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Is It Low Back Pain or Hip Pain?

Is It Low Back Pain or Hip Pain?

Can you tell if it’s low back pain or hip pain? When patients present with low back pain, it is not uncommon for pain to arise from areas other than the low back, such as the hip.

There are many tissues in the low back and hip region that are susceptible to injury with have overlapping pain pathways that often make it challenging to isolate the truly injured area. Hip pain can present in many different ways.

hip pain

When considering the anatomy of the low back (lumbar spine) and hip, and the nerves that innervate the hip come from the low back, it’s no wonder that differentiating between the two conditions is often difficult.

Complaints may include the inside, outside, front, or back of the thigh, the knee, the buttocks, the sacroiliac joint, or the low back and yet, the hip may truly be the pain generator with any of these presentations.

To make diagnosis even more complex, the hip pain patient may present one day with what appears to be sciatic nerve pain (that is, pain shooting down the back of the leg to the knee if mild or to the foot if more severe) but the next visit, with only groin pain.

When pain radiates down a leg, the almost automatic impression by both the patient and their healthcare provider is, “…it’s a pinched nerve.” But again, it could be the hip and NOT a pinched nerve that is creating the leg pain pattern.

Throwing yet another wrench in the works is the fact that a patient can have more than one condition at the same time. So, they truly MAY simultaneously have BOTH a low back problem AND a hip problem. In fact, its actually unusual to x-ray the low back of a hip pain patient without seeing some low back condition(s) like degenerative disk disease, osteoarthritis (spurs off the vertebrae), or combination of these.

Differentiating hip pain from low back pain

So, how do we differentiate between hip vs. low back pain when it is common for both low back and hip pain to often coincide?

During our history, we often ask the question, “…what activities make your pain worse?” If the patient replies that weight bearing activities like standing, walking, getting up from sitting, etc., provoke the pain (and they point to the front or side of the hip), a hip-related diagnosis is favored but it STILL may be arising from the low back or both! I

If they say, “…crossing my right leg over the other hurts in my groin,” then that’s getting more hip pain-specific as hip rotation is frequently lost before the forward flexion motion.

When we ask the hip pain patient to point to the area of greatest discomfort, they usually point to the front of the hip or groin, and less often to the inner and/or anterior thigh or knee. Non-weight bearing positions like sitting or lying are almost always immediately pain relieving.

When there is arthritis in the hip, motion loss is often reported and may include a shorter walking stride and pain usually gets worse the longer these patients are on their feet. Initiating motion often hurts, sometimes even in bed when rolling over.

During the chiropractic examination, with the patient lying on the back with the knee and hip both bent 90°, moving the bent knee outwards or inwards will almost always reproduce hip/groin area pain. Pulling on or applying traction to the affected leg usually “…feels good.” Knee & ankle reflexes and sensation are normal but muscle strength may be weak due to pain. Bending the low back into different positions does not reproduce pain if the pain is only coming from the hip.

Though sometimes challenging, doctors of chiropractic are well-trained to be able to differentiate between hip and low back pain and will treat both areas when it is appropriate.
Chiro-Trust.org

Related Article:
Chiropractic Helps with Low Back Pain

Dr. Allamm Morales, M.D.
Neurologist

Dr. Allamm Morales has over 15 years experience in personal injury and a wide range of neurological disorders. He has privilege, and provides patient care in local Baptist hospitals.

He was Chief Resident at the Neurology Residency Program of the University of South Florida, and worked at the Florida Hospital of New Smyrna, and St. Luke Hospital in Ponce, Puerto Rico. He also served many years with the Florida Neurology Institute, Inc.

Dr. Morales is a Diplomate of the American Board of Vascular Neurology, and a Diplomate of the American Board of Psychiatry and Neurology.

Dr. Morales studied in Nova Southeastern University, Davie, FL, had residency at the Caibarien General Hospital, Cuba, and obtained the MD degree at the Superior Institute of Medical Science in Cuba.

Fiaz Jaleel, M.D.
Physical Medicine & Rehab, Pain Management

“Life is short and precious. As a Physiatrist and Pain Physician my goal for my patients is to reduce their pain and suffering, enhance form, improve function and ultimately promote the best quality of life for that individual.”

Dr. Fiaz Jaleel graduated from the University of The West Indies in 1987. He completed a two year internship at Port of Spain General Hospital in Trinidad and Tobago. He completed his internship in Internal Medicine at St. Francis Hospital in Evanston, IL and went on to do a residency in Physical Medicine and Rehabilitation at Barnes Jewish Hospital in St. Louis , MO. In 2007, Dr. Jaleel joined the team at Absolute Injury and Pain Physicians as Medical Director. He is currently Board Certified in Physical Medicine and Rehabilitation as well as Pain Medicine via the American Board of Pain Medicine.

In Trinidad and Tobago, Dr. Jaleel held positions as an Intern, House officer, and District Medical Officer. He has also practiced in Illinois, Missouri, South Dakota and Central and North Florida.

While practicing in Trinidad , Dr. Jaleel also worked in Internal Medicine, General Surgery, Pediatrics, Neonatology, Obstetrics and Gynecology, Ear, Nose and Throat Surgery, Ophthalmology, Radiology, Neurosurgery, Plastic Surgery, Orthopedics, Emergency Medicine and Community Medicine.

Dr. Jaleel has encountered many diseases, disorders and clinical situations related to multiple aspects of trauma including penetrating and non-penetrating injuries, motor vehicular accidents and concomitant injuries including intra-abdominal injuries, closed head injuries, fractures and burns.

When not treating his patients, Dr. Jaleel enjoys travelling, reading and spending time with friends and family.

Dr. Jaleel has the following affiliations:
Diplomate, American Board of Physical Medicine and Rehabilitation
Diplomate, American Board of Pain Medicine
Fellow, American Academy of Physical Medicine and Rehabilitation
Member, American Academy of Pain Medicine
Member, Florida Society of Physical Medicine and Rehabilitation
Member, Florida Academy of Pain Medicine
Member, Florida Medical Association

Deric L. D’Agostino, D.C.
Chiropractic Physician

“The health of a body is in direct proportion to the health of its nervous system. The nervous system controls every cell, tissue and organ in your body, tap into that and “miracles” will most certainly happen!”

Dr. Deric D’Agostino attended the Logan College of Chiropractic and has been helping patients at Absolute Injury and Pain Physicians for the past nine years. Around here we call him “Dr. D.”

Dr. D’Agostino specializes in Koren Specific Technique and in the treatment of injuries resulting from motor vehicle accidents. He is a master of his craft and firmly believes that chiropractic treatment can not only help the body but also the mind. His sense of humor and the personal attention that he provides really puts patients at ease.

Dr. D’Agostino genuinely listens to the patient while working very hard to erase their pain-inducing symptoms. He is always seeking out continuing education and new methodology to add to his care repertoire.

When he is not helping patients find relief, Dr. D’Agostino enjoys training for sprint triathlons, gardening, as well as being an awesome father and husband. You will most likely find him at our Arlington location dawning a huge smile while drinking his homemade juice.

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