Orthopedic surgeons are aware of the hip-spine syndrome but no one has ever studied it. The hip-spine syndrome refers to low back pain (LBP) that occurs as a result of hip osteoarthritis (OA). This is the first study to show the positive effect of hip replacement on low back pain.

The authors set out to see if reducing hip pain and improving hip function would change back pain. Patients with severe hip OA who were scheduled to have a total hip replacement were included in the study. All patients in the study also had at least moderate LBP.

Everyone was followed for a minimum of two years. After two years, patients were still reporting continued improvement in pain levels and function of the hip. Improvement in LBP did not change from what was experienced by the end of three months after hip replacement. But relief from back pain was maintained at the two-year follow-up.

This study documented improvement in back pain and function after hip replacement. The results validate the theory that hip-spine syndrome is a real condition.

The exact cause remains unknown. Change in posture because of pain may be a factor. The authors were unable to show that it was from a true change in the spinal or sacral alignment. Future studies may be able to identify the link between these two sets of symptoms.

Peleg Ben-Galim, MD, et al. The Effect of Total Hip Replacement Surgery on Low Back Pain in Severe Osteoarthritis of the Hip. In Spine. September 1, 2007. Vol. 32. No. 19. Pp. 2099-2102.