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Hitting Back Pain Below the Belt

Pinpointing where your lower back and hip pain is coming from can be quite a puzzle

If the pieces don’t line up, no matter what procedure you undergo, including surgery, you could likely still be hurting.

Dr. Peter Ameglio, M.D.

Dr. Peter Ameglio, M.D.

Solving the mystery is something that has become a mission of Dr. Peter Ameglio at Gardner Orthopedics. Dr. Ameglio is the primary hip surgeon for the respected practice and says, “When you have done all you can to treat the hip and you’ve reached the point of surgery, you want to make sure the procedure you are offering will actually resolve the pain.”

While that might seem logical, some people with seemingly successful hip replacement surgeries still experience pain, and Dr. Ameglio has resolved to find out why.

He discovered that the cause of pain in many patients was from sacroiliitis or inflammation the sacroiliac joint (SI)

It’s located where the lower spine and pelvis connect. Sacroiliitis is typically a condition treated by spinal surgeons rather than joint surgeons, such as Dr. Ameglio. It’s a diagnosis that can fall between the cracks.

Dr. Ameglio explains, “The SI joint can mimic symptoms of an arthritic hip. I have seen patients who’ve had a hip replacement but still have symptoms of hip arthritis, even though the joint has been replaced.”

If a patient has hip and low back pain, and x-rays show arthritis, Dr. Ameglio will first inject the hip joint. If the patient is still in pain, he looks for other possible sources. That is how he landed on the SI joint.

15-30% of people with low back pain have sacroiliitis

If you are having low back and hip pain and only have a little bit of arthritis, despite what you may have been told, surgery might not be the answer. Dr. Ameglio explains, “If the patient still has a great range of motion, but they are just in pain, they are a good candidate for an SI issue.”

The sacroiliac joint functions as a shock absorber, supporting the entire spine. It dissipates the shock to the sacrum and pelvis; however, as we get older it is less able to absorb shocks. It becomes stiff and less mobile.

Problems with the SI joint often result in pain in the pelvis, around the sacrum or lower back, buttocks, groin, lateral thigh, leg, and foot. Some patients have referred pain in other areas, making an SI diagnosis even more difficult.

Patients who have had back fusion but still have pain below the belt could have an issue with the SI joint. SI could also be the culprit if you’ve had a hip replacement and your groin still hurts; your hip may not have been the problem after all. Dr. Ameglio says, “It’s not common but it happens.”

Joints in the hips and back directly affect each other and can cause overlapping symptoms. For instance, if your hip is stiff, it puts a strain on your low back and vice versa.

Surgery is not always the answer to joint pain

Dr. Ameglio and the entire team at Gardner Orthopedics view it as a last resort and in fact, have quite an arsenal of treatments to help keep you out of the operating room.

If you are having back pain below the belt, if you’ve had a hip replacement and are still in pain, if you’ve been told you have arthritis and need a hip replacement but still have great mobility, find the real source of your pain and treat it with the help of Dr. Ameglio and Gardner Orthopedics.


Gardner Orthopedics

239-277-7070

3033 Winkler Ave, Fort Myers

www.gardnerothopedics.com