Ankylosing spondylitis is a type of arthritis that specifically affects the spine. Ankylosing spondylitis causes a severe inflammation of the spinal vertebra that can cause debilitating pain throughout the back region. This condition can cause stiffness and pain not only in the spine but also inflammation, pain and stiffness in the ribs, shoulders, ribcage, hands, and feet as well. Symptoms include a dull pain in the lower back and buttocks, stiffness and lack of mobility in the hips, back, and legs, loss of appetite, fever, and general malaise. Treatment includes physical therapy, medication, hot and cold therapy, and exercises that reinforce good posture practices.
But moving is important for hip and knee OA. It causes your joints to compress and release, bringing blood flow, nutrients, and oxygen into the cartilage. “This can help prolong the function and longevity of your joints,” says Eric Robertson, DPT, a physical therapist and associate professor of clinical physical therapy at the University of Southern California.
Sometimes pain on the side of the hip is a result of bursitis. A weak abductor muscle, a leg length discrepancy, overuse, and an underlying early degenerating hip joint can cause bursitis. At times, the origin cannot be determined. Symptoms include pain on the side of the hip with prolonged walking, side lying in bed or when rising from a chair or similar types of movement.

Along with mobility and strength exercises, it's a good idea to do some flexibility work on a regular basis, especially as the season progresses and you start increasing your training mileage. Yoga is a great option—variations of hip openers and other poses can really help the overall function of your hips. The following stretches will help increase flexibility in your hips.

Tight hip flexors can result in lower back pain, hip pain and injury.  A lot of strain is put on those muscles during activities that involve sprinting and kicking.  For example, runners are more prone to hip flexor injuries because of the small, repetitive movement during running.   But even if you’re not an athlete, hip flexor injuries can occur during everyday activities (for instance, slipping and falling or running to catch a bus).  When those tight muscles are suddenly stretched beyond what they are accustomed to, you might also experience pain in the upper groin region, typically where the hip meets the pelvis.   

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Today’s guest post comes from Dr. Sarah Duvall, a physical therapist who specializes in women’s health and pelvic function, and who also loves to lift stuff off the floor while helping others do the same. She also has an awesome new course on Postpartum Corrective Exercise for fitness professionals which closes on January 22nd, so definitely check it out.

Straight leg raise: Lie on your back with your legs straight out in front of you. Bend the knee on your uninjured side and place the foot flat on the floor. Tighten the thigh muscle on your injured side and lift your leg about 8 inches off the floor. Keep your leg straight and your thigh muscle tight. Slowly lower your leg back down to the floor. Do 2 sets of 15.


If most inner-thigh openers feel too easy (and your ankles and knees are injury-free), try Frog Pose. Get down on all fours, with palms on the floor and your knees on blankets or a mat (roll your mat lengthwise, like a tortilla, and place it under your knees for more comfort). Slowly widen your knees until you feel a comfortable stretch in your inner thighs, keeping the inside of each calf and foot in contact with the floor. Make sure to keep your ankles in line with your knees. Lower down to your forearms. Stay here for at least 30 seconds.

Arthritis is a common cause of radiating lower back pain. Symptoms include back pain that fluctuates, coming and going throughout the day and night and numbness in the neck area, as well as stiffness and lack of mobility. Recommended treatment for arthritis of the back includes heat, ice, rest, exercising and stretches, and over the counter anti-inflammatories. In severe cases, patients seek surgery but sometimes, surgery does more harm than good.


Symptoms may worsen with sitting, standing, sleeping, walking or climbing stairs. Often the SI joint is painful sitting or sleeping on the affected side. Some people have difficulty riding in a car or standing, sitting or walking too long. Pain can be worse with transitional movements (going from sit to stand), standing on one leg or climbing stairs.
These issues tend to be more rampant in women because they generally have wider pelvises than men, Ali Kotek, M.A., A.T.C., P.E.S., a performance enhancement specialist and fellow endurance program manager at Athletico, tells SELF. So to keep the thighs vertical, rather than angled in toward each other, the outer hips have to be even stronger. That’s especially true for women who are bounding from one foot to the other as they run down trails and treadmill belts.
That’s a problem. “Elongated periods of sitting sends messages to certain muscles to stay turned on, which keeps other muscles turned off,” says Beachbody fitness expert Cody Braun. “This creates an imbalance, which can immobilize your hips.” Your hips are built to move in almost any direction, explains Braun, and when they’re stiff, they don’t just make exercise more difficult; they also make you more prone to pain in surrounding joints — including the oft-troublesome lower back.
A vertebral compression fracture in the spine occurs when one or more vertebra become smashed or compressed. This injury is typical in individuals with osteoporosis and the elderly and can be caused by severe trauma to the back as well, such as in a car accident or following a fall. Symptoms include a sudden popping sound in the back and pain in the back. Treatment may include rest, wearing a back brace, or procedures such as vertebroplasty.
Tight hamstrings are a common cause of lower back pain, and if you have a desk job, you’re at risk for both. Perform the seated forward fold paschimottanasana several times a day to stretch your shoulders, hamstrings, and spine. Sit on your mat with your legs straight, your feet together and flexed, your torso erect (but not arched), and your chin lifted like you’re proud to be performing this pose (which you should be!). Take a deep breath in, straightening up as much as you can, and then fold forward, walking your hands down the sides of your legs as you lower your torso as far as you can. Hold the pose for 8-10 breaths, and then slowly reverse the movement to raise your torso back up.

Most back pain is harmless – caused by sleeping in an awkward position, stretched muscles, overexertion, sitting down too long or falling on the ischial tuberosity (the bones of the butt that you sit on), or minor hip injuries caused by twisting a certain way during sports like volleyball. Many injuries arise simply from improper form during exercise, sports injuries, or strains.

With a roster of muscles ranging from the powerful glutes to the small and agile abductors, the hips control practically all your movements. Almost every endurance athlete overworks some hip muscles while underworking others, causing severe imbalances: Runners are infamous for having weak hip adductors—the muscles on the side of the hip that help you step laterally—while cyclists tend to have massive quads and tiny glutes.
Although cauda equine syndrome is a rare condition—it is one that can cause permanent loss of movement in the lower body (paralysis) and permanent incontinence if not caught quickly. Cauda equine affects the leg nerves in such as way as to cause feeling of loss of control of the muscles in the leg. Cauda equina syndrome (Latin for Horses' Tail syndrome) is a condition caused by compression of the nerves at the base of the spine in the lumbosacral region of the spinal cord.
The iliotibial band is a thickening of the fascia lata, the deep fascia of the thigh. Think of it as a thick long ligament like structure that connects the hip to the lower leg along the outside of the thigh.  Tightness in the iliotibial band can cause patellofemoral pain, trochanteric bursitis, and friction syndromes at the knee. This is a hip stretch I commonly prescribe to runners and people suffering from knee pain.
3. Hug it out. Start the supine hip flexor stretch the same as the glute bridge, but keep the right leg relaxed on the floor. Pull shoulder blades down and back to lift hips. Grab the back thigh of the left leg and pull the knee toward the chest. Keep the right leg straight and push its heel into the floor (to feel it in the butt). Hold for 30-45 seconds and switch legs.
Meanwhile, many non-dangerous problems can cause amazingly severe back pain. A muscle cramp is a good analogy — just think about how painful a Charley horse is! Regardless of what’s actually going on in there, muscle pain is probably the main thing that back pain patients are feeling. The phenomenon of trigger points — tiny muscle cramps, basically11 — could be the entire problem, or a complication that’s more painful and persistent than the original problem. It’s hard to overstate how painful trigger points can be, but they are not dangerous to anything but your comfort.
The cross-legged twist will stretch the outside of your hips and part of your buttocks. Sit crossed-legged on the floor and then lift your right leg and place your foot on the outside of the bent left leg. Twist your upper body to look over your right shoulder. You can reach your left arm to the outside of your right leg to hold the stretch and place your right hand on the floor behind you for support. After 30 to 40 seconds, switch sides.
A few cancers in their early stages can be hard to tell apart from ordinary back pain — a bone cancer in the vertebrae, for instance — and these create a frustrating diagnostic problem. They are too rare for doctors to inflict cancer testing on every low back pain patient “just in case.” And yet the possibility cannot be dismissed, either! It’s an unsolveable problem.
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.

If the problem originates in the hip joint itself, common symptoms include groin pain on the affected side, and sometimes down the inner aspect of the thigh in the front of the leg. This pain can move to the knee and sometimes feels like a knee problem instead of a hip problem. Walking worsens the pain and with continued activity, the pain increases. Rest relieves it; however, when hip arthritis becomes severe, you may have pain most of the time. Minimal activity such as slight movements while in bed can worsen the pain. Other conditions such as advanced congenital hip dysplasia or avascular necrosis of the hip can cause these symptoms as well.
While the content and materials contained in the articles on this website have been written & researched by Sally Ann Quirke, a professional, practising & fully qualified Chartered Physiotherapist (Physical Therapist) based in Ireland, they are provided for general information and educational purposes only. They do not constitute medical advice on any particular individual situation. Please see your Chartered Physiotherapist or other medical practitioner for full and individual consultation.
When it comes to your workouts, low-impact aerobic exercises are generally best and least likely to cause issues, says Kelton Vasileff, M.D., an orthopedic surgeon at The Ohio State University Wexner Medical Center. “I recommend swimming, walking, elliptical, cycling, and stationary biking for general exercise,” he says. All of these are great ways to move your body without pounding your joints.
When it comes to your workouts, low-impact aerobic exercises are generally best and least likely to cause issues, says Kelton Vasileff, M.D., an orthopedic surgeon at The Ohio State University Wexner Medical Center. “I recommend swimming, walking, elliptical, cycling, and stationary biking for general exercise,” he says. All of these are great ways to move your body without pounding your joints.
If you are experiencing true numbness14 around the groin and buttocks and/or failure of bladder or bowel control, please consider it a serious emergency — do not wait to see if it goes away. These symptoms indicate spinal cord injury or compression15 and require immediate medical attention. (Few people will have symptoms like this without having already decided it’s an emergency, but I have to cover all the bases here.)
Greater trochanteric pain syndrome describes pain that is felt along the outer hip area. Causes include sports injury, muscle tears, and injury due to motor vehicle accidents. The pain is caused by a combination of inflammation in two distinct areas: the bursa of the hip and pain in the buttock (gluteal muscles). Pain may also be caused by tendinitis of the hip abductor muscles. Symptoms of greater trochanteric pain syndrome include hip pain at night lying on side, dislocated hip symptoms, and hip muscle weakness. Hip pain relief can be sought through anti-inflammatory medications, physical therapy, and stretches for hip pain.
Too much sitting is the enemy of stiff or achy hips, says Lisa Woods, a personal trainer and yoga teacher in Eagle, Colorado. The big problem, though, isn’t just the discomfort in the sides of your thighs. It’s the chain of pain that dysfunctional hips can create, including often-debilitating sciatic nerve pain that can start in your lower back and go down the backs of your legs.
If the problem originates in the hip joint itself, common symptoms include groin pain on the affected side, and sometimes down the inner aspect of the thigh in the front of the leg. This pain can move to the knee and sometimes feels like a knee problem instead of a hip problem. Walking worsens the pain and with continued activity, the pain increases. Rest relieves it; however, when hip arthritis becomes severe, you may have pain most of the time. Minimal activity such as slight movements while in bed can worsen the pain. Other conditions such as advanced congenital hip dysplasia or avascular necrosis of the hip can cause these symptoms as well.
Along with mobility and strength exercises, it's a good idea to do some flexibility work on a regular basis, especially as the season progresses and you start increasing your training mileage. Yoga is a great option—variations of hip openers and other poses can really help the overall function of your hips. The following stretches will help increase flexibility in your hips.
At the very least, the tension and/or spasm in muscles that cross over the hip and attach onto the pelvis can contribute to imbalance, in terms of how strong and flexible each muscle group is in relation to the others. But muscle imbalance in the hips and the spine may make for pain, limitation and/or posture problems. It can also increase the healing challenge put to you by an existing injury or condition, for example, scoliosis.
An ideal pose for stretching out your hips, lower back, glutes, hips, and knees, it also can help to relieve sciatica. Start on your back with your knees bent, and your feet hip-width apart and flat on the floor. Raise your right foot and rest it on top of your left thigh above your knee. Thread your right hand between your legs and grip the back of your left thigh, bringing your left hand to meet it. Pull both legs toward your chest as far as you can. Take 8-10 breaths, and then release. Switch legs, and repeat.

This pose is one of the most comfy ones for the lower back and hips. It will also stretch your neck, shoulders, and chest. Lie on your back and hug your knees into your chest. Breathe in deeply, and then exhale completely, lowering both legs to the floor on your left (keep your knees higher than your hips). Position your arms out to your sides, or place your left forearm on your right thigh (as pictured) to encourage a deep stretch, relaxing both shoulders to the floor. Shift your gaze over your right shoulder. Close your eyes, take 10 deep breaths, and then release. Repeat to your other side.
Joint injections: Steroids can reduce the swelling and inflammation of the nerves. Joint injections are a minimally invasive procedure that involves an injection of a corticosteroid and an analgesic-numbing agent into the painful joint (Fig. 2). While the results tend to be temporary, if the injections are helpful they can be repeated up to three times a year.
Along with mobility and strength exercises, it's a good idea to do some flexibility work on a regular basis, especially as the season progresses and you start increasing your training mileage. Yoga is a great option—variations of hip openers and other poses can really help the overall function of your hips. The following stretches will help increase flexibility in your hips.
Although some of us are familiar with a pinched nerve, which is associated with sciatic-like pain in the leg, irritation or inflammation of nerves in the low back region can also cause a sensation in the upper leg or hip region. It is important to realize there are many things that can go wrong in the spine. Remember, sciatica is not a diagnosis but, instead, a symptom of an underlying problem. It is possible to feel back-related pain in the hip region and upper leg as well. It depends on the nerves involved and ultimately the actual diagnosis. Back pain or hip pain is not a diagnosis but simply an explanation of the area of pain. Symptoms are correlated with physical examination and confirmed through x-rays and similar tests.
You can strain or tear one or more of your hip flexors when you make sudden movements such as changing directions while running or kicking. Sports and athletic activities where this is likely to occur include running, football, soccer, martial arts, dancing, and hockey. In everyday life, you can strain a hip flexor when you slip and fall, for example.
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