What prompts hip replacement?

MRI imaging of both the hip and the lumbar spine.
Pain can be referred in either direction.

A chiropractor would give you a good idea, might even be able to fix it.

@gently I agree with the concept that the pain can be referred pain. But I would be hesitant to go to a chiropractor until I knew what was causing it. I, for one, have both spinal and lumbar stenosis and I have a skilled neurosurgeon on call. I am hesitant to let anyone else mess with my back.

steveinarizona, sometimes people think that a chiropractor will man handle you without knowledge. Most of them read MRIs and are quite careful with adjustments. The first appointment, in my experience, has always been without adjustment. It is the most careful examination of how all of your joints are working and working together. And they talk. They tell you everything they palpate and want to know how each movement causes or relieves pain. It's the most thorough, most interactive exam ever. If you don't want the adjustment, you won't have the adjustment. Chiropractic is a way to understanding what is causing the pain. It's a way to understand what movements you should avoid to escape injury and what exercise my might employ to mitigate pain.
I applaud your hesitation and your decision for whatever reason, though I don't think chiropractors "mess" with anyone's back.

If you need a hip replacement, usually only an xray is needed to diagnose how much space is left between your femur and pelvis. MRI is usually needed for lumbar pain. Once again, quite often people have SI joint problems which is right between the hip and lumbar spine. Many people are looking for answers for pain in the same area you describe. Many times a direct diagnosis is not that easy. However, if you have no cartilage in your hip, an xray is the easiest thing to diagnose.

From having gone through all of this, I can ABSOLUTELY tell you that you might not know until they have all had attention! Absolutely get multiple opinions absolutely find a great spine and hip surgeon. You can love and trust. I had the best hip surgeon in the world, Dr. Hellgager and although my hips DID need to be done and we’re done and that pain is all gone. It was frustrating to realize there was much more to be done, and I had to find a Spine orthopedic surgeon to handle my lumbar region. A few years after the hips, the Spine needed attention and it was done. Because I have degenerative disc disease and problems with my bones as well. I will be returning periodically for repair (I sound like an auto don’t I?) There are things that will help guide you as to what to attend to first second and third. Putting shoe orthotics in and having MRIs and steroid injection on your hip will let you know if you feel better and that will let you know that you need your hips done. Having MRIs and mostly x-rays on your lower lumbar will tell you about your spine lumbar. I was very fortunate that I had conservative surgeons and I was very fortunate that I advocated for myself and got second third and even fourth opinions. I had some lousy opinions by some good doctors. You just gotta keep plugging away talk to people and continue doing your own research. Try an MFR therapist and get a good acupuncturist to relieve pain along the way. I can absolutely say that all of it needed to be done in my case and unfortunately, the neurologist kept me from my spine surgery whereas the orthopedic surgeon jumped right on it. However, the neurologist was exposed to a lot of really bad back surgeries that made things worse for people 20 years ago. He should’ve thrown me over to the orthopedic spine surgeon sooner so my spine nerves, the nerves exiting my spine wouldn’t have been crushed to their demise and I would’ve had a possibly a better recovery in that regard. Don’t delay getting in front of doctors due delay. If you don’t feel like you have enough information. Don’t be afraid be informed.

Extremely interesting question solely based on the same symptoms endured by my spouse. She chose her own orthopedic surgeon, who was affiliated with a good hospital. The diagnosis was lower back nerve compression, and my spouse agreed to go forward with the surgery. In brief, after six months the pain she initially endured was still present and, in my opinion, was worse, indicating that the lower back apparently may not be the source of her problems. Accordingly, I took her to the Hospital for Special Surgery in New York, where she was seen by a talented surgeon who ordered both lower back and hip scans; the result of the tests revealed severe arthritis in the right hip. The surgeon urged my spouse to have a hip replacement, which she agreed to proceed with the new diagnosis; it was a minimally invasive hip replacement that resulted in the resolution of my wife's pain. I am not suggesting that her back may have been in some way contributing to her pain issues, but it is very clear to me that the initial diagnosis of spinal surgery was at least questionable. I am not a physician, but I can suggest to you that if you want to avoid a wrong diagnosis, it is extremely important to:
1. Go to the very best hospital within your travel or financial circumstances, that is, a hospital rated as one of
the best for spine, knee, and hip replacements The discovery or search is easily done. with a prompt to your A.I. device. Some surgeons will take Medicare, but it has been my experience that many top-rated surgeons seek better health plans or your ability to pay the premium rates they charge, which are above Medicare rates.

2. Do your homework on the surgeon that you are most comfortable with, one that has significant experience, expresses empathy with the patient, and most importantly, feels positive about the problem, and educates the patient on the causes and solutions to the problem that you may be suffering.
There are many surgeons and hospitals across the U.S., but only a limited number that are truly the very best in treating spinal, knee, and hip replacements based on a correct diagnosis. Good luck with your intuitive analysis!
oceanconveyor

@loriesco In my case the neurologist has been the key to my back health. He has ordered the MRIs and sent me to the neurosurgeon he most trusts who is the Director of Minimally Invasive Spinal Surgery at the Barrows Neurological Institute.

I am an 81 YO male and would prefer to avoid back surgery (who doesn't want to avoid it?), especially at my age. I have been diagnosed with spinal and lumbar stenosis for many years and my neurologist has ordered and reviewed many MRIs. For most of that time it was, to the puzzlement of my neurologist, asymptomatic. Then, suddenly at the beginning of 2025 it became symptomatic radiating pain down both legs. It took me a while for an accurate plan because at the same time my right knee had failed.

Eventually my pain doctor gave me an epidural steroid shot in May of 2025 and, fingers crossed, it is still working. On October 1, 2025 I had my right knee replaced. I have a deal with the neurosurgeon...when steroid shots stop working I call him.

You don't say how old you are. I agree with you about finding the best surgeon but I would put Dr. Chow over Dr. Hellgager. Jimmy Chow replaced my left hip six years ago with a Superpath method (he is the primary inventor of that method) and my right knee a year ago using a mid vastus method, no tourniquet, a robotic assistant, the extremely rare bicruciate retaining implant and a Functional alignment to repair my severe valgus misalignment. I had zero post surgery pain after each surgery!

This really proves one of my points. Hip/knee replacement surgeons are professionals and they adhere to the Bell Curve. Some are extraordinary outliers. Some are mediocre outliers and most are somewhere in the middle. I suspect that Hellgager and Chow might be two of the positive end outliers; I know Chow is. The trick is to find the positive outliers in a cohort of thousands of surgeons in the cohort.

What is unusual is to find a hip/knee surgeon who is also a back neurosurgeon (or a back neurosurgeon who is also a hip/knee surgeon). Yours is the first instance I have seen of that. That is a singular combo but a terrific one for someone like you or me who has had to do endure both hip and back pain.

Whenever, if at all, a patient does a joint replacement, I believe that the single most important decision the patient can make is surgeon selection. Find the extraordinary outlier. For me and for my hip and knee it was Dr. Chow. For my carpal tunnel surgery (four weeks ago) it was the Director of hand surgery at the Mayo Clinic in Phoenix. She is one of the two top rated hand surgeons in Arizona. I had a previous experience with the other one so I started with him but ran out of his office after I had told him I was terrified at my age of general anesthesia and wasn't demanding perfection but just some relief. He ignored me, flatly refused to do endoscopic surgery and told me he would have to do two surgeries under general anesthesia, one on each arm. Dr. Noland, at the Mayo Clinic, listened to me and did an endoscopic surgery on my worst hand four weeks ago under local anesthesia. I had similarly switched neurosurgeons. We have scheduled the other hand for early December so I can train my non dominant hand to better handle some tasks for the first few days after the surgery.

So I couldn't agree more that one should strive for the best and keep looking until you find her. Once you do, my advice is to listen to her and to do what she says. My hip/knee surgeon believes that the most important criteria for a person looking for such a surgeon should be extensive experience doing the EXACT SAME PROCEDURE. I couldn't agree more. As I said above, my surgeon did not use a tourniquet and I am glad. But if he did, as the majority of knee surgeons still do, I would still have gone to him and let him use one because of that criteria trumping all others.

While finding a great surgeon is the hardest decision for one planning to do a joint replacement, such as a hip or a TKR or UKR, deciding whether and when to proceed is even more difficult and very personal to the patient. We are all different and our needs and wants are different.

Get MRI To Get Correct Dianosis. I take prescription vitamin D's and some over the counter. Best Wishes For You!

Sorry, wrong patient!!

The very best answer within the community of Mayo Connect that I have read comes from "loriesco," who writes a comprehensive analysis, which I believe to be thorough and right to the point. I can only add that my hip pain became so significant that I could not walk without severe pain. An X-ray taken correctly identified osteoarthritis. I chose the Hospital for Special Surgery for my r/hip, which was done on a minimally invasive basis without general anesthesia. Two hours after surgery I was walking, and seven weeks later I was back to my gym routine. It has been my lifetime experience that most hospitals treat patients much akin to another Medicare Part B patient provided by a greedy insurance carrier who pays the minimum amount for a hip replacement. Go out of the network if possible, find a great insurance carrier if you are 65+, look at the hospital ratings, and most importantly seek out references for the best surgeon who still has a heart and soul for the patient.....it's called compassion.