well.

I would advise you to get an MRI of your lumbosacral spine done to look for the same.

Avoid bending forwards and lifting weights. Avoid squatting, cross leg sitting, kneeling or cycling. Continue with Physiotherapy upto within your normal limit and avoid painful activities. You need to strengthen your muscles around your hip like the Abductors, Extensor, Gluteus muscles, Quads and Hamstrings. Eat a healthy diet.

If ultrasound therapy isn't working for you then you don't need to do it. You can try other methods like Wax bath to help relieve muscle spasm in the back. Also apply a hot water bag for relief from the painful muscle spasm.

Kindly follow up with me in this regard an also get the MRI done.

I hope I have answered your query.

I will be available to answer your follow up queries.

Regards,

Dr. Aashish Raghu

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Aashish Raghu (2 hours later)

hi and thanks. i has a mri in august of 2014 and it showed degenerative disc disease and bulging disc in my lower back. its been a little over a year since I had this mri taken. Do you think it is necessary to have another one taken at this time? also, had the ultrasound taken today. is it supposed to work right a way or should i try more. i only had it once. do you think i should go to pain management to get a more essavive shots than the cortisone shot that i had like one where thry would guide it in? i really dont want to go for physical therapy because that is when all this pain started. If i do get a more detailed essavive shot like epidural, would that help? Also do they have a way of doing it without having to lay ony my stomach since i just had hip replacement. I am trying to figure out my best option since this pain in si joint not getting any better. i have had this pain for over 4 weeks. do you get many patients that have problems with this after hip replacement? thanks in advance

Answered by Dr. Aashish Raghu (12 hours later)

Brief Answer:
Epidural and Sacroiliac joint injection

Detailed Answer:
Hi there.

Thanks for the follow up query.

Yes, You can get an Epidural steroid anaesthetic injection which will offer relief did a few months. Kindly follow the precautions mentioned previously.

There may hedge been undiagnosed Sacroiliac arthritis is the indolent stage such may have aggravated after the surgery. You can get a Sacroiliac joint injection as well to relieve the pain.
Quite a few patients have presented to me this way
I hope I have answered your query.

Regards,

Dr. Aashish Raghu

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Aashish Raghu (10 hours later)

thanks again. I did get a MRI today. Won't know results for another week. They could feel a knot maybe in my muscle near lumbar. she said when she was feeling my back, she could feel it and it felt like it was moving around. Is that possible? in your opinion, what would be a good treatment to get rid of that if that is what it is. ultrasound machine? ice? heat? massage? thanks again

Answered by Dr. Aashish Raghu (3 minutes later)

Brief Answer:
Wax bath, Ultrasound therapy

Detailed Answer:
Hi there.

That knot is a localised region of muscle spasm. Usually massage, Ultrasound therapy are useful to find relief.

Since you have metal in your body in the form of the joint replacement components, I cannot refined Interferential therapy or TENS therapy such are also good.

You can try Paraffin wax bath from your Physiotherapist as well where a coating of warm Paraffin wax will be applied to the region of muscle spasm.

I hope I have answered your query.

Regards,

Dr. Aashish Raghu

Above answer was peer-reviewed by : Dr. Sonia Raina

Follow up: Dr. Aashish Raghu (48 hours later)

I wont know until I get my MRI results back, but if I do have some kind of a knot in my muscle near lumbar, would that cause me to have difficulty sitting? I cannot believe that the knot would last over 4 weeks now. Is that possible? thanks again

Answered by Dr. Aashish Raghu (1 hour later)

Brief Answer:
Kindly follow precautions and Physiotherapy

Detailed Answer:
Hi there.

Yes. An area of muscle spasm can be of a chronic duration as well because the nerves are compressed and causing the spasm. Unless the nerves are decompressed, the spasm shall remain.

Kindly get the MRI done and try the various physiotherapy methods I mentioned from a good Physiotherapist.

Wishing you a speedy recovery

Regards,

Dr. Aashish Raghu

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Aashish Raghu (47 hours later)

Thanks. I had MRI done but haven't heard anything yet. Is physical therapy the only way to decompress nerves or is there anything else besides surgery? I got trigger point injections yesterday in my muscle by lumbar where it hurt, but I am still getting nerve sensations in my buttocks when I sit. Drives me nuts sometimes Also had ultrasound machine about 3 times. How many times before I c a difference. I have been trying everything as I am determined to make this OK. Thanks again for your help

Answered by Dr. Aashish Raghu (14 hours later)

Brief Answer:
Epidural steroid injection

Detailed Answer:
Hi there.

If the medication and physiotherapy do not help, then you can get Epidural steroid injection which can offer relief for 3 months. You'll feel much better after one. Kindly let me in on the MRI Report so that I can guide you in the best step to take.

Wishing you a speedy recovery.

Regards,

Dr. Aashish Raghu

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Neel Kudchadkar