Spinal Fusion: Causes of Hip Pain After Procedure

Experiencing hip pain after spinal fusion surgery is relatively common. However, finding relief necessitates determining the main cause and choosing the right treatment.

Spinal fusion is a procedure to connect (fuse) two or more vertebrae. It is frequently done to relieve pain and improve spinal stability.

While it can be useful for many, it can occasionally cause new problems, such as hip or pelvic pain. This is typically related to the relationship between the spine and the hip, which may be injured as a result of surgery.

If you've had spinal fusion and are experiencing hip pain, you may be wondering if the two are related.

This article discusses the spine-hip link, the causes of hip pain after spinal fusion, and your treatment choices.

The link between the spine and hip

Your bones and muscles are connected from your head to your toes to help you move around.

The pelvis and spine, in particular, attach your upper body to your lower body. The sacroiliac (SI) joint joins each side of the sacrum (the bottom of your spine) to the inside surface of the ilium (the butterfly-shaped hip bone).

The acetabulum, a hip socket that holds your femur bone in place, also connects your pelvis to your femur (thigh bone).

Because your pelvis and spine are so tightly linked and play such an important part in the movement, problems in one might impact the other.

Potential causes of pain

You'll need time to heal after spinal fusion surgery, which means you'll be less active. To protect yourself while you heal, your muscles may stiffen and work differently than usual.

For example, your hip flexors may stiffen, putting additional strain on your hips and producing further pain.

Because the spine — particularly the lumbar spine — and hips are inextricably linked, decreased lumbar spine mobility may increase reliance and stress on the pelvis and hips to maintain posture and support movement.

Spinal fusion surgery is known to produce alterations in posture and gait (walking and balance) and may need overcompensation of the hips and pelvis, resulting in pain or discomfort. Furthermore, increased stress on the sacroiliac joint may result in increased pain.

There are numerous possible reasons for hip pain after spinal fusion. The main causes include:

1. greater load onto the SI joint after spinal fusion

2. misdiagnosis of back issues instead of hip issues

3. bone graft harvesting in the iliac joint (which is next to the SI joint)

4. concurrent spine and hip issues (known as hip-spine syndrome)

5. muscle weakness (which is why physical therapy is often recommended).

Treatment of hip pain after spinal fusion

Because hip pain after spinal fusion is multifactorial, you'll need to work closely with your healthcare expert to receive a proper assessment, especially if the pain does not improve or worsens following recovery from surgery.

Conservative therapies, such as nonsteroidal anti-inflammatory medicines (e.g., ibuprofen, naproxen), wearing a pelvic belt to reduce hip mobility, and physical therapy, are likely to be recommended first.

During physical therapy, your therapist may employ techniques to increase pelvic stability, restore posture and balance, address any walking and balancing issues, and strengthen the surrounding musculature.

If conservative treatments are ineffective, steroid injections or surgery may be required.

Few more facts

- Hip pain, particularly SI joint pain, is extremely frequent after spinal fusion surgery, affecting an estimated 32-42% of patients. However, this number includes patients who may have had pre-existing SI pain before the surgery.

- Your hip pain may be transient as you recover after surgery, or it may last much longer and necessitate treatment, depending on the cause.

- Your hip pain could be a sign of a failed spinal fusion, commonly known as failed back surgery syndrome. New or exacerbated pain, burning, tingling, or weakness in the lower limbs, restricted movement, headaches or neck pain, or a return of past symptoms are all signs of a failed spinal fusion.

In conclusion

Because the hips and spine are so tightly linked, if one is injured or has restricted mobility, the other may have to compensate.

To improve your post-surgical prognosis, make sure you and your surgeon have a good grasp of any other co-existing hip and pelvic disorders before opting to undergo spinal fusion surgery.

Following spinal fusion surgery, it is normal for the hips to "pick up the slack" from the spine, which can produce pain or discomfort.

Your healthcare practitioner may offer first-line treatments such as pain medication or physical therapy to improve strength, posture, and hip stability to ease this pain. Additional surgery may be required in rare circumstances.

If you feel that a spinal fusion causes your hip pain, consult with your doctor about the best course of treatment for you.