Various conditions of the lower back, or Lumbar Spine, can cause pain that may be felt as hip pain. These include osteoarthritis of the small joints in the spine called Facet Joints, stenosis (narrowing) of the spinal canal or neural foramen where the spinal nerves exit the spine and form the main nerves going to the pelvis and legs, and degenerative disc disease, where the discs between the bones of the spine, become thinner and lose their supportive properties. The pain caused by these pathologies can sometimes be mis-interpreted as pain caused by hip osteoarthritis. Often, a patient will have BOTH hip arthritis AND low back pain. It is important in these cases to identify the true cause of the pain, as performing a Total Hip replacement on a patient with early OA of the hip may not take away their pain if it is due to degenerative changes of the lumbar spine.
Dr. Thornton-Bott will assess you for both hip pain and low back pain. If your pain history and clinical examination indicate it, an X-ray of the lumbar spine will be arranged. If this shows any of the degenerative changes described above, then he can arrange further imaging such as an MRI. If both hip and lumbar spine show problems, Dr. Thornton-Bott will arrange an injection of local anaesthetic and steroid into your hip. The benefits of this procedure, which is performed under image guidance, is that it will identify the level of pain that is being caused by your hip OA.
Following a hip injection, if you have complete resolution of your pain, even if only for a short period, then it will prove that it is indeed your hip OA that is your main problem. If the injection has little effect on your pain, then it is likely that your spine is the main cause. Following this determination of the cause of the pain, Dr. Thornton-Bott will then discuss with you further management. The steroid injection into the hip can often be very therapeutic and take away your hip pain for months and sometimes even up to a year. If the pain in your hip is relieved by the hip injection but lasts only a short time, it is likely that your hip arthritis is more advanced and will likely require surgery.
If it is your lumbar spine that is causing the main problem, then a steroid injection into the offending area can often prove very effective. Failing this, Dr. Thornton-Bott will refer you on to a Spinal Colleague for further management.