I got some not surprising news. I'm still swimming daily and it feels good, but my lower back is still super achy and actually feeling a little worse (I overdid the yard work, because I'm an idiot).
I got two massage treatments that were awesome (my partner is a masseuse/acupuncturist) and they suspect that I have disc damage.
I got x rays, which of course don't show soft tissue problems, and now I'm waiting for my MRI request to go through insurance.
The not surprising part is that I have advanced arthritis in my hip.
I asked if that means I need a hip replacement. The doctor said at some point I will, but I'm "a little young" (56).
The lower back is definitely more problematic than the hip, but how much is the hip affecting the back, and vice versa?
My inclination is to just get the hip replacement now. I'm not sure why I should wait?
That would be a very good question for your surgeon.
I literally just had my femur broken just to buy time before likely needing hip replacement, so yeah, the waiting part is important.
Why? Because hip replacements have a lifespan and because you can only replace them so many times.
No one can tell you what that lifespan will be (could be 15 years, could be over 25), and when it fails, it makes the revision surgery harder and less predictable, and "success" is seen through the lense of patients having "realistic" expectations of how a second artificial hip should function.
That said, you also don't want to wait too long, at a certain point damage can make the surgery less predictable as well.
So there is some golden window for hip replacement, but who knows what the hell that actually is for an individual. Hence why the consensus is basically: put it off for as long as you can reasonably function.
For me, I was 38 when I lost my ability to walk due to hip damage, but I had almost no arthritis and breaking and rotating my femur could theoretically prevent arthritis, but most likely would buy me 20 years before hip replacement, otherwise I would need hip replacement before 40.
A friend of mine had the same exact issue (no coincidence, we're friends because we have the same issue). But she was 43, obese, and a former smoker, she also had substantial arthritis. Breaking her femur wasn't a great option, so she got hip replacement in her mid 40s.
We were both needing wheelchairs by the time we had our surgeries, so both had urgent need for intervention of some sort. The choice for either of us wasn't obvious, and strong patient preference could have theoretically tipped the scales for the surgeon (same surgeon) to change the plan in either case.
All this to say, it's pretty nuanced, and the key is to find a surgeon whose instincts you trust.
ETA: don't ask me how my surgery turned out, my surgeon has aged a few years thanks to my case. Not his fault, I'm just more nuanced than expected. My buddy though, she's doing great and was hiking by month 2.