Back of hip pain? I examined a judge from Michigan this week who had been told she needed a hip replacement because of pain in the back of her hip. When I spoke to her on the phone about her candidacy for the Regenexx stem cell procedures, her “hip” pain didn’t sound like most of it was coming from the hip joint itself, but rather from either the low back nerves or SI joint. This because it wasn’t the classic groin dominant hip pain that is usually associated with pain from the hip joint, but more back of hip pain and side of the hip pain. I told her that once I performed an exam, we would likely take the extra time to numb her hip versus her SI joint to see which one gave her greater relief. Comparative blocks (numbing two sites one after the other to see which one is causing more pain) are rarely done in our usual rush toward declaring the patient needs a joint replacement solely based on the fact that the picture looks bad and they have pain in that area. Sure enough, her SI joint injection took away more of her pain than did the hip joint injection. This means that someone would have amputated her hip joint and inserted a hip replacement prosthesis when it was really her SI joint that was causing the most pain. As you can see from the diagram above, the SI joint and hip joint are distinct. Regrettably after this very serious operation, she would have still had her very familiar pain in the back of her hip. The upshot? If your “hip” pain is more in the back of your hip or side of your hip, make sure that comparative blocks are done between the SI joint and hip! Amputating joints that aren’t causing your pain is not a good idea.
About the Author
Christopher J. Centeno, M.D. is an international expert and specialist in regenerative medicine and the clinical use of mesenchymal stem cells in orthopedics. He is board certified in physical medicine as well as rehabilitation and in pain management through The American Board of Physical Medicine and Rehabilitation.…