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Bone, Muscle & Joint Health | Brain & Spine Health | Family Health | Living With Chronic Conditions
woman's-back

Oh, My Aching Back — Or Is It My Hip?

How to pinpoint the source of your pain

Back problems can masquerade as hip problems. “There is a lot of overlap,” says Trevor Murray, MD, a hip specialist in Cleveland Clinic’s Department of Orthopaedic Surgery.

Most pain from hip and back problems is due to ordinary wear and tear on the body.

When the hip is the usual suspect

Surprisingly, hip problems usually produce groin pain on the affected side. That’s because the actual joint of the hip is near the spine.

“Groin pain is a hip issue until proven otherwise,” says Russell DeMicco, DO, a back pain specialist at Cleveland Clinic Twinsburg Family Health and Surgery Center. “Pain above the belt line is not a hip issue.”

The most common cause of hip pain is osteoarthritis of the hip joint. You may have hip arthritis if:

  • Pain is in your groin
  • Discomfort comes and goes, becoming more frequent over time
  • Pain worsens with standing, walking and activity, and is relieved by rest
  • You feel stiff
  • You walk with a limp

Avascular necrosis, or AVN, is a serious condition marked by death of hip bone at the joint. The pain is usually worse and far more constant than in osteoarthritis. “People come to me saying, ‘My hip is killing me,’” says Dr. Murray.

When the spine is the likely culprit

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Most lower spine problems are caused by a herniated disc that presses on nerves in the spinal column. This produces the pain known as sciatica, which can be felt in the hip. You may have a herniated disc if pain:

  • Is limited to your back, buttocks or hip
  • Shoots down your leg
  • Worsens with sitting or bending
  • Improves when standing or walking

If you have night sweats, a history of cancer, or pain that is not relieved by lying down (“night pain”), see your doctor — the problem may be more serious.

Some people develop what Dr. DeMicco calls a “double whammy” — problems in both the hip and lower back. “It’s not surprising, since both osteoarthritis and spinal changes are more common with each passing decade,” he explains.

First steps for relieving hip pain

  1. See your primary care doctor. He or she will likely prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) to see if hip pain improves.
  2. Lose weight. Shedding extra pounds is critical in relieving hip pain. “Losing weight often reduces symptoms to the point where surgery is not necessary,” says Dr. Murray. “It also increases your chances of a successful outcome if surgery is one day warranted.”

First steps for relieving back pain

  1. See your care primary doctor, and stay active. He or she will likely prescribe NSAIDs for two weeks. Meanwhile, stay active. “Activity can and should be continued. Prolonged bed rest (more than 24 to 48 hours) is bad advice,” says Dr. DeMicco.
  2. Schedule P.T. if needed after two weeks. If you’re still in pain after two weeks, a physical therapist can show you exercises that can strengthen the muscles supporting your spine as well as back-friendly maneuvers.
  3. Lose weight, and quit tobacco. Maintaining your ideal weight will take the pressure off your spine. It’s important to avoid tobacco products too. “Nicotine impedes microcirculation, so your spine will degenerate at a faster rate,” says Dr. DeMicco.

If the source of your pain is difficult to pinpoint, seek help from a hip or spine specialist. The specialist may order an injection of lidocaine. If the problem is the hip, this will numb the hip joint and relieve symptoms immediately. “If the pain does not improve, we know we’re barking up the wrong tree,” says Dr. Murray. The same technique can rule out or confirm back pain.

Tags: arthritis, back pain, Be Well e-News, herniated disc, hip pain
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  • Mike

    Some sciatica is also hip related. I had terrible sciatica on my right side. The problem was relieved by working on the LEFT hip muscles. My hips were uneven. After four physical therapy appointments, I started to get relief. Now I am fine.

  • http://www.facebook.com/buzzsbaby717 Sharon Chapman

    Ive been thru PT twice now, I would rather do traction than surgery. I have herniated disk on L4-L5 that causes sciatic pain. This can be found on an MRI. Good luck to all with this affliction as it has changed my life drastically.

    • Cindy Wade

      I am just now starting treatment with a chiropractor who is treating both the LUMBAR l4-5 and the Left Hip Muscles. I have the same sciatic pain. I was kicked by a horse in the left hip and lumbar area almost 4 years ago and still deal with this chronic pain and suffering every single day. pain meds, mris,injections, now chiro care. There seems to be nothing that the Orthosurgeon has offered as of yet to do about it. I don’t know what to do next but it surely has impacted my life as well. Good luck with yours. If you ever get a good result with anything new, please let me know! I would really appreciate it!

      • Janet Lucas

        I too am suffering from sciatica and can’t take pain meds. Epidurals did not help and am thinking of trying a chiropractor. Is chiropractic care helping you relieving the pain?

        • Vickie

          The best thing that has helped my sciatica is to position a tennis ball at that point on my buttock where the pain is most intense and then sit down on it on a raised area like a fireplace hearth. Then, supporting yourself on your hands, roll around on the ball and adjust how much pressure you are putting on your buttock. (It will hurt a LOT at first.) Finally, after doing it for awhile the muscle that is so tight around your sciatic nerve will loosen up and give you relief. You may feel numbness in your foot before the muscle finally loosens up. If the tight muscle is higher up in your hip, you can roll the tennis ball between your hip and a wall, but it’s harder to get the kind of pressure you need on that muscle to get it to finally loosen up. Good luck!

          • Janet Lucas

            Thank you – I need all the help I can get to avoid surgery – I will try this

          • Rick

            I *highly* recommend yoga to anyone with sciatica. After trying chiro, massage (incl acupuncture), physio and pain meds for 3 years, I finally listen to my massage therapist to try yoga, and it gave me back the life that sciatica took away.

          • steelrfan68

            Chiropractic care is GREAT! Beats meds & surgery. Dr. Oz recommended the tennis ball exercise on his show.

  • Jeanne

    What about lazer surgery?

  • Macey

    I’ve had injections, pain pills, p/t, and I suffer lower back/hip pain. It gets worse each month and pains shoot down both of my legs and keeps me awake at night. I have a spot on my left backside/ hip that is actually tender and somewhat swollen. My pain mgmt. Dr. ordered a set of x-rays on my left hip a week ago, and I have not heard back. I have another follow-up on the 18th of this month. When I stand I feel crippled up somewhat, and not to mention bending over is a real nightmare. I work F/T as a health aide/homemaker. When I get home at night I can hardly move. It hurts really bad when I first lie down in bed at night and within about 45 minutes the pain will let up a little, but through the night the left hip will hurt and the pain down my legs is just something I cannot get to calm down through the entre night. Does this soundlike something that can just be managed with p/t and pills?

    • karen

      Try epson salt in a warm bath before bed. I too have a very arthritic left hip and have had 2 injections.

  • Chris Prosperie Molaison

    After having six major lumbar back surgeries I have been diagnosed with Arachnoiditis in both hips and I am in chronic pain everyday. It was also recommended that I go to one of four clinics and The Cleveland Clinic was one of them. Any information would be greatly appreciated !!! I also have neck and shoulder pain. After reading your description of what the pain could be it seems like I have problems with my rotator cuff. Any information on that would also be greatly appreciated !!!

  • GeorgeBMac

    This article is stereotypical, over simplified back advise…
    Many people have scoliosis — whether it is diagnosed or not — and, for most of those, the scoliosis of the spine originates in the hips. If the hips are out of line, the spine will be out of line (or at least stressed) — and back pain results.

    Is that a back problem? No! The back pain is a symptom — but the problem is still in the hips. The two should not be arbitrarily separated. The hips form the foundation that the spine sits on. A house is a good analogy: if it has a bad foundation, the house will have problems.

    • nancy alexander

      Have had lower back & hip pain for yrs. Just saw my kidney Dr & he says much to my surprise “your scoliosis is getting pretty bad my reply was I don’t have scoliosis then he showed me the Xrays. Wow @ my shock. How fast can adult onset scoliosis kick in? Knew I had Arthritsis & pertruding disc boy orthopedic surgeon never mentioned scoliosis

  • Ohmy

    I would love to lose weight… but you know this pain in my hip and back is making it kind of hard to exercise at the moment. So, that advice sucks.

  • lisa

    my pain is on the back side of my left hip. I don’t know why all of a sudden it hurts. its not worse I think ( or hope ) because it only triggers momentarily. by the way, I have I don’t know if it’s in the muscle or bone but it hurts anyway, on the same, left side too. it really hurts when I bend my left leg. please I need clarifications. I couldn’t go to the doctor for I think my situation isn’t bad. but still, I’m worried. by the way, does my pain in the leg has something to do with the one of my hip? answer please. thanks.

  • debster

    Once again, chiropractic treatment is left out of the mix. That is a viable alternative without the use of harmful medications.