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Will I need a hip replacement?

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Believe it or not, hip issues can be quite confusing. Why? Because when people refer to their “hip” issues there are three totally separate anatomical areas that people refer to when they say “the hip”.

When we talk about hip replacements, this involves the head of the femur (the long bone of the leg) and the socket it fits into. This is what many people fear they have issues with when they say they have “hip” pain. However, when they point to their pain, they quickly reveal this is not the situation. The hip usually causes pain on the front of the body, by the groin. A quick x-ray of the femur head with these symptoms will reveal if a hip replacement is needed.

If the above pain pattern is not seen, there are two other areas that people refer to as the hip. These two areas are usually related to lower back issues. The first would be pain on the side of the hip. This is typically tenderness in the ITB muscle and sensitivity of the skin above this muscle. This is usually a response to irritation of the nerves that exit the lower lumbar spine. The other “hip” pain involves pain on the back side of the body, below the belt and outward where the hump of the gluteal muscle starts. Some doctors will refer to this as an issue with the SI joint. However, this joint is extremely thick and offers very little motion. In fact, if you were hit by a car, you would be more like to fracture your pelvis than to disrupt this joint.

This final “hip” pain is typically another issue with the joints of the lower lumbar spine. When they become inflamed, the inflammatory fluid will typically move downward with gravity and cover the SI joint, making it very sore. In addition, the gluteal and hip muscles are also controlled by the lower lumbar spine. Irritation of these nerves can cause muscle tightening.

So, what do you do? Come talk to us. We can assess if we need to proceed with an x-ray of the head of the femur or the lumbar spine. This is one of the most common problems we see and we would love to help you. Our number is 316-729-2528.

Ian Dopps
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