Lower back pain in combo with hip issues

You needed to describe where the pain was exactly in order for us to be more helpful, but I can say that I would get locked up at the end of my hips, having ran out of their cushion. It was an excruciating pain going from a seated position to standing. Luckily, I was in the queue for surgery. But I got stuck one night I couldn’t get up off the floor. I got stuck in the driver seat. I got stuck at the dining room table. After I had one hip done, I handed the surgeon a check to do the other hip. He said no Miss Escalera you don’t need it and I said yes I do. I did need it. They can’t see everything on an MRI and I was missing some cushion in the other hip. After the hips were done in 2012 in 2014 the pain in my back didn’t stop and in 2018 I had lumbar fusion surgery. They all needed to be done. And then I was a very happy camper. In the meantime of 20 years, I had every procedure known to man the surgeries fixed everything. I have degenerative disc condition and osteoarthritis. They all needed to be done eventually. Get yourself a good orthopedic surgeon who will know when it’s the right time for everything.

@marjul so you’ve used steroid injections to deal with the pain. You obviously have received a diagnosis for your back ailments and hoping to postpone surgery as long as you can tolerate. You maybe at that point to consider something more invasive unfortunately? I’m sure you’ve read plenty of posts by people asking similar questions. Please get a second opinion and go to someone who has done many backs and at a larger teaching hospital so you receive optimum care.

@jenatsky

I agree but don't assume that because a surgeon works out of a teaching hospital, he is terrific. There are duds in those positions.

My view is that the overall level of medical knowledge and delivery is greater at facilities like the Mayo Clinic and Cleveland Clinic and at teaching hospital groups like Harvard (Mass General, Brigham and Women's, etc.) but the very best individual for a particular procedure might be outside of one of those groups.

I would research neurosurgeons. My neurologist, top rated in the city, wanted me to get an opinion from a neurosurgeon on my stenosis and the surgeon we wanted to see was temporarily not taking my insurance. So he sent me to another surgeon who reviewed my MRIs and declared that if he did surgery, he would have to start with the stenosis in my neck and it was so bad in there that he could not go in minimally invasively.

I didn't trust his skill. The surgeon my neurologist wanted me to see finally was able to schedule an appointment with me. We put off any analysis until my knee situation was resolved but he said he could go in from the front minimally invasively if surgery were needed (he has written a primer for surgeons on doing minimally invasive spinal surgery). I trust this surgeon and I trust that he will not recommend surgery unless he is convinced that it is the best and only solution.

The first neurosurgeon was highly rated; the second, my current neurosurgeon, is top rated. Starting at a teaching hospital, if there is one in your area, is a terrific starting point. But then research the heck out of the results and check locally to see if there is some great surgeon out there for your particular operation.

For example, there is a surgeon in Los Angeles that is considered the best for elbows, shoulders, etc.: Neal Elattrache. Professional athletes flock to him. he is a single practitioner.

So my advice is research, research, research and then research some more. One more example. My brother, in a small city in the middle of the country, was getting a knee replaced at the same time as me. He is a busy Professor and he stopped once he found the best rated knee surgeon that city (someone with a bit of a positive reputation for doing knees but a conservative surgeon). I am retired and had time to do a lot more research and found a surgeon who met all of my requirements:

newest approach (sub or mid vastus)
no tourinquet
if my ACL is strong, do a BCR procedure
fix my severe misalignment (valgus) with one of the newer tools (kinetic, inverse kinetic, functional, etc.)
Has successfully performed ) many (at least a hundred) such procedures
Great mind
Great hands

Fortunately I found someone who met all of these requirements and is in my city. Once I identified a possible I research the heck out of her and the procedure. For example, I found a video of my surgeon doing exactly this procedure, back in 2020 at an Orthopedic Innovations Conference.

We had our operations within five days of each other. The only pain I had/have is some pain around the incision site that mostly goes away after about twenty feet of walking. I never took a pain pill. My brother is on opiods and is in constant pain. His doctor did use a tourinquet, did cut the tendon, etc. Two years down the road we will probably be the same. But the process of getting there can be a lot more painful if one doesn't fully do one's research.

Steve, doctors who are teaching new physicians are usually at the top of their game. Otherwise why would you want them teaching inferior techniques to up and coming docs? It looks bad for the schools reputation and ranking. Also, the number of those procedures a year the surgeon does is also a good point to consider. Bad docs usually aren’t doing a lot of surgeries, hence they are not practiced enough. Lucky for me my neck is fine and I will not have any further surgery than my L4-S1 fusion from 1990.

In my opinion re: teaching hospitals (remember the residents are doing the surgery with the attending only needing to be present for the “key aspects” of the surgery), is to avoid the chairman of the department. It might seem like they would be the best and lots of VIP patients insist on the chairman. This can be a mistake. They are usually older and spend a significant portion of their time away from the OR. That is a generality of course.

I had a fusion of the L5, S1 in 2010 and then in 2012, I had to go to Northwestern in Chicago, Illinois because I developed Ectopic bone.
I also have terrible pain in my R-hip and I had a CT scan with contrast and it showed Osteoarthritis. I would ask your Orthopedic surgeon or your family doctor for a CT scan or MRI to see what it shows. If it shows bone on bone, then it's possible you could be looking at a hip replacement. Do you hear any clicking when you move your hip?
I know it can be very painful! My husband and I try to walk every night and it's difficult, because the hip pain can hurt worse than my back.
I hope you get some kind of resolution with your hip. Get a CT or MRI , that's the 1st step.
Wishing you all the best.