But how can you tell? It can be tricky. This is a concise, readable guide to symptoms that need better-safe-than-sorry investigation with your doctor. (It’s basically just a plain English version of clinical guidelines for doctors.9) In other words, this article explains the difference between “dangerous” and “just painful” as clearly as possible. Tables, checklists, and examples ahead.

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.

To make a long story short, I have been experiencing acute pain in my right hip as a result of driving so much. It does not really hurt while I am driving, but when I try to get out of the vehicle, the pain can be quite severe (making it almost impossible to walk for a ten seconds or so). In fact, it had gotten so bad that I was having trouble after sitting period (i.e. in chairs, etc). I was beginning to fear that I was going to be fundamentally disabled unless something changed.
However, runners are infamous for imbalances in their hip muscles. The most common weak ones are the hip abductors, the muscles on the side of your butt responsible for moving your leg out away from your body to the side. Lev Kalika, D.C., clinical director of New York Dynamic Neuromuscular Rehabilitation & Physical Therapy, tells SELF that since most runners run, run, and only run, they are constantly training their hip flexors and extensors through a very small range of motion. That can lead the hips to be unstable on the less-frequent occasions when you bring your knee all the way to your chest or thrust your hips forward.

Sacroiliitis is an inflammation of one or both of the sacroiliac joints, the spot where the lower spine connects to the pelvis. Sacroiliitis can cause pain in the buttocks, lower back, and may even extend down one or both legs. The pain can worsen with prolonged standing or climbing stairs. Sacroiliitis can be caused by arthritis, injury, pregnancy, or infection.
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.
This pose targets your spine, groin, and the backs and insides of your legs. Sit tall with your feet flexed, and your legs straight and spread as wide as possible. Place your palms on the floor in front of you, pressing them into it as you straighten and stretch your spine. Keeping your torso erect, inhale deeply, and then exhale completely, walking your hands forward as you lower your torso as far as you can towards the floor. Stop when you feel a deep stretch in the areas mentioned above. Hold for 8-10 breaths, and then slowly raise your torso back up.
In addition to these exercises, there are simple things you can do every day to help reduce your risk of hip flexor pain.  If you sit at a desk for long periods of time, try to get up and move around every hour or so.  Warm up properly before any physical activity, and stretch regularly at the end of each workout.  Your hips will thank you for it! 
But there are some pretty serious causes for back and hip pain as well. Lower back pain, in particular, can be a sign of various serious conditions such as advanced kidney infections or a condition called interstitial cystitis, which can cause inflammation of the tissues of the bladder. Sciatica causes lower back pain, pain in the back of the knee, pain in right buttock cheek, unilateral (one-sided) pain, thigh pain, pain behind the knee and calf, and muscle weakness in legs as well.
The irritation of the sciatic nerve causes hip and lower back pain, which spreads downwards to the limbs and feet. It is estimated that 4 out of 10 people will develop sciatica or irritation of this nerve at some point in life. The sciatic nerve is located deep in the buttock, beneath the piriformis muscle, so its constriction and swelling can also cause sciatica pain and irritations.
In cases of strains, tears, and other injuries, strapping or taping your lower back will provide the extra support it needs. Alternatively, for extra support, try the Elastoplast back brace. This will not only promote the natural shape of your lower back during exercise or daily life, but also limit any extra strain placed on your back. For tips on how to apply strapping and tape effectively, see our section on tape and strapping preparation.
Start on your hands and knees with your palms flat on the floor and shoulder-width apart. Your neck should be in line with your back, and your gaze should be down or slightly forward. Brace your core, and raise your left arm and right leg until they’re in line with your body. If that’s too challenging, only raise your leg. Either way, hold for five to 10 seconds, and then return to the starting position. Repeat on the opposite side (right arm and left leg) to complete one rep. Aim for five to seven reps total.

I use this for people that really present in an anterior pelvic tilt, or with people that appear to have too loose of an anterior hip capsule.  In fact, this has completely replaced the common variations of hip flexor stretches in all of our programs at Champion.  This works great for people with low back pain, hip pain, and postural and biomechanical issues related to too much of an anterior pelvic tilt.
While sciatica is healing, try to remain active. Motion can actually help reduce inflammation and pain. A physical therapist can show you how to gently stretch the hamstring and lower back. Practicing tai chi or yoga can help stabilize the affected area and strengthen your core. Depending on your medical condition, certain exercises may not be recommended. Your doctor may also recommend taking short walks.
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.
However, even the things you do every day — like sitting in front of a computer or at a desk for hours — can both weaken and shorten (tighten) your hip flexors, making them more prone to injury. Because of this, exercises (such as squats) and targeted stretches which focus on strengthening the hip muscles and improving hip mobility are key to preventing injuries.
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.
Kneel on your mat with thighs perpendicular to the floor and tops of of your feet facing down. Place a yoga block between your feet. Bring your inner knees together. Slide your feet apart so they are slightly wider than your hips, and press the tops of your feet evenly into the mat. Slowly sit down on the yoga block. Use your hands to turn the top of your thighs inward. Allow the backs of your hands to rest on your thighs. Hold for at least 30 seconds.
In this study, one patient with sciatica was sent for ten MRIs, which produced 49 distinct “findings,” 16 of them unique, none of which occurred in all ten reports. On average, each radiologist made about a dozen errors, seeing one or two things that weren’t there and missing about ten things that were. Yikes. Read a more detailed and informal description of this study.

A diagnostic SI joint injection may be performed to confirm the cause of pain. The SI joint is injected with a local anesthetic and corticosteroid medication. The injection is given using X-ray fluoroscopy to ensure accurate needle placement in the SI joint. Your pain level is evaluated before and 20-30 minutes after injection, and monitored over the next week. Sacroiliac joint involvement is confirmed if your pain level decreases by more than 75%. If your pain level does not change after the injection, it is unlikely that the SI joint is the cause of your low back pain.

To achieve this stretch, start out on your hands and knees. Slowly widen your knees out as far as they can go, and make sure to keep your lower legs in line with your knees. Your lower legs and feet should be parallel with one another. Next, ease your upper body forward on your forearms and reach forward until you feel the stretch. Hold this pose for about 10 seconds.
Some of these red flags are much less red than others, especially depending on the circumstances. For instance, “weight loss” is common and often the sign of successful diet! (Well, at least temporarily successful, anyway. 😃) Obviously, if you know of a harmless reason why you have a red flag symptom, it isn’t really a red flag (duh!). But every single actual red flag — in combination with severe low back pain that’s been going on for several weeks — is definitely a good reason to get yourself checked out.

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 you suffer with hip pain, this can be especially hard, as every movement we make, it seems, utilizes the hip in some way. Often, hip pain presents as dislocated hip symptoms because the hip pops when you move. This can be especially frightening, making one think the hip is broken. When one experiences hip pain running all down the right side of the body, with lower back pain in the right side above the hip area-- combined with pain that runs down the back of the leg, or upper thigh pain when walking, you may have sciatica, a condition caused by a compression of the sciatic nerve.

How to: Get on your hands and knees, in a tabletop position (a). Slowly widen your knees out as far as they can go and bring your feet in line with your knees. Your shins should be parallel with one another (b). Flex your feet and ease yourself forward onto your forearms. (If the stretch is too intense, try putting your arms on a block or firm pillow.) Hold for eight to 12 breaths (c). If holding the stretch for longer, try slowly moving your hips forward and backward to bring the stretch to different parts of your hips.

The hip flexors are the muscles at the front of your hip. They’re responsible for several essential functions. Since they’re so often overlooked, we often forget to stretch them before exercising or engaging in rigorous activities. Tight hip flexors can also be a product of being sedentary. So, if you don’t lead an active lifestyle, or if you spend most of your day sitting at a desk, you’ll be susceptible to hip flexor tightness.

This pose targets your spine, groin, and the backs and insides of your legs. Sit tall with your feet flexed, and your legs straight and spread as wide as possible. Place your palms on the floor in front of you, pressing them into it as you straighten and stretch your spine. Keeping your torso erect, inhale deeply, and then exhale completely, walking your hands forward as you lower your torso as far as you can towards the floor. Stop when you feel a deep stretch in the areas mentioned above. Hold for 8-10 breaths, and then slowly raise your torso back up.

Sacroiliitis is an inflammation of one or both of the sacroiliac joints, the spot where the lower spine connects to the pelvis. Sacroiliitis can cause pain in the buttocks, lower back, and may even extend down one or both legs. The pain can worsen with prolonged standing or climbing stairs. Sacroiliitis can be caused by arthritis, injury, pregnancy, or infection.
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.
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.
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.
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.
How to: Sit down with your knees bent and feet flat on the floor in front of you (a). Place your right ankle on top of your left thigh and flex your right foot (b). Put your hands behind your body, fingertips facing away from your body and begin to press your hips toward your heels until you feel a stretch through your outer left hip. Keep your back tall and chest open (c). Hold for six to eight breaths, then repeat on the other side.
Located deep in the front of the hip and connecting the leg, pelvis, and abdomen, the hip flexors— surprise, surprise— flex the hip. But despite being some of the most powerful muscles in our bodies (with a clearly important role), it’s easy to neglect our poor hip flexors— often without even knowing it. It turns out just working at a desk all day (guilty!) can really weaken hip flexors since they tend to shorten up while in a seated position. This tightness disrupts good posture and is a common cause of lower back pain. Weakened hip flexors can also increase the risk of foot, ankle, and knee injuries (especially among runners) Hip muscle weakness and overuse injuries in recreational runners. Niemuth, P.E., Johnson, R.J., Myers, M.J., et al. Rocky Mountain University of Health Professions, Provo, VT. Clinical Journal of Sport Medicine, 2005 Jan; 15 (1): 14-21.. So be sure to get up, stand up every hour or so! And giving the hip flexors some extra attention is not just about injury prevention. Adding power to workouts, working toward greater flexibility, and getting speedier while running is also, as they say, all in the hips The effect of walking speed on muscle function and mechanical energetics. Neptune, R.R., Sasaki, K., and Kautz, S.A. Department of Mechanical Engineering, The University of Texas, Austin, TX. Gait & Posture, 2008 Jul; 28 (1): 135-43..
Imagine not being able to climb stairs, bend over, or even walk Changes in hip joint muscle-tendon lengths with mode of locomotion. Riley, P.O., Franz, J., Dicharry, J., et al. Center for Applied Biomechanics, University of Virginia, Charlottesville, VA. Gait & Posture, 2010 Feb; 31 (2): 279-83.. All pretty essential if you ask us! But that’s what our bodies would be like without our hip flexor muscles. Never heard of ‘em? It’s about time we share why they’re so important, how your desk job might be making them weaker (ah!), and the best ways to stretch them out.
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.
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