Enthoven WT, Geuze J, Scheele J, et al. Prevalence and "Red Flags" Regarding Specified Causes of Back Pain in Older Adults Presenting in General Practice. Phys Ther. 2016 Mar;96(3):305–12. PubMed #26183589. How many cases of back pain in older adults have a serious underlying cause? Only about 6% … but 5% of those are fractures (which are serious, but they aren’t cancer either). The 1% is divided amongst all other serious causes. In this study of 669 patients, a vertebral fracture was found in 33 of them, and the chances of this diagnosis was higher in older patients with more intense pain in the upper back, and (duh) trauma. BACK TO TEXT
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.
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.

The same lack of correct breathing also perpetuates a diastasis. Without proper deep breathing, you can compensate a couple ways. The first is to draw in your belly button and go into a shallow breathing pattern and the second is to have belly only expansion. Both of these can hinder diastasis healing. The cool thing is that I’ve actually had women experience spontaneous firming of their diastasis when we get down a correct breathing pattern. It’s a phenomena that always amazes me. The same thing can happen with decreasing prolapse symptoms.
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.
AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS Find an Orthopaedist program on this website.
How to do it: Put a 20- to 36-inch box behind you. With your feet hip-width apart, lift your leg and place the instep of your rear foot on the bench. Lower your hips toward the floor so your rear knee comes close to the floor, keeping your back straight. As you descend, make sure you don’t bend the torso excessively forward and your front knee does not pass your front toes. Pause when your rear knee is close to the floor and your front quad is parallel with the floor, then drive through your front heel to return to the start position. Repeat this movement, alternating sides each time.
Apply the above concept to your hips. When you sit, your hips are in a "flexed" position. Therefore, the muscles that flex your hips are in a shortened state. You probably spend at least a third of your day sitting down. Think about how much time those hip flexor muscles stay shortened. A lot. Over time, they become tighter and tighter until you look like the old man in the picture. So unless you want to look like that, perform the stretches shown below.
• Scoliosis. Instead of running straight up the center of the back, a spine with scoliosis twists to one side. Scoliosis can be classified as true (meaning it has to do with abnormal development of the spine) or functional (meaning its cause is not directly related to the spine). Functional scoliosis may occur when a discrepancy in leg length causes the pelvis to tilt to one side to compensate. The cause of true scoliosis is largely unknown, although doctors suspect that it may be the result of imbalanced growth in childhood.
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.)
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.

The most common cause of sciatica is a herniated disk. Disks act like cushions between the vertebrae of your spine. These disks get weaker as you age and become more vulnerable to injury. Sometimes the gel-like center of a disk pushes through its outer lining and presses on the roots of the sciatic nerve. About 1 in 50 people will get a herniated disk at some point in life. Up to a quarter of them will have symptoms that last more than 6 weeks.
Unilateral exercises like step-ups and single-leg toe touches are particularly effective at strengthening the glutes, while walking lunges, lateral lunges, air squats, and jump squats will zero in on all the muscles surrounding the hips. Whether you’re at the gym or heading out for (or back from!) a run, these five moves will strengthen and open your hips, keep them loose long-term, and not only make you a better runner, but make running feel better to you.
• Osteoarthritis. The most common form of arthritis of the back, osteoarthritis is a chronic condition characterized by the breakdown of the cartilage that cushions the ends of the bones where they meet to form joints. In the spine, this breakdown occurs in the cartilage of the facet joints, where the vertebrae join. As a result, movement of the bones can cause irritation, further damage and the formation of bony outgrowths called spurs. These spurs can press on nerves, causing pain. New bone formation can also lead to narrowing of the spinal canal, known as spinal stenosis.
It’s well established that about eight in 10 people in the U.S. will experience back pain at some point in their lives. And while the causes of such pain often vary, say physical therapists and other medical professionals say that increasingly, in a world that accommodates a more sedentary lifestyle, the blame for low-back pain can often be traced to an area a little lower in the kinetic chain: the hips.
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.
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.
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.
Trochanteric bursitis is a condition which causes pain in the hip region. Trochanteric bursitis is inflammation of the bursa at the outside area of the hip, which is called the greater trochanter region. When this bursa becomes irritated or inflamed, it causes severe pain in the hip area. Treatment may include stretches for hip pain, NSAIDs and anti-inflammatory medications, opiate pain medications, and physical therapy.
“For millions suffering from lower back pain (LBP), most do not realize that tight hip flexors are also a source of what’s hurting us,” said Sherwin Nicholson, a medical research scientist with SN Health Resources. “If you neglect [your hip flexors and hamstrings], not only will they tighten up, but your back can suffer and anything that you do will become a chore instead of an activity.”
If, like most of us, your hip joints could use some TLC, help has arrived. All you need to do is spend a moment or two before and after your workouts — or, heck, while watching TV — on a time-honored fitness activity few of us do enough of: stretching. Below, we’ll show you some of the best hip stretches to improve flexibility and mobility, hopefully making up for all that time on the couch.
• Osteoarthritis. The most common form of arthritis of the back, osteoarthritis is a chronic condition characterized by the breakdown of the cartilage that cushions the ends of the bones where they meet to form joints. In the spine, this breakdown occurs in the cartilage of the facet joints, where the vertebrae join. As a result, movement of the bones can cause irritation, further damage and the formation of bony outgrowths called spurs. These spurs can press on nerves, causing pain. New bone formation can also lead to narrowing of the spinal canal, known as spinal stenosis.
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.
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