You’d think so. But consider this story of a motorcycle accident: many years ago, a friend hit a car that had pulled out from a side street. He flew over the car & landed on his head. Bystanders showed their ignorance of spinal fracture by, yikes, carelessly moving him. In fact, his thoracic spine was significantly fractured … yet the hospital actually refused to do an X-ray because he had no obvious symptoms of a spinal fracture. Incredible! The next day, a horrified orthopedic surgeon ordered an X-ray immediately, confirming the fracture & quite possibly saved him from paralysis.

The pain of back pain almost always makes it seem worse than it is. The most worrisome causes of back pain rarely cause severe pain, and many common problems (like slipped discs) are usually much less serious than people fear. Only about 1% of back pain is ominous, and even then it’s often still treatable. Most of the 1% are due to cancer, autoimmune disease, or spinal cord damage.
This Australian study concluded that “prognosis is moderately optimistic for patients with chronic low back pain,” contradicting the common fear that any low back pain that lasts longer than 6-9 weeks will become a long-term chronic problem. This evidence is the first of its kind, a rarity in low back pain research, a field where almost everything has been studied to death. “Many studies provide good evidence for the prognosis of acute low back pain,” the authors explain. “Relatively few provide good evidence for the prognosis of chronic low back pain.”
Loop a resistance band either above your knees (least resistance), below your knees (medium resistance), or around your ankles (greatest resistance). Bend knees slightly with your feet hip-width apart. Step to the side until the band provides resistance, then slide your other foot over to re-create your original stance. Repeat this sidestepping movement for 10 to 15 feet in one direction (or as far as you can), and then cover the same distance in the other direction.
Place a mini band around your ankles and spread your feet about shoulder-width apart. Keeping your legs relatively straight (you want the motion to come from your hips) and toes pointing forward, walk forward 10 steps, then backward 10 steps. Take a short break and then walk to the right 10 steps, then to the left 10 steps. Again, focus on keeping your legs straight and toes pointing forward.
Premkumar et al present evidence that the traditional “red flags” for ominous causes of back pain can be quite misleading. The correlation between red flags and ominous diagnoses is poor, and prone to producing false negatives: that is, no red flags even when there is something more serious than unexplained pain going on. In a survey of almost 10,000 patients “the absence of red flag responses did not meaningfully decrease the likelihood of a red flag diagnosis.“ This is not even remotely a surprise to anyone who paid attention in back pain school, but it’s good to have some harder data on it.
The more common name for diabetic amyotrophy is diabetic neuropathy. It is a condition caused by advanced diabetes mellitus which affects the nerves in the legs, feet, hips, and buttocks. Symptoms include a wasting of the muscles of the legs as well as weakness of the leg muscles and severe, chronic pain in the buttocks, legs, and feet. Treatment includes monitoring blood glucose and keeping blood sugars well controlled as well as physical therapy and rest.
Meanwhile, it’s extremely common for non-life-threatening low back pain to be alarmingly severe and persistent — to have a loud bark! Your doctor may not appreciate how true this is, and may over-react to all persistent low back pain, even without other red flags. In most cases, you shouldn’t let them scare you. Being “freaked out” about persistent back pain is the real threat: it can make low back pain much worse, and much more likely to last even longer (a tragic irony).
Lucky for us, there are tons of different ways to stretch hip flexors. We’ve put together a broad selection of some of the most popular tight hip flexor stretches below. Some of these stretches may work better for you than others, and there’s also many more hip flexor stretches you can try beyond these. So, experiment with all different kinds of stretches and decide which ones are best for your body.
How to: Lie on your back with your right knee bent and foot flat on the floor (a). Extend your left leg up to the ceiling and wrap a strap around the sole of your left foot (b). While holding both ends with your left hand, extend your right arm directly out to the side in order to anchor yourself (c). Slowly let the left leg fall toward the left while keeping your right side grounded. Hold for six to eight breaths, then repeat on the opposite side.
AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS Find an Orthopaedist program on this website.
How to: Stand with your feet hip-distance apart. Your feet should be flat, and your legs should be straight. Step your right back behind your body, keeping your hips parallel, and stretch your right hand up overhead at the same time. Step back up to starting position. That's one rep. Repeat eight times on each side. Do three to four sets before moving on to the next move, resting for 30 seconds in between each set.
The sciatic nerve is the largest and longest nerve in the body. It arises from the spinal cord as a collection of fibers from the lower vertebrae. This nerve is responsible for the sensation of the skin of the foot and entire lower leg except for a small area on the inner side. It also supplies muscles in the anterior, lateral and posterior compartments of the leg.
A pinched nerve in the hip or back can cause radiating lower back and hip pain. If you wonder what does nerve pain feel like – it often involves severe pain and numbness that may be referred from other areas of the body. For example, a pinched nerve in the upper back can cause numbness in the fingers. But if you're suffering with a pinched nerve—your main questions are probably ones of how to fix a pinched nerve, how long does a pinched nerve last, and how do you get pinched nerve relief? Often, pinched nerves are due to inflammation due to muscle tears, injuries, or pulled muscles. Sometimes, scar tissue from old injuries begins to accumulate and press on nerves. The best treatment for pinched nerves is often rest. But medications such as glucocorticoid injections and oral NSAIDs may help. For patients whose radicular pain has not improved with conservative treatment over six weeks and who want nonsurgical treatment, epidural injection of glucocorticoids may be reasonable.
Both types of problems are frequently helped by anti-inflammatory medications particularly in mild to moderate situations. Some types of analgesics can be used intermittently as well. It's important to realize that both problems can be helped significantly by weight loss, proper forms of exercise and conditioning. In fact, back pain can become chronic without a commitment to the appropriate exercises necessary to stabilize and strengthen the spine. Epidural blocks (corticosteroids are injected into the canal of the low back to reduce inflammation and pain) can help several types of back disorders. Using a cane when walking can help both hip and back pain.
• Gout. Gout is a form of arthritis that occurs when excess uric acid, a bodily waste product circulating in the bloodstream, is deposited as needle-shaped monosodium urate crystals in tissues of the body, including the joints. For many people, the first symptom of gout is excruciating pain and swelling in the big toe – often following a trauma, such as an illness or injury. Subsequent attacks may occur off and on in other joints, primarily those of the foot and knee. Less commonly gout can affect the spine, causing extreme pain, numbness and tingling. It can be confused with a spinal infection.
The sciatic nerve is the largest and longest nerve in the body. It arises from the spinal cord as a collection of fibers from the lower vertebrae. This nerve is responsible for the sensation of the skin of the foot and entire lower leg except for a small area on the inner side. It also supplies muscles in the anterior, lateral and posterior compartments of the leg.
Tight hip flexors can also make it harder for your glutes to activate—since they're opposing muscle groups, when one is really tight the other becomes lengthened. When a muscle is more lengthened than it should be, it takes away some of its ability to contract. When your glutes are in this compromised position, it can cause other muscles to do more work than they should, making your workouts less efficient and sometimes, increasing your risk of injury.
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