A Review of Hip-Spine Syndrome

Abstract

Purpose of ReviewThis review is aimed at summarizing our current understanding of hip-spine syndrome. In particular, the review discusses the clinical assessment and diagnosis of commonly implicated conditions to help a practitioner realize an efficient and organized approach to the evaluation and management of pain in the setting of hip-spine syndrome.Recent FindingsWhile initially described as the concurrent presence of hip osteoarthritis and lumbar spinal stenosis, the catalog of diagnoses associated with hip-spine syndrome has expanded and includes femoroacetabular impingement, acetabular dysplasia, hip osteoarthritis, sacroiliac joint-mediated pain, facet arthropathy, and lumbar spinal stenosis. There is a limited body of evidence describing clinical findings and treatment recommendations when these diagnoses present concurrently. From the available literature, it seems that patients may be successfully managed with a multimodal approach, although absolute resolution of symptoms is not always plausible.SummaryIn the context of hip-spine syndrome, identification of a primary pain generator or etiology, when present, is important to guide successful management. Lingering symptoms may persist and can suggest the presence of a more co-dependent relationship between the hip and the spine (so-called complex hip-spine syndrome). Further research is needed to clarify the influences that underlie hip-spine syndrome, particularly in these more complex cases, and in turn better define diagnostic and treatment algorithms.