myDr myDr provides comprehensive Australian health and medical information, images and tools covering symptoms, diseases, tests, medicines and treatments, and nutrition and fitness.Related ArticlesSciatica: symptoms, causes and diagnosisSciatica is characterised by pain deep in the buttock often radiating down the back of the leg. One Sciatica: treatmentMost sciatica gets better within a few weeks. If not, there are treatments that may help relieve youNeck pain: symptoms and causesKnowing the symptoms of your neck pain and when to see a doctor can help in finding the cause and geNeck pain: treatmentTreatment for neck pain depends on the cause and how severe it is. Neck pain treatment, includiOffice ergonomics: workstation comfort and safetyComputer users often develop aches and pains. Avoid discomfort by setting up your workstation accordPilates no better for low back painCochrane researchers found no significant difference between Pilates and other exercises for pain anDormant butt syndrome is linked to knee and back painDormant butt syndrome, characterised by weak glute muscles and tight hip flexors, can be caused by sSpinal surgery for low back pain over-optimisticSpinal fusion surgery has at best a 50% success rate for the initial operation and patients would beVideo: Reframing pain to overcome lower back painReliance on opioid painkillers and unnecessary back surgeries may be preventing us from beating loweAdvertisement
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.
Approximately 15 degrees of hip extension is required to walk normally. If hip flexors are tight then in order to walk, compensatory movement needs to take place through the lower back causing back pain and premature disc degeneration. Like other joints, if we fail to take them through their full range on a regular basis we eventually lose mobility.
There is a significant overlap of nerve supply to many of the discs, muscles, ligaments, and other spinal structures, and it can be difficult for the brain to accurately sense which is the cause of the pain. For example, a degenerated or torn lumbar disc can feel the same as a pulled muscle – both creating inflammation and painful muscle spasm in the same area. Muscles and ligaments heal rapidly, while a torn disc may or may not. The time course of pain helps determine the cause.
Pregnancy commonly leads to low back pain by mechanically stressing the lumbar spine (changing the normal lumbar curvature) and by the positioning of the baby inside of the abdomen. Additionally, the effects of the female hormone estrogen and the ligament-loosening hormone relaxin may contribute to loosening of the ligaments and structures of the back. Pelvic-tilt exercises and stretches are often recommended for relieving this pain. Women are also recommended to maintain physical conditioning during pregnancy according to their doctors' advice. Natural labor can also cause low back pain.
Paget's disease of the bone is a condition of unknown cause in which the bone formation is out of synchrony with normal bone remodeling. This condition results in abnormally weakened bone and deformity and can cause localized bone pain, though it often causes no symptoms. Paget's disease is more common in people over the age of 50. Heredity (genetic background) and certain unusual virus infections have been suggested as causes. Thickening of involved bony areas of the lumbar spine can cause the radiating lower extremity pain of sciatica.
Lay on your back on your mat and pull your knees to your chest. Place your hands on the inside arches of your feet and open your knees wider than shoulder-width apart. Keeping your back pressed into the mat as much as possible, press your feet into hands while pulling down on feet, creating resistance. Breathe deeply and hold for at least 30 seconds.
John Wolf is Onnit's Chief Fitness Officer, and an expert in unconventional training methods such as kettlebell, steel club, and suspension training. With 15-plus years of experience in the fitness industry, he has worked with rehab clients and athletes of all levels. He moves like Spider Man and can deadlift more than 500 pounds any day of the week.
5. Feel free as a bird. Open up those hips with yoga’s pigeon pose! Start on all fours with hands below the shoulders and knees below the hips. Bring the right knee forward until it touches the right hand and place the leg flat on the ground across the body (the right foot is now on the left side of the body, parallel to the front of the mat). Drop left leg to the ground, and extend it back with toes turned under. Keep the hips level, inhale, and walk hands forward. Exhale, and fold the torso over, lowering elbows to the floor. Stay in this position for 5-10 breaths before coming back up to switch sides.
Along with mobility and strength exercises, it's a good idea to do some flexibility work on a regular basis, especially as the season progresses and you start increasing your training mileage. Yoga is a great option—variations of hip openers and other poses can really help the overall function of your hips. The following stretches will help increase flexibility in your hips.
If you’re lucky, you won’t notice your hips are tight until you’re trying to do the Half Pigeon pose in your yoga class. But if you’re not so fortunate, your tight hips are making themselves known every time you so much as walk to the bathroom or sit on the couch—expressing themselves in the form of lower back pain and muscle stiffness. Tight hips can even shorten your stride, slowing your 5K goal time!
Blood tests are not routinely used to diagnose the cause of back pain; however in some cases they may be ordered to look for indications of inflammation, infection, and/or the presence of arthritis. Potential tests include complete blood count, erythrocyte sedimentation rate, and C-reactive protein. Blood tests may also detect HLA-B27, a genetic marker in the blood that is more common in people with ankylosing spondylitis or reactive arthritis (a form of arthritis that occurs following infection in another part of the body, usually the genitourinary tract).
Massage therapy does not appear to provide much benefit for acute low back pain.[1] A 2015 Cochrane review found that for acute low back pain massage therapy was better than no treatment for pain only in the short-term.[89] There was no effect for improving function.[89] For chronic low back pain massage therapy was no better than no treatment for both pain and function, though only in the short-term.[89] The overall quality of the evidence was low and the authors conclude that massage therapy is generally not an effective treatment for low back pain.[89]
“Red flags” are signs or symptoms that something medically ominous may be going on. Red flags are not reliable, and their presence is not a diagnosis. When you have some red flags, it only indicates a need to look more closely. Sometimes red flags are missing there really is something serious going on … and sometimes they are a false alarm.18 Check off all that apply … hopefully none or few or only the least alarming of them!
Start in a runner’s lunge with right leg forward, right knee over right ankle and back leg straight. Walk right foot over toward left hand, then drop right shin and thigh to the floor, making sure to keep right knee in line with right hip. Allow left leg to rest on the floor with top of left foot facing down. Take a moment to square your hips to the front of the room. Hold here, or hinge at hips and lower torso toward floor, allowing head to rest on forearms. Hold for at least 30 seconds, then repeat on opposite side. You want to feel a moderate stretch in the outside of the right thigh, but if this pose hurts your knees or feels too uncomfortable, stick with Thread the Needle.
Spondylolisthesis. This condition occurs when one vertebra slips over the adjacent one. There are 5 types of spondylolisthesis but the most common are secondary to a defect or fracture of the pars (between the facet joints) or mechanical instability of the facet joints (degenerative). The pain can be caused by instability (back) or compression of the nerves (leg).
According to the National Institute of Neurological Disorders and Stroke, the ancient Chinese practice of acupuncture may be effective for treating moderate, chronic lower back pain. While this practice of inserting small, thin needles into the body to restore energy flow may seem daunting at first, acupuncture can stimulate the release of pain relieving chemicals in the body.
The good news is that there are plenty of good hip stretches out there that you can do to relieve discomfort, decrease tightness, and increase mobility in your hips. Since your hips are involved in so many of the movements you make (both inside and outside of the gym) stretching them is a great way to keep them feeling good and ready to work for you. Add some of the 12 hip stretches Atkins demos below to the end of your workout, or spend 10 minutes each day just doing a few of them, to improve mobility in your hips.
People understandably assume that the worst back pain is the scariest. In fact, pain intensity is a poor indicator of back pain ominousness,10 and some of the worst causes are actually the least painful (especially in the early stages). For instance, someone could experience the symptoms of cauda equinae syndrome, and be in real danger of a serious and permanent injury to their spine, but have surprisingly little pain — even none at all in some cases!
Following any period of prolonged inactivity, a regimen of low-impact exercises is advised. Speed walking, swimming, or stationary bike riding 30 minutes daily can increase muscle strength and flexibility. Yoga also can help stretch and strengthen muscles and improve posture. Consult a physician for a list of low-impact, age-appropriate exercises that are specifically targeted to strengthening lower back and abdominal muscles.
Lie on your back with your knees bent and your feet flat on the floor. Tighten your buttocks and lift your hips off the floor. Tighten your abdominal muscles and lift one foot a couple of inches off the floor. Then put it down and lift the other foot a couple of inches, all while remembering to breathe. “It’s like taking alternate steps,” Pariser says. Work up to doing 30 steps at a time.
Neglect your lower body too often and you risk losing mobility — that thing that allows you to plop down on the floor to play with your kids, or get up and out of even the cushiest chair with ease. “A lot of people sit all day, so they’re not necessarily using their glute muscles,” says Daily Burn Fitness/Nutrition Coach Allie Whitesides. “And a lot of people are in the car all the time, so we’re not using our leg muscles much, either.”
Sciatica is a form of radiculopathy caused by compression of the sciatic nerve, the large nerve that travels through the buttocks and extends down the back of the leg. This compression causes shock-like or burning low back pain combined with pain through the buttocks and down one leg, occasionally reaching the foot. In the most extreme cases, when the nerve is pinched between the disc and the adjacent bone, the symptoms may involve not only pain, but numbness and muscle weakness in the leg because of interrupted nerve signaling. The condition may also be caused by a tumor or cyst that presses on the sciatic nerve or its roots.
Management of low back pain depends on which of the three general categories is the cause: mechanical problems, non-mechanical problems, or referred pain.[52] For acute pain that is causing only mild to moderate problems, the goals are to restore normal function, return the individual to work, and minimize pain. The condition is normally not serious, resolves without much being done, and recovery is helped by attempting to return to normal activities as soon as possible within the limits of pain.[3] Providing individuals with coping skills through reassurance of these facts is useful in speeding recovery.[1] For those with sub-chronic or chronic low back pain, multidisciplinary treatment programs may help.[53] Initial management with non–medication based treatments is recommended, with NSAIDs used if these are not sufficiently effective.[6]
The big idea of classification-based cognitive functional therapy (CB-CFT or just CFT) is that most back pain has nothing to do with scary spinal problems and so the cycle of pain and disability can be broken by easing patient fears and anxieties. For this study, CFT was tried with 62 patients and compared to 59 who were treated with manual therapy and exercise. The CFT group did better: a 13-point boost on a 100-point disability scale, and 3 points on a 10-point pain scale. As the authors put it for BodyInMind.org, “Disabling back pain can change for the better with a different narrative and coping strategies.” These results aren’t proof that the confidence cure works, but they are promising.
It is unclear if among those with non-chronic back pain alternative treatments are useful.[84] For chiropractic care or spinal manipulation therapy (SMT) it is unclear if it improves outcomes more or less than other treatments.[18] Some reviews find that SMT results in equal or better improvements in pain and function when compared with other commonly used interventions for short, intermediate, and long-term follow-up;[19][20][85] other reviews find it to be no more effective in reducing pain than either inert interventions, sham manipulation, or other treatments, and conclude that adding SMT to other treatments does improve outcomes.[17][21] National guidelines reach different conclusions, with some not recommending spinal manipulation, some describing manipulation as optional, and others recommending a short course for those who do not improve with other treatments.[3] A 2017 review recommended spinal manipulation based on low quality evidence.[6] Manipulation under anaesthesia, or medically assisted manipulation, has not enough evidence to make any confident recommendation.[86]
Work on strengthening all of your core muscles and glutes. These muscles work together to give you balance and stability and to help you move through the activities involved in daily living, as well as exercise and sports. When one set of these muscles is weak or tight, it can cause injury or pain in another, so make sure you pay equal attention to all of them.
The treatment of hip pain depends on the precise cause of the pain. Treatments can include rest, non-weight-bearing, cold application, and anti-inflammatory medications. For local inflammation, sometimes injection of cortisone medication (steroids) is used to quiet the inflammation. If infection is present, antibiotics are used. Fractures can require treatment with surgical repairs, including pinning, plates and screws, and total joint replacement. For severe arthritis, total joint replacement is performed when possible.
Stretching is your next move, but not just any stretches. “Before your workout, you want to go for dynamic stretches, or stretches that put the joint through a full range of motion,” says Lefkowith. Moves like squats and lunges will get your muscles fired up (especially if you focus on squeezing your butt at the top of those squats), says Lefkowith.
The diagnosis of low back pain involves a review of the history of the illness and underlying medical conditions as well as a physical examination. It is essential that a complete story of the back pain be reviewed including injury history, aggravating and alleviating conditions, associated symptoms (fever, numbness, tingling, incontinence, etc.), as well as the duration and progression of symptoms. Aside from routine abdomen and extremity evaluations, rectal and pelvic examinations may eventually be required as well. Further tests for diagnosis of low back pain can be required including blood and urine tests, plain film X-ray tests, CAT scanning, MRI scanning, bone scanning, and tests of the nerves such as electromyograms (EMG) and nerve conduction velocities (NCV).
In terms of diagnosing hip pain, typically a patient will expect when they come in to be asked about their symptoms, and it’s very important to find out when did these symptoms start, how long they have been going on, how frequent they are, if they come on in the morning or the evening, do they come on with any certain activity, and if there is something that makes it better or worse. The intensity of the pain is also important. Does it have any associated radiating symptoms? Is it localized in one spot or does it move? After getting a history and finding out what type of pain the patient is having, which also includes whether the pain is dull, aching, sharp, or intense, then it’s important to do a good physical exam. The physical examination involves testing the muscle strength, testing for sensation, doing provocative maneuvers which might help us rule out one type of injury from another.
Work on strengthening all of your core muscles and glutes. These muscles work together to give you balance and stability and to help you move through the activities involved in daily living, as well as exercise and sports. When one set of these muscles is weak or tight, it can cause injury or pain in another, so make sure you pay equal attention to all of them.
Kidneys — The kidneys are a matched pair. One painful kidney can cause back pain on one side or the other. Kidney pain can feel like back pain, and may occur on only one side. It is usually quite lateral, and just barely low enough to qualify as “low” back pain. However, when kidney stones descend through the ureters, they can cause (terrible) pain in the low back. Kidney stone pain is often so severe and develops so rapidly that it isn’t mistaken for a back pain problem.
Radiofrequency denervation is a procedure using electrical impulses to interrupt nerve conduction (including the conduction of pain signals). Using x-ray guidance, a needle is inserted into a target area of nerves and a local anesthetic is introduced as a way of confirming the involvement of the nerves in the person’s back pain. Next, the region is heated, resulting in localized destruction of the target nerves. Pain relief associated with the technique is temporary and the evidence supporting this technique is limited.
The pain of back pain almost always makes it seem worse than it is. The most worrisome causes of back pain rarely cause severe pain, and many common problems (like slipped discs) are usually much less serious than people fear. Only about 1% of back pain is ominous, and even then it’s often still treatable. Most of the 1% are due to cancer, autoimmune disease, or spinal cord damage.
Stop focusing on a specific diagnosis. Up to 85% of low back pain can be classified as "non-specific." This means that the origin of your pain cannot be localized to one specific structure or problem. While common diagnostic tests for low back pain can show the bones, discs, and joints with great detail, no test can tell the exact cause of your pain with 100% accuracy.
Luckily, you don’t have to quit your day job or forgo spin class to loosen them up. Simply stretching those hips can get your body back in alignment, increase your mobility (and thus your exercise performance) and maybe even ease pesky back pain, Moore says. “Given the amount of time we sit [each] day and the stress we put our bodies under, hip-opening moves are a necessary party of our daily routine.”
Two types of strength-training moves that may benefit the lower back are flexion and extension exercises. In flexion exercises, you bend forward to stretch the muscles of the back and hips. In extension exercises, you bend backward to develop the muscles that support the spine. One example is doing leg lifts while lying on your stomach. Depending on the cause of your back pain, there are some exercises you should not do. If you have back pain, make sure to talk to your doctor about what exercises are safe for you.
