Pain in the low back, hips, and other areas of the lower body, the source isn’t always easy to pinpoint.
Pain may originate in the lumbar spine (low back) the hip or both.
It’s important that a doctor identify the source of the problem, in order to create the correct treatment plan.
Because the hips and lower spine are located so close it can be easy to mistake back pain for hip pain the other way around.
Most low back pain and hip pain share a common cause:
Normal wear and tear on the body due to aging or triggered by overuse injuries (possibly referred to as degeneration or degenerative changes).
- Lumbar sprains
- Herniated discs
Are common degenerative culprits behind low back and hip pain.
Symptoms that the Hip Is the Root
One of the biggest symptoms that pain is caused by a problem in the hip is groin pain.
The hip joint is located behind the groin, which is why groin pain typically means the hip is the root.
In some cases, the groin pain will radiate downward toward the knee.
Another symptom that the hip is the source is pain around or over the hip joint.
Hip problems can also refer pain to the low back.
This is what causes the confusion over where the true source of the pain.
Hip-related pain is most often caused by osteoarthritis in the hip.
Osteoarthritis in the hip can cause pain in the:
- Front of the thighs
Limping when walking and a reduced range of motion in the hips, along with pain that worsens with activity and improves with rest.
Osteoarthritis is the most common cause, hip pain can also come from:
- Piriformis syndrome
- Avascular necrosis in the hip
- Sacroiliac joint dysfunction
- Piriformis syndrome will cause dull, mild pain in the low back, buttocks and can radiate down the leg.
- Hip pain attributed to avascular necrosis will be severe and constant.
- Sacroiliac joint pain could be attributed to the hip and the low back because the sacroiliac joints connect the sacrum in the spine to the hip bones.
Symptoms that the Spine Is the Root
Where groin pain is a sign that the pain is linked to the hip when the pain is above the waistline and travels down the body usually indicates a low back issue.
Among the most common degenerative conditions that affect the lumbar spine are:
- Herniated discs
- Spinal stenosis
Pain is caused by irritating the low back nerves, which result in pain shooting down the leg/s and:
- Reduced range of motion
Arthritis of the spine brings on pain usually when first getting out of bed or rising up after sitting.
It usually improves after beginning to move.
Spinal stenosis or nerve pressure compression pain worsens with prolonged standing or walking, while relief comes with sitting.
Getting to the Root
When there is pain in the lower body and are not sure whether it’s the back or hip, the first course of action is to visit your doctor or a chiropractor.
They will review your medical history and perform a series of physical exams, such as various movements to get an idea of what is going on.
Your primary doctor may refer you to a doctor/chiropractor who specializes in hip or spinal conditions to make an accurate diagnosis.
The doctor will ask you to describe the:
- When it worsens
- When it’s relieved
- What the pain feels like (e.g., sharp, dull).
The doctor may have you perform various movements to observe your biomechanics.
The goal is to determine what movements trigger the pain.
One such maneuver called the Flexion Abduction External Rotation (FABER) test helps determine if the pain is sourced in the hip and possible sacroiliac joint problems.
For this test, you lie on your back while flexing and rotating the hips.
The doctor will also palpate (press) on the pain area.
The doctor may order image scans, like x-ray, MRI that can reveal the root of the spine or hip problem.
Treating Back Pain and Hip Pain
Once the pain is identified whether the hip or low back, your doctor will work with you to create a treatment plan.
This regimen includes a specially designed physical therapy program to teach:
- Physical therapy
To help alleviate symptoms and prevent their return.
Once the nature of the pain is determined, your doctor may recommend lifestyle changes:
- Exercise program
- Quitting smoking
- Diet change
- Foot orthotics
For both spine and hip pain, surgery is rarely necessary and only utilized as the last-resort option.
Labrum Tear Hip & Physical Therapy Rehabilitation El Paso, TX
Andrew Hutchinson turned into chiropractic care and CrossFit rehabilitation after suffering a high ankle sprain and a hip labrum tear for which he moved with surgery to fix it. After being bedridden for weeks so as to correctly recuperate, Andrew Hutchinson transitioned to chiropractic care and CrossFit rehab to recover his strength, mobility, and flexibility before returning to play. Although he has endured other sports injuries, Andrew Hutchinson proceeds to trust in chiropractic care and CrossFit rehab to maintain his spine correctly aligned and maintain overall health and wellness.
Labrum rips in athletes may occur from a single event or recurring trauma. Running can cause labrum tears due to the labrum being utilized more for weight-bearing and carrying excess forces while at the end-range motion of the leg. Sporting activities are likely causes, specifically the ones that need frequent hip turning or pivoting to some loaded femur as in ballet or hockey. Constant hip rotation areas increased strain on the capsular tissue and injury to the iliofemoral ligament. This then causes cool uncertainty placing increased strain on the labrum and resulting in a hip labrum tear.
Muscle imbalances in the hip, such as tight hip flexors, can cause low back pain – or at least contribute to it. When the hip flexor muscles are too tight, it causes what is known as an anterior pelvic tilt. In other words, the muscles cause an anterior pull on the pelvis. This affect posture and throws the entire lower body out of alignment. It can also affect the knees and feet if left untreated.
Hip flexors can become too tight if the person sits for extended periods of time or engages in activities like cycling and jogging. A chiropractor can guide you through exercises that will help release the tight muscles and stop the micro spams that occur as a result. They will also assess your knees, feet, and ankles to ensure that the issue has not through them out of alignment as well. Correcting the cause of the problem will often correct the associated issues and resolve the pain allowing you to return to your normal activities.