While a sharp pain in the hip, groin, pelvis, or thigh is an obvious sign of a hip flexor injury, pain in the lower back and leg are easy to misdiagnose. After all, it’s natural to assume that radiating pain in the leg or lower back originate from these areas. Unfortunately, diagnosing the source of a patient’s pain is not always straightforward. In fact, it’s possible for patients to go years with a misdiagnosed injury.
Tendinitis: Symptoms, causes, and treatment Tendinitis is the inflammation of a tendon caused by repetitive overuse or injury. It can occur in an elbow, wrist, finger, thigh, or elsewhere. Tendinitis includes a range of disorders, such as housemaid's knee, tennis elbow, and trigger thumb. This article explores symptoms, diagnosis, treatment, and prevention. Read now
If most inner-thigh openers feel too easy (and your ankles and knees are injury-free), try Frog Pose. Get down on all fours, with palms on the floor and your knees on blankets or a mat (roll your mat lengthwise, like a tortilla, and place it under your knees for more comfort). Slowly widen your knees until you feel a comfortable stretch in your inner thighs, keeping the inside of each calf and foot in contact with the floor. Make sure to keep your ankles in line with your knees. Lower down to your forearms. Stay here for at least 30 seconds.
When I do a deep knee bend like a sumo squat I get a popping in the outside of my left knee. It feels like a big tendon or ligament is slipping per something. It isn’t painful peer se but I’m afraid if I do it a lot it will be. Is that a relatively common symptom for a guy with tight flexors, it bands, etc? Should I just push through it or have it checked out?
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.
Bleeding in the pelvis is rare without significant trauma and is usually seen in patients who are taking blood-thinning medications, such as warfarin (Coumadin). In these patients, a rapid-onset sciatica pain can be a sign of bleeding in the back of the pelvis and abdomen that is compressing the spinal nerves as they exit to the lower extremities. Infection of the pelvis is infrequent but can be a complication of conditions such as diverticulosis, Crohn's disease, ulcerative colitis, pelvic inflammatory disease with infection of the Fallopian tubes or uterus, and even appendicitis. Pelvic infection is a serious complication of these conditions and is often associated with fever, lowering of blood pressure, and a life-threatening state.
Shingles (herpes zoster) is an acute infection of the nerves that supply sensation to the skin, generally at one or several spinal levels and on one side of the body (right or left). Patients with shingles usually have had chickenpox earlier in life. The herpes virus that causes chickenpox is believed to exist in a dormant state within the spinal nerve roots long after the chickenpox resolves. In people with shingles, this virus reactivates to cause infection along the sensory nerve, leading to nerve pain and usually an outbreak of shingles (tiny blisters on the same side of the body and at the same nerve level). The back pain in patients with shingles of the lumbar area can precede the skin rash by days. Successive crops of tiny blisters can appear for several days and clear with crusty inflammation in one to two weeks. Patients occasionally are left with a more chronic nerve pain (postherpetic neuralgia). Treatment can involve symptomatic relief with lotions, such as calamine, or medications, such as acyclovir (Zovirax), for the infection and pregabalin (Lyrica) or lidocaine (Lidoderm) patches for the pain.
How to: Sit on the floor with knees bent so that your right shin is positioned in front of you, your left shin behind you and your left hip dropped all of the way to the floor (a). Inhale and press your left hip forward until you feel a stretch in the front of your hip (b). Exhale and press left hip back to the floor. That’s one rep (c). Complete six to eight reps, working each time to increase your range of motion. Repeat on the opposite side.
Example: a friend of mine went to the hospital after a motorcycle accident. He’d flown over a car and landed hard on his head. Bizarrely, he was sent home with very little care, and no imaging of his back, even though he was complaining of severe lower back pain. A doctor reassured him that it was just muscle spasms. (This all happened at a hospital that was notorious for being over-crowded and poorly run.) The next day, still in agony, he went to see a doctor at a walk-in clinic, who immediately took him for an x-ray … which identified a serious lumbar fracture and imminent danger of paralysis. He had been lucky to get through the night without disaster! He was placed on a spine board immediately and sent for surgery. The moral of the story? Sometimes, when you’ve had a major trauma and your back really hurts, it’s because your back is broken. BACK TO TEXT
If you develop a sudden onset of low back pain, a visit to your physical therapist can help you determine the correct things to do to manage your acute pain. Your physical therapist should be able to analyze your lifestyle, movements, and overall medical history to help determine the likely cause of your pain. By focusing on these mechanical causes of back pain, you can make a change that may give you relief.
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People routinely have no pain despite the presence of obvious arthritic degeneration, herniated discs, and other seemingly serious structural problems like stenosis and spondylolistheses. This surprising contradiction has been made clear by a wide variety of research over the years, but the most notable in recent history is Brinjikji 2015. There are painful spinal problems, of course — which was also shown by Brinjikji et al in a companion paper — but they are mostly more rare and unpredictable than most people suspect, and there are many fascinating examples of people who “should” be in pain but are not, and vice versa. Spinal problems are only one of many ingredients in back pain. BACK TO TEXT
The hip is a very stable ball and socket type joint with an inherently large range of motion. The hip contains some of the largest muscle in the body as well as some of the smallest. Most people lack mobility due to a relatively sedentary lifestyle. Periods of prolonged sitting results in tightness of the hip flexors and hamstrings. Tightness in the muscles and ligaments can created joint forces that result in arthritis, postural problems, bursitis, and mechanical back pain.
^ Chou R, Loeser JD, Owens DK, Rosenquist RW, Atlas SJ, Baisden J, Carragee EJ, Grabois M, Murphy DR, Resnick DK, Stanos SP, Shaffer WO, Wall EM, American Pain Society Low Back Pain Guideline Panel (2009). "Interventional therapies, surgery, and interdisciplinary rehabilitation for low back pain: An evidence-based clinical practice guideline from the American Pain Society". Spine. 34 (10): 1066–77. doi:10.1097/BRS.0b013e3181a1390d. PMID 19363457.
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
When a muscle contracts, it shortens. Take the biceps for example. Without getting too technical, the biceps are attached at the forearm and shoulder. When your biceps contract, they shorten and bring those two points closer together. When you rest, the muscle returns to its normal length, and the two points move farther away. Constantly contracting your biceps over a long period of time would cause them to get shorter, even at rest.
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).
The bony lumbar spine is designed so that vertebrae "stacked" together can provide a movable support structure while also protecting the spinal cord from injury. The spinal cord is composed of nervous tissue that extends down the spinal column from the brain. Each vertebra has a spinous process, a bony prominence behind the spinal cord, which shields the cord's nervous tissue from impact trauma. Vertebrae also have a strong bony "body" (vertebral body) in front of the spinal cord to provide a platform suitable for weight bearing of all tissues above the buttocks. The lumbar vertebrae stack immediately atop the sacrum bone that is situated in between the buttocks. On each side, the sacrum meets the iliac bone of the pelvis to form the sacroiliac joints of the buttocks.
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.