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- Wed Nov 17, 2004 11:07 pm
I have always been very active and healthy. I am a volunteer EMT, which is physically strenuous. Three years ago I jumped out of a squad onto a concrete surface. I was carrying around 100lbs of equipment and landed very hard. I suffered severe, debilitating lumbar pain and was told by the doctor that I had subluxated vertebrae at L5-S1. This has severly limited my physical activity. When I lie on my side I can hear and feel my spine popping from my neck down to the mid-thoracic area. It is usually painless but occaisionally I experience sharp pain. I also have hip and thigh pain on the right side and my hip frequently catches and pops on that side, which is also quite painful. The pain often wakes me up during the night. I have been given Vicodin but it doesn't help at all. I fear that my back injury has altered my gait and in turn caused degeneration in my hip. Do I have a hip replacement in my future? I can't take NSAIDS due to a hx of gastric ulcers.
| Dr. A. Saif
- Fri Dec 10, 2004 4:51 pm
I guess Degenerative Joint Disease can occur at you age...ceratinly you sound as if you have given your joints enough workout. Osteo-arthritis can be secondary to both specific injuries to the joints, as well as repeated low grade stresses over the years.
Your back and neck
Having a spondylolisthesis, "subluxated vertebrae at L5-S1", can cause low back pain and also cause pain radiating into the legs, if nerve roots are compressed. Instability here can be due to some injury, or something you have since childhood. If a lumbar suport helps, it is said to a sign of some instability here, which perhaps might benefit from surgery. Vertical impacts can cause stressed to your discs and the facet joints in your spine. DJD in the latter can cause the popping sounds in your back, although some people have them normally.
Your hip and thigh pains could reflect disease in the hip joint. However hip joint pains are more typically focused around the groin. It may necessary to check whether the pains in your thigh and side do not represent nerve root problems, caused by your back. Another cause of such pain may be DJD in the sacro-iliac joints...
Back problems can certainly cause abnormal gait, just as hip problems can...it is probably likely from your story that that both are caused by your previous stresses to your body.
If you can't take NSAIDs ( there are newer ones that do not irritate the stomach such as Celecoxib), it does limit the spectrum of drugs that help this condition. Physiotherapy and swimming will help in most cases. More radical treatment whether it is hip replacement, or spinal surgery to stabilise your lower back, requires a greater detailed examination and investigation. If you are having sleepless nights, I guess you need some help, and I would suggest you approach your friendly neighbourhood orthopedic surgeon for help. He may examine you to evaluate whther the pin in your hip comes from your hip or your back, do some blood tests to ensure your joints are not affected by some systemic inflamatory condition and perhaps do an X-ray of your pelvis, if he feels your hip is the culprit. At your relative youth, perhaps a hip replacement is bit extreme, and as for predicting whether you will need one in the future...welll it is a common operation, but my crystal ball has sadly lost its shine ;-)
Hope this helps