The hip is the primary contributor to all work that involves the core. Joining several bones to the spinal column, the hip joint can move in various directions and at various angles, bearing our bodies’ weight and the force of the powerful hip and leg muscles . According to medical literature, the actions performed by the hip joint include extension (standing), flexion (sitting or bending), adduction (when the leg moves towards the body), abduction (when the leg moves laterally away from the body), and circumduction (when the leg moves in a circular motion from the front, side, back, and front as in dancing).
While the hip joint is designed to withstand a significant amount of wear and tear, repetitive motion such as cycling, running, jumping, and squatting may wear down the cartilage that prevents friction as the bone moves in its socket, and so the pain occurs. Pain in the hip can be a result of a variety of factors, including problems with the skin, tissues, nerves, bones, joints, veins, and soft tissues of the hip. The conditions that most often lead to hip pain include: arthritis, injuries (dislocation, bursitis, hip fracture, tendinitis, sprains and strains), pinched nerves, cancer, osteoporosis, rickets, synovitis, and others.
Oftentimes, people come into the doctor’s office and complain about hip pain, indicating pain in the side of their upper thigh or upper buttock, when in reality they suffer from spine problems. Lower back pain, for instance, can masquerade as hip pain, as there is a lot of overlap between back problems and hip problems. Some sufferers accusing pain in their hip joint may be misdiagnosed and start receiving treatment only to notice little or no improvement after spending time and money on treatments that are simply for something else. Here’s how to distinguish between the two.
Pain Originating in the Hip
In the hip, pain may arise from the structures within the hip or from those surrounding it. There isn’t much fluid inside the hip joint to allow the head to glide in the socket, so any trauma that causes inflammation will cause this space to fill with fluid or blood, stretching the capsule lining and resulting in pain. Because the hip joint is near the spine, people suffering from a hip problem may indicate groin pain as one of their symptoms. Other symptoms include:
- Inability to walk normally (limping)
- Discomfort that becomes more frequent in time
- Acute pain worsened by moving and relieved by resting
By far, the most common cause of non-traumatic hip pain in adults over 50 is osteoarthritis, whose symptoms can vary greatly from patient to patient, but typically includes:
inflammation of the tissues in and around the hip joint, bony growths around the edge of the hip joint, and cartilage damage. When it comes to causes of traumatic hip pain, falls resulting in hip fracture are the most common, especially in senior adults also suffering from osteoporosis (the thinning of the bones) and/or loss of balance.
Establishing the diagnosis of the cause of the hip pain should start with the physician asking the patient about the location, type, and intensity of the pain, carefully reviewing underlying complaints, as well. Taking into account the medical history of the patient will help narrow the list of potential causes, while specific imaging and blood tests will pinpoint the correct diagnosis.
Pain Originating in the Spine
The lower back is a complex structure of interconnected tendons, muscles, soft tissues, highly sensitive nerves, small and complex joints, and spinal discs. Irritation of any of these structures can result in lower back pain that radiates to other parts of the body. In younger adults, the common lower back pain causes include: back muscle strain, lumbar herniated disc, degenerative disc disease, and isthmic spondylolisthesis. In individuals over 60, lower back pain is often related to the degeneration of the joints in the spine, most common causes including osteoarthritis and spinal stenosis.
Lower back pain includes any combination of the following symptoms:
- Pain is localized (and sometimes limited) to the buttocks, hip, and back
- Pain is worsened when sitting and relieved somewhat when walking or standing
- Pain may shoot down the leg, accompanied by numbness, tingling, and weakness of the leg and foot
- Localized soreness and tenderness when the affected area is pressed
- Loss of flexibility in the back
- Pain is more intense at the beginning of the day and again at the end
- Mild to severe muscle spasms
Because the causes of lower back pain are so numerous and the structures so complex, establishing an accurate diagnosis can be challenging. In order to discover the exact causes of the pain and design an appropriate treatment plan, the caregiver should ask information regarding the type, location, severity, and history of the pain (when it started, what activities trigger it, etc.). If the pain is not relieved over the course of 6-12 weeks, additional tests – X-rays, CT scan, MRI scan, and myelogram – can be of help to determine further treatment.
If you want to steer clear from medication and surgery, chiropractic care can help restore mobility to your joints and relieve pain from your muscles, bones, tendons, and connective tissue. The treatment plan may include chiropractic manipulation to improve range of motion, flexion distraction to decompress the spine, as well as nutritional counseling and physical exercise/rehabilitation. Contact your local chiropractor to obtain an accurate diagnosis of your pain and start a treatment that will enable your body to heal itself.
About the Author
Dr. Marc Browner is the Founder of iChiropractic and Wellness in Naples, Florida. A graduate of the University of Florida in 1991, he earned his Doctor of Chiropractic degree from Life Chiropractic in 1995. In private practice since 1998, Dr. Browner is a member of the Florida Chiropractic Society, the Florida Chiropractic Association, and he attends continuing education seminars, classes, and workshops to remain abreast of the most current treatment methods and technological advances in the field.