A Hidden Cause Of Low Back Pain
While there are many causes of lower back pain, a commonly overlooked cause is the sacroiliac joint. The sacroiliac joint is a commonly underdiagnosed cause of both acute and chronic back pain. This is because the pain is typically located in the lower back and can radiate to the groin and buttock which is also common with hip problems, sciatica or even a pinched nerve.
Then SIJ is located in the pelvis and connects the base of the spine to the hip bones . Your SI joint is supported by various muscles and ligaments that let your body transfer energy from your legs to your body when you walk, run or move around. These muscles and ligaments also act as shock absorbers from your lower body and reduce compression on your spine.
There are several potential causes of SI joint pain, but the most common include injury, such as a fall on the buttock, a sudden twist or lifting from a twisted position. Other causes of SIJ pain include osteoarthritis, intense exercise, or biomechanical problems such as an abnormal walking pattern. SI joint pain is also common during pregnancy.
Stretching the muscles around your SI joint may help reduce pain by relieving tension in your lower back. Doing a few stretches for a couple of minutes each day can be beneficial. Its important to note that when stretching its always better to be too gentle than too aggressive. Stretching too vigorously can worsen your symptoms. Here are a few stretches you can try at home:
Causes Of Hip Pain In Women
When a female patient comes to Dr. Siegrist complaining of hip pain, she considers the patient’s age, build, and activity level. If the patient is a thin 20-year-old runner or a heavy, sedentary 80-year-old grandmother, the possibilities at the top of my list will be different, she says.
Among the most common causes of hip pain in women are:
1. Arthritis Chronic hip pain in women is often due to arthritis, particularly osteoarthritis, the wear-and-tear kind that affects many people as they age. The ball-and-socket joint starts to wear out, Siegrist says. Arthritis pain is often felt in the front of your thigh or in the groin, because of stiffness or swelling in the joint.
2. Hip fractures Hip fractures are common in older women, especially those with osteoporosis . Symptoms of a hip fracture include pain when you straighten, lift, or stand on your leg. Also, the toes on your injured side will appear to turn out, a sign that can aid your doctors preliminary diagnosis.
How Doctors Get To Root Of Your Pain
If you have pain in your lower body and arent sure whether your back or hip is to blame, a good first course of action is to visit your personal doctor. He or she will review your medical history and may perform a series of physical exam tests to get to the root of your pain. Alternatively, your personal doctor may refer you to a doctor who specializes in the hip or spine to make an accurate diagnosis.
Your doctor will ask you to describe your pain, including its location, when it worsens/is relieved, and what the pain feels like .
After listening to your description of your pain, your doctor may have you perform several maneuvers or movements as part of a physical exam. The goal of these maneuvers is to determine what movements recreate your pain. One such maneuver is called the Flexion Abduction External Rotation test, which helps determine if the disorder is sourced in your hip and may illuminate sacroiliac joint problems. During this test, you lie down your back while flexing and rotating your hips. Your doctor may also palpate the area of pain.
Next, your doctor may also order imaging scans, such an x-ray to view your bones or an MRI to view soft tissues , which may help reveal the true nature of the spinal or hip problem. It is important for your doctor to then determine if your complaints and exam findings can be explained by what is seen on the images.
What Does Spinal Stenosis
For some patients, spinal stenosis-related hip pain is mild and occasional. For others, the pain is severe and increases gradually over an extended period of time. It is also possible for the hip pain to extend through the buttocks and the groin or radiate down through the legs.
Generally, spinal stenosis-related hip pain only affects one side of the body. It typically occurs when the space inside the spinal canal and between vertebrae narrows and compresses a nerve root in the lower spine. Nerve roots are structures that branch off the spinal cord on the left and right sides of the spinal column and travel out to provide motor and sensory function to the rest of the body. The pain caused by nerve root compression is often limited to the side of the body served by the nerve root being compressed.
Timing Of Movement: Athletes With And Without A History Of Lbp
One aspect of coordination considered important to LBP is the timing of movement of the lumbopelvic region, in particular, early lumbopelvic movement during a limb movement. The proposal is that if the lumbopelvic region moves early in a limb movement, the frequency of lumbopelvic movement might increase across the day. The increased frequency could contribute to accumulation of tissue stress in the lumbopelvic region and, eventually, LBP symptoms. Our studies based on clinical measures indicate that many people with LBP display the early lumbopelvic-movement pattern with limb movements.62 We did not know, however, whether the pattern was specific to people with LBP. We compared our LBP group with our group without a history of LBP who were active but did not regularly participate in rotation-related sports.49 We predicted that, compared with subjects without a history of LBP, subjects with a history LBP would display earlier lumbopelvic movement during the limb-movement tests.
Subjects were positioned with the hip in neutral abduction and adduction and neutral rotation. For the HLR test, the knee was positioned in 90° of flexion. Subjects were instructed to move as far as they could in each lower extremity test while kinematics were collected.
To Relieve Hip Pain Try Thesefirst:
- See your primary care doctor. He or she will likely prescribe nonsteroidal anti-inflammatory drugs to see if hip pain improves.
- Lose weight. Shedding extra pounds is critical in relieving hip pain. Losing weight often reduces symptoms to the point where surgery is not necessary, says Dr. Murray. It also increases your chances of a successful outcome if surgery is one day warranted.
Common Causes Of Weak Hips And Lower Back Pain
- Prolonged periods of sitting cause the hip flexors to become shortened and weakened. This can lead to the pelvis being pulled out of its healthy alignment, affecting the lower back.
- Uneven posture when standing, such as shifting your weight onto one leg, slouching in one hip, or carrying kids on one hip causes muscles to contract unevenly, affecting the muscles.
- Certain exercises can cause dominance in one area of the body or weakness in another. Weak glutes are fairly common in runners.
- Pregnancy and giving birth affects the pelvic region and can lead to lower back pain. A Womens Health PT can help support you with the unique issues affecting womens bodies.
- Stress: when we are in fight-or-flight mode, the muscles of the hips tense up as the body prepares to take action, even when there isnt a physical threat. Prolonged periods of low-level state of stress causes unconscious tensing of the muscles that cause issues over time.
Early And Correct Diagnosis Is Key
When seeing a physician for hip or lower back pain, imaging such as x-rays and MRIs are usually conducted at the sight of the symptoms. Yet, these studies can sometimes show abnormalities that are not actually the root cause of the pain. Let me share a quick example.
A fifty-year-old gentleman had severe pain in the outside of his hip. He saw a physician and had an x-ray of the hip area performed. It was determined that he had mild arthritis in the hip, but the arthritis should not have caused the extensive symptoms he was enduring.
So, he started physical therapy for a period of time and saw no improvement. He then received a cortisone shot in the hip, and that didnt work either. His treatment plan moved on to a stem cell injection with platelet rich plasma in the hip, which also offered no improvement to his symptoms.
This mans symptoms started in April and proceeded to get worse and worse to the point that he was in a wheelchair when he came to the OrthoVirginia office in August. I looked over his symptoms and decided to have a MRI performed on his lower back, even though he had absolutely zero pain coming from his lumbar spine.
It turned out that the L3 and L4 nerves in his back were being compressed, and the symptoms were appearing in his hip. A minimally invasive surgery was performed, and his pain was gone immediately.
Sharp Pain In The Lower Back And Hip On One Side
A shooting and sharp pain felt on one side on your lower back and hip may be caused by muscle spasm, joint dysfunction, and/or nerve compression in the region. Common conditions that cause this type of pain are discussed below.
Spasm of the piriformis muscle located deep in the buttock may cause 5:
- Moderate to severe lower back, hip, and buttock pain
- Referred pain that may extend into the back of the thigh
- Inability to sit for a long time
The pain is typically felt on one side and may be worsened by hip movements, such as when getting out of bed.5
Piriformis syndrome is commonly caused by overactivity of the hip rotator muscles or sitting on hard surfaces for prolonged periods of time. An injury to the buttock may also cause this pain.6
Read more: What Is Piriformis Syndrome?
Is It My Hip Or My Back 5 Causes Of Hip And Lower Back Pain
As an orthopedic surgeon, when I hear about complaints of hip pain, I think of pain in the hip joint or groin. But as it turns out, the word hip can refer to lots of different areas such as the groin , buttock , side of the hip, or even the lowest part of the lower back. Its not uncommon that hip pain is actually coming from the spine or lower back.
Heres a breakdown of 5 common problems I see:
Hip joint arthritis typically leads to pain in the groin with activity. It is usually worse with stairs, getting in and out of cars, loss of hip motion makes certain daily tasks like putting socks and shoes on difficult. Its caused by the loss of cartilage in the hip socket.
Spinal stenosis is compression of a spinal nerve or bundle of nerves that can cause pain in the buttocks . This type of pain is usually worse with standing and walking and immediately better with sitting. Its caused by arthritis in the spine that compresses nerves.
Hip bursitis and tendinitis refers to inflammation of the tendons around the hip or the bursa on the side of the hip. Bursitis can be particularly painful at night when lying on your side. Sometimes this pain can cause radiating pain towards the knee similar to nerve pain from the lower back.
Sacroiliac joint dysfunction is a problem of the complex joint formed by the sacrum and the bony part of the pelvis. Because it can generate pain in many areas, diagnosing SI joint pain can be challenging.
Do I Have Hip Bursitis Or Back Pain
Its a common story that I hear in the clinic, and a frustrating one. A patient complains of prolonged lateral hip pain that came out of nowhere. They went to see their doctor and the doctor says Congratulations, its a boy! Just kidding, they take an x-ray which comes back negative and then say You have hip bursitis. Lets give you some cortisone and send you on your way. The only problem is that your hip doesnt improve and you are left frustrated, questioning Why? The answer is, you probably dont have hip bursitis, you probably have a back problem. Allow me to explain further.
Whats Hip Bursitis?
Hip bursitis is an inflammation of the bursa sac on the outside part of your hip. Its job is to keep your muscles and tendons from rubbing on your greater trochanter and damaging them. Bursitis happens when the bursa sac gets compressed and inflamed which will cause pain in the area.
Most of the time the pain is due to activity and will improve if you rest. The patients that I see are the exact opposite. They hip hurts when they rest and will feel better with certain movements. If that is the case then you probably dont have true hip bursitis.
If I Dont Have Bursitis Then What Do I Have?
Why Do You Hate My Doctor?
Accurate Diagnosis Is Key
If your physician examines your hip joint and notes no hip pain, and then examines your back and notes leg pain, the spine is usually the source of the problem. Some people may have localized hip pain without leg pain, but are found to have a normal hip and an abnormal spine. Others may have only leg pain, but are found to have an abnormal hip and a normal spine. Therefore, in addition to a good physical examination, imaging is important. Plain X-rays may be helpful, but sometimes an MRI is needed as well. If imaging does not determine the source of the pain, the next step would typically be to perform an injection of pain-relieving medication directly into the area suspected of causing pain. Whether you get pain relief from the injection can help your physician better understand where the pain is coming from.
What Causes Low Back And Hip Pain When Walking
Once again, poor posture could be the culprit in back and hip pain while walking. To potentially improve your pain, make sure to:
- Avoid looking down too much when you walk, which reduces neck and back strain.
- Avoid slouching when you walk.
- Keep your hips level when walking, avoid unnatural hip swaying.
- Pull in your stomach and engage your core to take the pressure off your lower back.
- Make sure your feet hit the ground heel-first, then roll through the ball of your foot.
- Own comfortable shoes, especially if you have flat feet which can cause back pain.
Another potential cause of hip and back pain when walking is being overweight. According to a review by the American Journal of Epidemiology, people who are overweight are at a higher risk of developing sciatica. This is because the lower back supports more weight as a person gets heavier, naturally causing pain. Stretches that target your back and hips can ease the pain, and frequent exercise keeps you fit while fighting muscle pains caused by a sedentary lifestyle.
If improving your posture, stretching, and exercising doesnt improve your back or hip pain, stop by SPORT Orthopedics + Rehabilitation and well take care of you.
Hip Pain Vs Low Back Pain Summary
To summarize the information above, heres how to tell if you have hip or back pain.
- If the pain radiates from the hip and groin area and spreads down to your thigh and knee, then your hip is most likely the source of the pain.
- If the pain radiates from your low back, buttocks, hips, and hamstring, you are most likely dealing with a lower back or spinal problem.
Again, taking medication such as Advil for back pain and hip pain can be effective. However, getting a kind of care that addresses the root of the issue is better.
You may need upper cervical chiropractic care to correct the underlying cause of lower back pain, such as nerve and spinal issues. Your upper cervical spine is responsible for the balance of your head and neck. A misalignment in this topmost region of your spine can irritate your spinal nerves, leading to lower back pain issues. So, correcting upper cervical misalignment is the best way to prevent low back pain from recurring. After addressing this problem, you may experience long-term relief and complete recovery.
Also Check: Advil For Back Pain Dosage
What Is Radiating Pain
Radiating pain is pain that “radiates” from one area of the body to other areas of the body. When pain in one area of the body causes pain in other areas, this is known as “referred pain.” In fact, radiating lower back and hip pain can cause pain in all kinds of places near these areas like
- Thigh muscle pain
- Pain back of the knee
- Knee pain at night
- Pain in the upper thigh
- Numbing of nerves in leg
- Hip and groin pain
- Pain in the back of leg behind the knee
- Pain in one side side
- Pain in the calf
- Pain in back of the knee
- Hip and groin pain
- Sharp pain in the toes
- Lower calf pain
Note your symptoms from the list above and use these to learn your diagnosis with our helpful descriptions of symptoms, possible causes, and when you should get to a doctor or emergency room to know how to treat your injury.
When The Hip Is The Usual Suspect
Surprisingly, hip problemsusually produce groin pain on the affected side. Thats because the actualjoint of the hip is near the spine.
Groin pain is a hip issue until proven otherwise, says back pain specialist Russell DeMicco, DO. Pain above the belt line is not a hip issue.
The most common cause ofhip pain is osteoarthritis of the hip joint. You may have hip arthritis if:
- Pain is in your groin.
- Discomfort comes and goes, becoming more frequent over time.
- Pain worsens with standing, walking and activity, and is relieved by rest.
- You feel stiff.
- You walk with a limp.
Avascular necrosis, or AVN,is a serious condition marked by death of hip bone at the joint. The pain isusually worse and far more constant than in osteoarthritis. People come to mesaying, My hip is killing me, says Dr. Murray.