Hip pain or back pain? Don’t be misled!
Hip joint and lower back are anatomically located very close to one another. Sometimes when we are in pain, it isn’t very clear where the source of it actually is and this leads to a misjudgement of what is hurting. Especially when it comes to hip and lower back pain the differentiation can be particularly tricky as symptoms can easily spread from one location to the other, confusing the whole picture.
So how can we differentiate hip from lower back pain?
Location of pain
The hip joint tends to show pain in the groin area. Depending on the nature of the condition pain can be perceived as sharp or dull. Even though the groin can also be an area of referred pain from the lower back, this one tends to show predominantly around the lumbar spine and gluteal muscles and the groin becomes a secondary location of pain which starts aching subsequently to the lumbar spine.
Conditions that can cause hip pain are:
– Pubis osteitis: very commonly affecting footballers and more generally athletes, this is the inflammation of the tendinous attachment of the adductor muscles on the pubic bone. Pain is commonly perceived as sharp when moving the hip at certain angles.
– Capsulitis: the inflammation of the fibrous structure that folds around the hip joint keeping together the head of your thigh bone (femur) and the socket where it sits. It can be caused by a traction trauma of the hip such as stretching beyond a natural range of motion. Pain nature is usually sharp.
– Osteo-arthritis: one of the most common causes for hip pain. It is due to natural wear and tear and its incidence increases with age. Having said this not only older people are affected by it. In fact, research has shown that people with an intense/professional sports history are more likely to develop early osteo arthritic changes. Nature of pain is usually dull and deep at initial stages but can be linked with sharp pain as the condition progresses.
– Hip flexors tendinopathy: particularly affecting desk bound workers this condition can be caused by prolonged sitting leading to chronic shortening of the muscles in the front of your hip (flexors). With time their flexibility reduces altering the alignment of the pelvis and causing dull pain and stiffness.
Main conditions that can cause lower back pain are:
– Disc injuries: ranging from a mild annular tear which represents an irritation or damage of only a few fibres of the disc’s outer layer to the more severe bulging, prolapsing or herniating disc injuries that in this order correspond to a progressively more relevant damage to the disc layers. The onset of disc injuries is commonly acute, with a clear trauma determining sharp pain on the lumbar spine slowly developing into a dull deep ache as times passes.
– Muscle spasm: this can anticipate a disc injury. A muscle spasm is in fact the first protection mechanism that the body puts in place when it senses a threat. By triggering a muscle spasm the body makes sure that the area threatened by a potential injury locks up. When this is successful, it really prevents further damage from occurring. However, very often a muscle spasm can last for far longer than needed and this can lead to mechanisms of adaptation and compensation of your body which aren’t helpful anymore and need addressing with treatment. Pain is usually sharp at onset on the lumbar spine with residual stiffness after a few days.
– Chronic postural fatigue: very often affecting desk bound workers, this is originating from the regular underuse of the lumbar spine muscles. A direct consequence of sitting for long is in fact the weakening of the musculature which then struggles to keep up with daily routine tasks that would otherwise be completely plausible. Nature of pain being usually dull and constant.
Can osteopathy and physiotherapy help?
Both hip and lower back conditions are within the remit of osteopaths and physiotherapists who are trained healthcare professionals and will be able to clinically test your joints and muscles to reach a diagnosis. A diagnosis is the identification of what the cause of pain is and should always be followed by a prognosis, the timeframe within which a recovery is expected to happen.