Spinewala: Your Back In Action.

World AIDS Day Awareness Blog

By Dr. Om Patil – Endoscopic Spine Surgeon, Mumbai

Low back pain and hip pain are among the most common musculoskeletal complaints worldwide—but in immunocompromised patients, including those living with HIV/AIDS, these symptoms require special attention. Their reduced immunity changes both the kind of spine/hip conditions they develop and the way these conditions progress.

On the occasion of World AIDS Day, it’s important to raise awareness about how HIV and immunosuppression affect the spine, joints, and overall musculoskeletal health. Early recognition and timely care can prevent serious complications and improve quality of life.

Why Do Immunocompromised Patients Develop More Back & Hip Pain?

Immunocompromised individuals include:

People living with HIV/AIDS Patients on long-term steroids, immunosuppressants, or chemotherapy Organ transplant recipients Elderly individuals with weakened immunity

Their weakened defense system makes them more prone to infections, inflammatory disorders, degenerative changes, and medication-related bone loss.

Common Causes of Low Back Pain & Hip Pain

1. Infectious Causes (Most Important)

Immunocompromised patients are at higher risk of spine and joint infections, such as:

✔ Spinal Tuberculosis (TB) – Pott’s Spine

Very common in India, especially among HIV patients.

Symptoms:

Severe back pain Night sweats Fever Weight loss Leg weakness Difficulty walking

✔ Pyogenic (Bacterial) Spondylodiscitis

Rapidly progressive and can lead to deformity or paralysis if not treated early.

✔ Septic Arthritis of the Hip

Bacterial infection of the hip joint causing:

Severe groin/hip pain Inability to bear weight Fever Swelling

✔ Fungal Infections

Seen in advanced HIV or patients on high-dose immunosuppression.

2. Inflammatory & Autoimmune Causes

HIV can trigger or worsen conditions like:

Reactive arthritis Psoriatic arthritis Sacroiliitis These lead to persistent hip and lower back stiffness, especially in the morning.

3. Degenerative Spine Disorders

Because of chronic inflammation and medication effects, HIV patients often experience early degeneration such as:

Disc prolapse (slip disc) Lumbar spondylosis Facet arthropathy Hip osteoarthritis

These conditions cause radiating leg pain (sciatica), tingling, or numbness.

4. Bone Loss Due to Medications

Long-term use of:

Steroids Antiretroviral therapy (ART) Chemotherapy drugs

…can weaken bones, leading to:

Osteopenia Osteoporosis Vertebral fractures Avascular necrosis (AVN) of the hip

AVN is especially common in HIV patients and causes deep groin pain, limping, and reduced mobility.

Warning Signs That Need Immediate Medical Attention

Seek urgent evaluation if you or your patient experiences:

Fever with back pain Sudden inability to walk or bear weight Night pain worsening over time Numbness, tingling, or weakness in legs Loss of bladder or bowel control Rapid weight loss

These could indicate serious infections or spine instability that require emergency care.

Diagnosis: Why Evaluation Should Not Be Delayed

For immunocompromised patients, early imaging and investigations are crucial.

Essential tests:

MRI of spine or hip X-ray / CT Scan Blood tests: ESR, CRP, CBC HIV viral load & CD4 count TB PCR (GeneXpert) Joint aspiration if infection suspected

Early diagnosis prevents complications like deformity, paralysis, or hip destruction.

Treatment Options

1. Medical Management

Depending on the cause, treatment may include:

Antibiotics (bacterial infections) Anti-TB therapy (spinal TB) Antifungals Anti-inflammatory medications ART optimization Vitamin D & calcium supplementation

Pain control and inflammation management are essential.

2. Non-Surgical / Minimally Invasive Spine Treatments

For stable conditions, we offer:

Physiotherapy for mobility Core strengthening Posture training Epidural or nerve root block injections Ozone/PRP for selected degenerative cases

These help reduce pain and improve function.

3. Surgical Management (Only When Necessary)

Spine Infection Surgery

Indicated when there is instability, abscess formation, or neurological deficit.

Modern techniques like endoscopic and minimally invasive decompression allow faster recovery with reduced blood loss—especially important for HIV patients.

Hip Infection Surgery

Arthroscopic washout, drainage, or joint replacement if the hip joint is severely damaged.

AVN of Hip

Depending on stage:

Core decompression PRP/BMAC regenerative therapy Total hip replacement in advanced cases

Prevention: Protecting the Spine & Joints in Immunocompromised Patients

✔ Maintain a strong immune system

Regular ART in HIV patients Adequate nutrition Control chronic illnesses Avoid smoking & alcohol

✔ Prevent bone loss

Vitamin D & calcium Weight-bearing exercises Regular bone density scans

✔ Early physiotherapy

Keeps spine flexible and reduces mechanical pain.

✔ Avoid heavy weightlifting

The spine is more vulnerable when immunity is low.

✔ Regular follow-up with your spine specialist

Early intervention → better outcomes.

Key Message for World AIDS Day

People living with HIV can lead full, active, pain-free lives with proper care.

Back pain or hip pain should never be ignored—because in immunocompromised individuals, even “simple pain” can be the first sign of a serious condition.

Spreading awareness, encouraging early diagnosis, and reducing stigma can save lives.

About the Author

Dr. Om Patil

Endoscopic Spine Surgeon – Mumbai

Founder, Spinewala | Your Back In Action

🌐 Websites: Endospineworld.com | Spinewala.com

📞 9819191896 , 9819195885, 9819195150

📍 Dadar East | Chembur East, Mumbai