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.


Piriformis syndrome is a type of neurological injury that is caused by compression of the sciatic nerve. The piriformis muscle sits deep within the buttock, behind the gluteus maximus. It starts at the lower spine and connects to the femur muscle. This nerve can become compressed from swelling of the piriformis muscle due to injury or muscle spasms or inflammation. Piriformis syndrome causes symptoms including pain in the back of the thigh, pain in the back of knee, buttock pain, pain in the calf, pain in sciatic nerve branches (pain in the nerves of leg and the buttocks, then), shooting pain in the legs, and hip pain after sitting.

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.
• Spinal stenosis. Literally meaning "spinal narrowing," spinal stenosis can occur when changes in arthritis lead to bony overgrowth of the vertebrae and thickening of the ligaments. This can occur with osteoarthritis or ankylosing spondylitis. If a significant overgrowth occurs, it can cause the spinal column to narrow and press on the nerves housed within. Because the affected nerves have many functions, the condition may cause diverse problems in the lower body, including back pain, pain or numbness in the legs, constipation or urinary incontinence.
Of course, you know what it feels like to have a tight muscle. But tight hips aren't just uncomfortable—they can lead to all sorts of other aches and pains, especially in the lower back. "People focus on the hips and say their hips are tight, but we don't always think about the fact that the lower back connects to our legs at the hip," Charlee Atkins, C.S.C.S., instructor at Soul Annex in New York City and creator of Le Stretch class, tells SELF. Tight hip flexors make it harder for your pelvis to rotate properly, which can cause your lower back to overcompensate, "and this can be a setup for lower-back injury," Teo Mendez, M.D., an orthopedic surgeon at NY Orthopedics who focuses on operative and non-operative management of sports-related injuries, musculoskeletal injuries, and arthritis, tells SELF.
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.

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.
How to do it: Grip the barbell so you’re standing straight with the barbell at arm’s length in front of your thighs. Kick your left leg back so it’s just off the floor. Bend over so you’re hingeing at the hip while allowing only a slight bend in the right knee, and lower the barbell to the floor while keeping it close to your body. Pause at the bottom, then reverse the movement back up to the top. That’s one rep. Repeat this movement, alternating sides each time.

How to do it: With your bar on the floor in front of you, place your feet slightly narrower than hip-width apart. Make sure the bar is as close to your shins as possible, and position your hands on the bar, just outside your shins. With your shins perpendicular to the floor, flex your hamstrings and lift your butt up and back, extending your legs so they’re nearly straight, with only a slight bend in the knee. Slide the bar up and toward the shins. Then, bend your knees slightly and proceed to lift the bar all the way off the floor in a straight line. Extend your hips fully at the top and stand tall with neck relaxed, arms straight. Pinch your shoulder blades together, squeezing your abs and glutes. Keeping the bar close to your body and with a straight back, reverse the movement. That’s one rep.

You may hear a clicking noise when you move your hip, but that sound is not necessarily a hip flexor issue. Siegrist says the clicking isn't generally the hip flexor alone and often comes from a moving part, like the joint. "Maybe there is a loose body in the joint or loose cartilage at the edge of the hip joint that is mechanically getting irritated,” she says.


Lumbosacral plexopathy, more commonly called diabetic lumbosacral plexopathy is a condition caused by advanced diabetes, in which patients begin suffering with debilitating pain in the hips, thighs, and legs. With lumbosacral plexopathy there is typically a wasting of the leg muscles asymmetrically. This condition can affect individuals who have both type I or II diabetes. Treatment includes controlling blood glucose levels, and chronic neuropathic pain management achieved through anticonvulsant medications (such as gabapentin for back pain) and selective norepinephrine reuptake inhibitors (such as duloxetine).

Keeping your hips mobile is important for overall hip function and athletic performance. Mobility refers to the ability of your joints to move through a pain-free, unrestricted range of motion. For cyclists, hip mobility is critical since pedaling occurs in one plane of motion, and after miles and miles in the saddle, hip tightness and restriction may develop. The following movements will help with hip mobility.
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.

Take a step back and think about where you spend most of your day. If you're a young athlete, you probably spend most of your time at school or maybe work or practice and  even a little time at home, if you're lucky. Now think about what position your body is in during those periods. I would bet that you spend most of your day sitting down. You may walk to class or run in practice, but the majority of your day is spent in a seated position.
With lumbar stenosis nerves in the spinal cord and lower back become compressed. This type of injury can cause many of the symptoms of sciatica—including numbness and tingling in the legs and pain in the buttocks. Possible treatments include a sciatic nerve block, steroid injections, opioid pain medications, physical therapy, and rest. However, the use of epidural steroid injections is not supported by limited amount of available evidence.
So, who cares right? Wrong. Everyone has seen that little old man walking with a cane, hunched over almost to the point of staring at the ground. Do you think he always walked like that? I'd bet you he didn't. Maybe he had an injury that never healed properly, or maybe after spending years and years in a similar position, his body became tighter and tighter until eventually he ended up bent over.
The hip joint is designed to withstand a fair amount of wear and tear, but it’s not indestructible. For example, when you walk, a cushion of cartilage helps prevent friction as the hip bone moves in its socket. With age and use, this cartilage can wear down or become damaged, or the hip bone itself can be fractured during a fall. In fact, more than 300,000 adults over 65 are hospitalized for hip fractures each year, according to the Agency for Healthcare Research and Quality.
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.
How to: Get in a standing position, with one foot about a foot's distance behind the other, hips in line. Your feet should be flat, and your legs should be straight. Cross the back foot behind the front one as you reach your arm on the same side overhead. Return to starting position. That's one rep. Do eight reps on each side. Do three to four sets before moving on to the next move, resting for 30 seconds in between each set.
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The main work of your hip flexors is to bring your knee toward your chest and to bend at the waist. Symptoms associated with a hip flexor strain can range from mild to severe and can impact your mobility. If you don’t rest and seek treatment, your hip flexor strain symptoms could get worse. But there are many at-home activities and remedies that can help reduce hip flexor strain symptoms.
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