Did you know that your hip could be causing your back pain? Or your hip pain could be the result of your back?
The close relationship of the back and hip can sometimes make determining the exact “source” of pain tricky. Internet searches and advice from family and friends based on “their issues” likely will be unhelpful. A simple picture or image of either body part often will not suffice. (Remember age-related changes in the body are normal and is not necessarily the CAUSE of anything specific though will often be reported by doctors as abnormal). And an exam without you moving or being touched by a medical professional will not help either.
How exactly can my hip cause my back pain or my back cause hip pain? Also, how does one learn whether it is the hip or back causing the pain?
Well, the answer is not so simple. These questions are intertwined so the answer will come together as well…
Learning the answer to these questions starts with the patient or client interview. Answers to specific questions help clue the provider in to the MORE likely source. For instance, how does it feel to squat? Or, can you cross your legs? If your hip hurts to squat and cannot cross your legs, then the hip may be involved. If you can fully squat and cross your legs without any hip pain then the hip is LESS LIKELY involved.
Beyond the patient interview, a THOROUGH physical exam is crucial. Watching the person walk can provide many clues to answer the question. If the person is limping or has a significant hip sway, those are important details. Hip muscle weakness or reduced hip motion can cause altered walking patterns. These altered walking patterns due to the hip can then result in increased strain on the back. Our bodies attempt to keep symmetry and will adapt to achieve this. Sometimes though, by trying to create this symmetry, increased strain is placed on a body part not typically responsible resulting in pain (i.e. the back trying to help out the hip).
As part of a good exam, we will not forget the back movements. By taking a person through motion in all possible directions, we can learn if the back is the source of hip pain. This means if moving the back (while the hip is in a relaxed state) causes the hip pain, that the back is MORE likely referring pain to the hip vs. the hip as the actual source. These series of movements are quick to do and will help lead the provider to the MOST likely culprit quicker.
I realize this posting likely does not answer all your questions BUT that is where talking to a medical provider (like a physical therapist) comes in handy. We can learn more of the specific details, watch and feel you move, and develop a plan to address your issue. All this can be done even before you decide to see a doctor, have imaging done, or even think about considering injections or surgery. I have worked on many cases (after the fact) where the wrong body part was addressed SURGICALLY because doctors relied on pictures and did not examine the patient well.
Please do not become one of those patients who has surgery only to get no relief. Don’t embark on painful injections or surgery without exhausting all conservative options 1st.