Should I do THR when I have back pain?

whyme6666, I would definitely have the lumbar MRI first. It shouldn't delay the THR which you may need without regard for the MRI results. THR can distort MRI imaging of the lumbar spine. And MRI can heat the metals used in THR. Simpler and more accurate to have the MRI first.

Thank you. Yes, I wondered how THR patients deal with back issues.

Hello, I, too had lower back pain, sciatica on my right side. It was difficult to discern which one was causing pain down my leg, as hip was severe and needed hip replacement. My orthopedic gave me a steroid injection and PT which relieved hip pain temporarily. He recommended I see spine specialist prior to scheduling THR. Spine specialist did an MRI which showed a bone cyst on L4/5 which was impeding sciatica plus a very inflamed SI joint. I received 2 separate x-ray guided steroid injections to address both issues which offered a huge pain relief. In the states, surgery cannot be done for 3 months post hip steriod injection. For me, the relief I received from the reduced inflammation caused by back pain, allowed me to go ahead and schedule anterior THR surgery Feb 20, 2025. I spent one night in hospital d/t other medical precautions, then one week in a rehab, 2 weeks home physical therapy followed by 6 weeks out patient PT. I am 73, lived alone and knew I'd be unable to take care of all my needs by myself. After one year, I'm doing well and glad I addressed lower back pain first. Best of luck to you!

I had both--I went to the spine specialist who told me I needed a Hip Replacement, then come back to address the lumbar stenosis and sciatica. They do interplay with each other. It's all the same skeletal structure. After the HR, I have had the spinal injections for my back and sciatica which has worked well for me. I see the spine specialist annually and he monitors my changes. Everyone is different but be your own advocate, and keep searching for that elusive cure!

I have had spinal and lumbar stenosis for years but it was asymptomatic which always surprised my neurologist. At the beginning of 2025 it suddenly became symptomatic with pain radiating down both legs, especially my left leg. About a year and a half before that I had a left hip replacement.

It took a couple of months before I realized that my right leg pain was not only from my back but also from my knee. A pain doctor had given me a steroid shot on my left side and that side stopped hurting. He then gave me a caudal one for both sides and I still had the pain on the right leg. That is when I realized that most of it was from my knee. X-Rays showed arthritis on both compartments and I went back to my knee/hip surgeon. About 5.5 months ago he replaced my right knee.

I had zero pain from both replacements. In the meantime I had a neurosurgeon who has written a primer for other surgeons on how to perform minimally invasive spinal surgery. We made a deal: when the steroid shots cease working, I call him.

So far...no calls as I have had zero pain from both replacements and the steroid shot I had about 10 months ago appears to still be working. I am an 80 YO male and before my RTKR I told my surgeon that I wanted to be back on the golf course by the end of the fourth week. He responded that this was an aggressive target but he was up to the challenge. On the 27th day post surgery, I was again playing golf.

Not sure you need spinal MRI, but if you have concerns about low back it may be useful to have side views of the low back sitting and standing. If you have had fusion or relatively inflexible spine this may impact your dislocation risk, and surgical technique and hardware. If the surgeon doesn't agree or appear to have heard of this, suggest a second opinion. Best wishes

I suffered from back pain since my late 20's. I had terrible back spasms that were debilitating. Spent a lot of time with chiropractors which was always a temporary fix. When I turned 60, I was diagnosed with spinal stenosis and was told I needed back surgery that requires rods and screws. I put that off for ten years until I developed this horrible groin pain. Research told me that it could be related to my stenosis, so I went to see my neuro surgeon who told me that it was my hip that was causing the groin pain. He took an MRI and exposed how bad my stenosis had become and told me that surgery should be done right away to avoid possible paralysis. So I had the surgery done and was told that my hip surgery would have to wait for 6 months to avoid any possible complications with having two surgeries close together. At exactly 6 months, I had my hip replaced, but had to endure the horrible groin pain for 6 months waiting for my THR. Upon reflection, if I could do it over, I would have done the THR first, then my back. The hip recovery time is far less than the back surgery recovery time. At 6 months my hip would be fully healed, and then I could focus on my back recovery. As it is now, I'm trying to recover from both and it is going to take a lot longer for me to fully recover. So, that is my advice for you. Do the hip first. Recover. Then focus on your back.

Thank you everyone.
I am booked for THR April 28.
I hope that it might help my lower back above and left knee below feel better.
I saw a chiro who said that my pelvis it torsioned slightly hence the development of my spinal synovial cyst 7 years ago. I seem develop a back issue every time I get a job sitting at a desk!