Lumbago After Hip Endoprosthesis
A 62-year-old man with hip replacements on both sides within one year came to my practice because he had developed severe pain in the lumbar spine on the left side ca. five months after the second operation. This pain had already persisted for four to five weeks now and was present almost continuously when at rest and as warm-up pain.
Hip mobility was limited on both sides in all directions, a consequence of the joint replacement. The LSC was reduced in its mobility as well, which can probably also be interpreted as arthritic changes.
On the left side, I was struck by the extreme tenderness of a back muscle (quadratus lumborum). I found trigger points there, a sign of strain in the muscle. This muscle strain could have arisen during the rehab stage following the hip operation. Now that the patient was able to fully pursue his old occupation, the damaged muscle was piping up and causing the back pain.
I treated the trigger points and sent him home with a stretching exercise as homework. After one week, the pain was clearly improved, after an additional week it was practically gone.
Sometimes we have a tendency to think around several corners, to make something more complicated than it is. This case showed once again that trigger points alone can be enough to make life difficult.