Correct posture and a protected spine requires strong muscles, and strong muscles require exercise. Rather than sit around waiting for lower back pain to fix itself, keeping active and exercising regularly can actually help it recover and stay in shape much more quickly. Not only that, regular exercise will help you lose weight which, in turn, will take pressure off your legs, hips, and back.
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.
You’ve heard the saying: it’s all in the hips, but for many of us, our hips – or more precisely, our hip flexors – are tight, stiff and inflexible. If you’re an office worker you can probably thank sitting down at your desk 8 or more hours a day for your tight hip flexors. Habitual sitting causes your hip flexors to tighten and shorten – adjustable standing desks, anyone?
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.
The only activity performed on a regular basis that fully extends the hip is walking and running. Hence as activity levels decrease so does the ability to extend the hip. This results in compensatory pelvic tilting and lumbar extension, with a reduction in the ability to accommodate uneven ground, negotiate obstacles, or attempt to change walking speed quickly. The compensatory pelvic tilt that accompanies tight hip flexors also predisposes the individual to postural problems and back pain. Hip stretches done on a regular basis can help you maintain extension range of motion and thereby improve function.
People routinely have no pain despite the presence of obvious arthritic degeneration, herniated discs, and other seemingly serious structural problems like stenosis and spondylolistheses. This surprising contradiction has been made clear by a wide variety of research over the years, but the most notable in recent history is Brinjikji 2015. There are painful spinal problems, of course — which was also shown by Brinjikji et al in a companion paper — but they are mostly more rare and unpredictable than most people suspect, and there are many fascinating examples of people who “should” be in pain but are not, and vice versa. Spinal problems are only one of many ingredients in back pain. BACK TO TEXT
Acute back pain is often the result of muscle sprains or strains. Sprains occur when your ligaments are overstretched and sometimes torn. Strains, on the other hand, are caused by stretching — and possible tearing — of your tendons or muscles. Though the immediate reaction is pain in your back, you may also experience dull aches or discomfort in your hip.
A thorough history and physical examination is a good start when sorting out symptoms. X-rays will attest to specific bony/cartilage changes but x-rays don't always correlate with the pain. It is possible to have little pain and much damage on the x-rays or visa versa. It is important to treat the patient, not the x-rays alone. Secondly, x-rays of the back can reveal degeneration of the discs or small joints in the spine but the person does well. Contrary, the back may look degenerative and because of the subsequent bone spurring and symptoms as arthritis progresses, it is important to obtain an MRI to confirm nerve impingements that are suspected. X-rays alone will not show nerve impingement. As you can see, it is important to undergo the history and physical examination and tests that can confirm your diagnosis before treatment begins.
How to do it: Stand up tall while holding onto a sturdy object like a chair, or rest your hands on a wall. Keeping your back straight and core tight, raise one leg up and lift it out to the side and away from your body, keeping your leg straight. Pause for one to two seconds, then return to the start position. That’s one rep. Repeat this movement, alternating sides each time.
Obtaining an accurate diagnosis is the first step to resuming activities and living an active lifestyle. Let's discuss the reasons for confusion and see if we can realize the causes and treatments for both hip and back pain. Some of a patient's misunderstanding about the origin of the pain is due to not understanding hip and back anatomy. Sounds odd but it's true. The hip joint lies just behind the groin area on each side of the body. At the same time, the spine runs from the base of the skull to the tip of the tailbone. The lumbar spine contains specific nerves that can influence the feelings in the region around the hip area.
I call it the true hip flexor stretch as I want you to truly work on stretching the hip flexor and not just torque your body into hip and lumbar extension. It’s very easy for the body to take the path of least resistance when stretching. People with tight hip flexors and poor hip extension often just end up compensating and either hyperextend their low back or stress the anterior capsule of the hip joint.
This standard recommendation reinforces the alarming idea that low back pain that lasts longer than a few weeks is Really Bad News. It’s not. It’s a clue. It’s a reason for concern and alertness. But many cases of low back pain that last for 6 weeks will still go away. Once again, see the 2009 research published in the British Medical Journal, which showed that more than 30% of patients with “new” chronic low back pain will still recover without treatment. BACK TO TEXT
Sacroiliac joint pain can occur when movement in the pelvis is not the same on both sides. Uneven movement may occur when one leg is longer or weaker than the other, or with arthritis in the hip or knee problems. Autoimmune diseases, such as ankylosingspondyloarthropathy, and biomechanical conditions, such as wearing a walking boot following foot/ankle surgery or non-supportive footwear, can lead to degenerative sacroiliitis.
MRI and x-ray for low back pain are surprisingly unreliable,1 because things like bulging discs usually aren’t a deal,2 most back pain goes away on its own,3 and trigger points (“muscle knots”) are common and can be alarmingly intense but aren’t dangerous.4 Most patients are much better off when they feel confident about these things. The power of justified, rational confidence is a huge factor in back pain.5 Sadly, many healthcare professionals continue to perpetuate the idea of fragile backs,6 which undermines that valuable confidence.
Ligaments connecting your back to your pelvis: Straining the ligaments around your buttocks and pelvis may result in this type of pain. This area can also be referred to as the sacro-iliac joint. Due to this area linking your lower back and hip you may feel your pain from your lower back through to your hip. Treatment in this presentation should be primarily to the ligament that is strained and addressing posture as well as back stretching exercises when indicated.
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.”
A basic bodyweight glute bridge is one of Lefkowith's favorites. Want to try it? Lie on the ground with your knees bent and your feet flat on the floor, and push your hips up toward the sky, squeezing your glutes at the top. This will not only help get your glutes in the game, but it also gives your hip flexors a chance to stretch out. (Try these five hip openers, too.)
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.