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Back pain

I wanted to enquire about my brother's current position. Having posted earlier today that he seems to be recovering well from his hip replacement op (which he had at the end of May), and now having started cap + oxy again as of last week, I thought once that settled down and his op recovery had progressed further, we would have a period of relative calm where he just got on with dealing with his chemo regime.

However, I just had a text from his wife saying that he has been telling her that his back was hurting the last few days, near the spot where he had his dodgy hip lesion which resulted in the op having to take place in the first place. I immediately asked whether he had told his team this and apparently when his wife was texting me he was on the phone to a nurse: I don't know if this is a nurse from his oncology team, or the team who did the hip op, as they are at different units at different hospitals. Apparently the nurse who spoke to him hasn't really said anything much. He does not have another appointment with his bone team till July.

I don't know if he would be able to have another MRI scan yet, due to when he had his hip op which is very recent. He is next seeing his oncologist for pre chemo meeting the week after next.

I am already now sick with worry about this, as it was this time last year when the spot was discovered in his hip and his team prevaricated about getting bone scans etc done, it seemed to me, as they told him that spread to bone was unusual. In the wasted time I think the hip lesion grew and that resulted in him having to have the hip op.

My question is: what should he do now? Who should he be speaking to and what should he be asking them to do? He had bone scans before his hip op, which so far as I know showed nothing in his back or this would have been mentioned. Those scans were only at the end of April/beginning of May, so not even 2 months ago.

Could this be anything sinister? Or might it be the result of his mobility having been limited for a while, as he has been recovering from this op? Any advice gratefully received.

Charlotte Nurse Advisor

Dear @CD1966,

I think the first thing to say is that as your brother has recently gone through hip replacement surgery there is a strong possibility that his pain is related to that and not a sign of further deposits. As you mentioned his mobility has been reduced whilst he is recovering and this could well create some stiffness in the region. Has he been seen by a physio. Very often problems such as these can be resolved with some gentle passive physio exercises. It is reassuring that his very recent scans showed no abnormality. That being said it is always important to check out any new symptoms.

Rather than being re-scanned straightaway it is definitely worth asking his team (either the oncology or hip team) to review his last scans looking specifically in the region where he is getting the pain. I know this may sound odd but it is possible that they focused on looking at the hip replacement itself. I am not saying they did but it is always worth reviewing the scans before proceeding with new ones.

If nothing is seen on these scans and his symptoms persist it would be advisable to scan again and compare the results. This would probably be done through his oncology team.

If I can help further please do let me know.

With kindest regards,