Back pain that presents with hip pain can indicate a number of potential causes. Pain in the back and hips is often tied to the same source, given that spinal nerves supply the hips and a number of muscles are shared by the two structures. The following are common causes of back and hip pain.
Sacroiliac Joint Dysfunction
The sacroiliac (SI) joints form where the large hip bones meet the sacrum at the base of the spine on each side. These joints allow for very little motion; if too much or too little motion is allowed, inflammation occurs and SI joint dysfunction is present.
SI joint dysfunction can be caused by an injury, ligament strain or muscle imbalance in the hips. The localized pain over the joint may radiate into the hips, lower back and buttocks. Chiropractic care, myofascial release and physical therapy may all help resolve SI joint dysfunction depending on the cause.
If you have pain in the lower back, hips and buttocks, you may be experiencing piriformis syndrome. The piriformis muscle extends horizontally from the sacrum to the thigh bone deep within the buttocks. The muscle takes part in nearly every movement of the hips and legs, and can become tight and short if another muscle nearby isn’t doing its job.
One major cause of piriformis syndrome is weak gluteal muscles. Glutes are largely responsible for hip rotation, and if they’re too weak to do that job, the piriformis will take over. Overuse due to compensation causes the muscle to shorten and tighten. This pulls on the sacrum, creating spinal pressure. The muscle may also impinge the sciatic nerve, whose path runs nearby. Hip pain may result from sciatica, muscle tension or change in pelvic alignment. Myofascial release and physical therapy can correct piriformis syndrome.
The psoas muscle stretches form the top of the thigh bone to three vertebrae in the lumbar spine. It is one of the main connectors of the upper and lower body. This muscle is in a location that is both hard to stretch and easy to tighten. Prolonged sitting, particularly with poor posture, can cause psoas tightness.
As with the piriformis, tightening of the psoas exerts a pull on the spine. A tight psoas can cause localized pain in the hip, or pain that radiates. Lower back pain will also likely be present. Myofascial release and physical therapy can restore elasticity to the psoas.
Pelvic tilt can occur with tightening of the piriformis and psoas muscles, or with other forms of muscle imbalance. If the quads and lower back muscles are shortened and tight while the abdominal and hamstring muscles are weak, there will be an uneven tug-of-war on the pelvis causing it to tilt down in front. This changes the tensions of muscles in the hips and lower back as well as increasing pressure on spine discs by causing the lumbar arch to increase.
Pelvic tilt can also go the other way; tight hamstrings and abdominal muscles can cause it to tilt down in back, flattening out the lumbar arch.
Myofascial release is generally needed to restore flexibility and length to chronically tense muscles. After that, targeted exercise can be conducted to build up a strong, balanced core.
The hips receive nerve supply from spinal nerves that exit the lumbar vertebrae. An impingement of nerves from the first lumbar vertebra (L1) to the fourth (L4) can lead to pain in the hips.
Nerves may become impinged in a number of ways including a herniated disc, bone spur, subluxation or muscular inflammation. Treatment largely depends on the cause, but generally includes either physical therapy, decompression treatments, chiropractic care or massage therapy.
The best ways to prevent hip pain are to practice proper body mechanics, stay active, keep a strong, balanced core and stretch your hips regularly. Check out the hip stretches at www.fitsugar.com.