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.

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.


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.”
Sacroiliac (SI) joint pain is felt in the low back and buttocks. The pain is caused by damage or injury to the joint between the spine and hip. Sacroiliac pain can mimic other conditions, such as a herniated disc or hip problem. Accurate diagnosis is important to determine the source of pain. Physical therapy, stretching exercises, pain medication, and joint injections are used first to manage the symptoms. Surgery to fuse the joint and stop painful motion may be recommended.
Progress to add core engagement.  Once they can master the posterior pelvic tilt, I usually progress to assist by curing core engagement.  You can do this by pacing both hands together on top of your front knee and push straight down, or by holding a massage stick or dowel in front of you and pushing down into the ground.  Key here is to have arms straight and to push down with you core, not your triceps.
Please note that none of the above given tips or recommendations substitute medical advice. Important: consult a health professional in case of an injury or if you suspect overuse of joints or a medical condition such as a fracture. A physician should be consulted in those acute cases when the condition is accompanied by reddening, swelling or hyperthermia of joints, ongoing joint trouble or severe pain and/or are associated with neurological symptoms
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.
The hip rotators not only rotate the thigh on the pelvis but more functionally rotate the pelvis on the weight bearing fixed thigh. Activities such as swing a golf club, and even just walking require some rotation of the pelvis on the weight bearing leg.  While we don't need that much range of motion to walk, activities such as running, dancing, tennis, and many other sports can require more hip rotation.
Mike, I cannot thank you enough for this instruction on stretching the hip flexor muscle. Over the past three years, my driving has increased dramatically. It is not uncommon for me to drive 1,000 business miles or more each week. I have always been very fit, but now, in my early 50’s, I am finding that it is easier to get “wracked up” by things like excessive driving.
The problem is that these muscles aren't designed to be prime movers—they're designed to support the action of the glutes. Inability of activating the glutes can result in low back pain (low back muscles compensating), hamstring strains (overacting hamstrings), hip pain (resulting from hamstring-dominant hip extension) and knee pain (poor glute medius strength).
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.
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.
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.
One of the biggest dangers to your health is constantly sitting for long periods of time which can cause physical and emotional damage. 10 key moves that will help loosen your hip flexor and unlock the power within your body. There is an easy to follow program to unlocking your hip flexors that will strengthen your body, improve your health, and have an all day energy..... https://bit.ly/2HYTPrJ Report
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?
Often, a pulled or strained hamstring muscle can cause radiating lower back pain, and pain in the butt area as well. So, often, if you exercise a lot and are suddenly telling your friends, "My butt hurts a lot when I exercise it's likely because of a pulled hamstring. Often, a pulled hamstring can cause referred pain, such as upper thigh pain or upper calf pain and pain in the back of knee area as well. Symptoms of a pulled hamstring include severe pain during exercise and tenderness, pain in thigh muscles, sharp front thigh pain, and tenderness and bruising in the thigh area. The best pain reliever for hamstring pain is to use the RICE method explained above and to do stretches that relax the muscles of the thigh.
While you can’t choose where the weight comes off, you can eventually slim your hips so long as you stay consistent in your training. Cardiovascular exercise can help you lose some fat, but strength training serves a twofold purpose, burning fat while developing muscle for all-over tightening. “The more you build a muscle, the more [that part of the body] is going to firm up,” Braun says.
• Psoriatic arthritis. Psoriatic arthritis is a form of arthritis accompanied by the skin disease psoriasis. The skin disease often precedes the arthritis; in a small percentage the joint disease develops before the skin disease. For about 20 percent of people with psoriatic arthritis, the disease involves the spine. In some cases, bony overgrowth can cause two or more vertebrae to grow together, or fuse, causing stiffness.
Your doctor may order imaging tests, such as an MRI, to get more information about the location and cause of the irritated nerve. An MRI can show the alignment of vertebral disks, ligaments, and muscles. A CT scan using contrast dye can also provide a useful picture of the spinal cord and nerves. Determining the cause of sciatica can help guide the course of treatment. X-rays can help identify bony abnormalities but can't detect nerve problems.
Stand with your feet hip-width apart, knees slightly bent, and hands on hips. Brace your core—imagine you’re about to get punched in the stomach. Without changing the position of your knees, bend at your hips and lower your torso until it’s almost parallel to the floor (or as far as you can comfortably go without rounding your back). Pause, then lift your torso back to the starting position. Be sure to squeeze your glutes and push your hips forward to lift your torso back to the starting position. This ensures you’re engaging your hip muscles instead of relying on your lower back. Do 10 reps total.
There is controversy and scientific uncertainty about trigger points. It’s undeniable that mammals suffer from sensitive spots in our soft tissues … but their nature remains unclear, and the “tiny cramp” theory could be wrong. The tiny cramp theory is formally known as the “expanded integrated hypothesis,” and it has been prominently criticized by Quintner et al (and not many others). However, it’s the mostly widely accepted explanation for now. BACK TO TEXT
Lie on your back with your knees bent and your feet flat on the floor. Tighten the muscles in your buttocks, then lift your hips off the ground and hold for about five seconds before slowly lowering yourself back down. Be sure to breathe throughout the exercise. As with the first exercise, you can work up to doing 30 repetitions, resting for a few seconds (or longer) between each. “If you start to get tired, stop and rest for a couple of minutes,” Pariser says.
Marvelously progressive, concise, and cogent guidelines for physicians on the treatment of low back pain. These guidelines almost entirely “get it right” in my opinion, and are completely consistent with recommendations I’ve been making for years on PainScience.com. They are particularly to be praised for strongly discouraging physicians from ordering imaging tests only “for patients with low back pain when severe or progressive neurologic deficits are present or when serious underlying conditions are suspected.”
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.
A sedentary lifestyle can lead to having weak and tight hip flexors as they are always in the shortened position. Tight hip flexors can lead to a limited range of motion, poor posture, lower back and hip pain, and even injuries. These muscles need to get a workout when you are standing and doing movements such as raising your leg to climb stairs, run, or ride a bicycle.​
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