Low back pain in hip replacement? As you know, we’re big advocates for the concept of the “hip bone’s connected to the back bone, and the leg bone’s connected to the knee bone…” We often see patients who have both hip and back pain and many assume that their back pain is a result of them walking funny due to pain. However, we have also frequently observed that fixing the low back in many of these patients often takes their hip pain away, especially if you catch them early in this cycle (before severe hip arthritis sets in). We often observe the same thing with low back and knee pain. Why? Some of the nerves in the low back can shoot pain to the hip. In addition, recent studies have started to show the inter-relationship between pain, nerves, and arthritis. A recent study supports this concept, finding that almost 50% of patients undergoing total hip replacement had low back pain. The rest of the study shows a complex inter-relationship between the hip and low back. For example, about 2/3’rds of patients had their back pain resolve after hip replacement surgery (which begs the question if 1/3 of these patients actually had their low back problem leading to most of their hip pain) and 20% had back pain develop after their hip replacement (which begs the question of if their hip pain was really a sentinel of their low back problem). The upshot? If you have low back and hip pain consider asking your doctor for a simple diagnostic test known as a “diagnostic block” of the hip. I would make sure the doctor that performs the block doesn’t use steroids as the high doses commonly used may make your back feel better even though the medications are being placed in your hip. In this procedure, the doctor will only numb the hip to ensure that all of your pain goes away. If all of your back and hip doesn’t go away, a doctor needs to take a closer look at your low back, and being evaluated for a Regenexx procedure could provide a logical and health saving hip replacement alternative.