New treatment for lower back pain? Your problem may be in your hip.
Chronic pain, especially that of the lower back, is a common ailment for millions of Americans. It is one of the main reasons people stay home from work or withdraw from physical activities. Millions and millions of dollars are spent trying to treat and diagnose this chronic condition. However, if you are like me, much of this money is wasted on trying to get real results.Credit: http://img.webmd.com/dtmcms/live/webmd/consumer_assets/site_images/articles/health_tools/lower_back_pain_overview_slideshow/getty_rm_photo_of_woman_with_lower_back_pain.jpg
I have spent thousands of dollars since the age of 11 trying to find the underlying cause and treat my nagging lower back pain. I have seen 5 orthopedic surgeons, a physiatrist, an acupuncturist, 2 chiropractors, 6 physical therapists, 2 massage therapists, and finally a pain management doctor. Since high school I have been on pain killers including Naproxen, Celebrex, Vicodin, Darvocet, Tramadol, Cymbalta, Neurontin, and several other NSAIDs. With all this being said, I decided I needed to do some research myself.
After being diagnosed with Bertolotti's syndrome, overdeveloped quadriceps, arthritis, hyper mobility, and L5 sacralization, and a dry disc, I had enough information to do some obscure internet research. Strangely, I found myself looking more and more at hip problems.
The last 10 years has brought about what some may call a "fad" in hip surgery. Femo-acetabular Impingement syndrome has become a buzz word for many in the sports medicine field. Hip Impingement syndrome occurs when the ball of the femur does not fit in the hip socket quite right, either from a boney irregularity on the femur (CAM type) or by an irregularity in the acetabulum (cartilage of the hip socket) called Pincer type impingement. There can also be a combination of both. This can cause sharp pain and lead to arthritis of the hip joint or labral tears in the acetabulum, resulting in deep groin pain.
This all sounds unrelated to lower back pain, but there is an important aspect that is missing from this puzzle. A strange muscle called the iliopsoas. This runs from the femur and attaches to-you guessed it- the lower back. It acts to raise the leg and is sometimes called the hip flexor. When this is inflamed, the pain can feel like deep sacro-iliac pain in the lower back and put strain on the lattisimus dorsi muscles in the lower back too. Now if the hip socket is having to work extra hard to hold everything in place from a boney abnormality, you can the domino effect this may have on the lower back muscles.Credit: http://reddoortherapies.com/wp-content/uploads/2013/06/384ilio1.gif
Bringing hip impingement syndrome as a possibility to my doctor, he scheduled a contrast MRI to confirm that this was indeed the case. When it was confirmed and other conservative treatments clearly have not been successful, I scheduled hip arthroscopy surgery to fix the labral tear and impingement syndrome. This surgery is attractive since it is minimally invasive, requiring only 3 small holes on my hip. The surgeon inserts the surgical tool in the holes and fixes the abnormality by stitching the labral tear and shaving down the boney abnormality. Crutches are to be used from 2 weeks up to 6 weeks with physical therapy.Credit: http://www.scottbarbourmd.com/images/hip-arthroscopy.jpg
I'm writing about my experience at the end of my second week from surgery. Minus some initial iliopsoas tendonitis during the beginning of recovery, my lower back feels somewhat free of pain for the first time in years. Will this be the solution? Only time will tell.