If you have hip pain, you may benefit from the skilled services of a physical therapist to help determine the cause of your pain. Your PT can work with you to develop a treatment strategy to treat your hip pain or hip discomfort. Understanding why your hip is hurting can help your physical therapist and doctor prescribe the right treatment regimen for your specific condition.
Treatment for greater trochanteric bursitis includes stretching and strengthening your IT band, hip abductors, and gluteal muscles, all while avoiding running on banked surfaces. Applying ice to the painful area for 15 minutes, three to four times per day can help, too. A cortisone injection may be beneficial if your injury is severe. Worsening pain should raise suspicion for a stress fracture, in which case you should see your doctor right away.
The lumbar (or lower back) region is made up of five vertebrae (L1–L5), sometimes including the sacrum. In between these vertebrae are fibrocartilaginous discs, which act as cushions, preventing the vertebrae from rubbing together while at the same time protecting the spinal cord. Nerves come from and go to the spinal cord through specific openings between the vertebrae, providing the skin with sensations and messages to muscles. Stability of the spine is provided by the ligaments and muscles of the back and abdomen. Small joints called facet joints limit and direct the motion of the spine.
Pain in the front of the joint—where the leg attaches to the trunk—is typically caused by hip joint problems. You may also feel pain associated with a hip injury in the lower part of your glutes and the top of the back of your thigh. Other symptoms include the inability to move the leg at the hip, inability to put weight on one leg due to pain at the hip, or swelling around the joint. As runners, you may also experience pain in the hipo joint only when running due to a hip injury.
Strength training is another key part of the “do” category, Dr. Vasileff says. “It’s a good idea to focus on quad, hamstring, and glute strength,” he says. These muscles surround your hips and provide support, along with your core—which is another area to focus on. “Strengthening your core helps to normalize your walking pattern and stabilize how your pelvis and hips move,” Dr. Vasileff says. That translates to less pain and better hip mobility.
As has been highlighted by research presented at the national meeting of the American College of Rheumatology, a very important aspect of the individual evaluation is the patient's own understanding and perception of their particular situation. British researchers found that those who believed that their symptoms had serious consequences on their lives and that they had, or treatments had, little control over their symptoms were more likely to have a poor outcome. This research points out to physicians the importance of addressing the concerns and perceptions that patients have about their condition during the initial evaluations.
Just because your hip flexor region feels sore doesn’t necessarily mean the muscles there are tight — in fact, they might need strengthening. This is where that sports science debate we mentioned earlier comes into play. It’s important to identify whether you’re tight or if the muscles are weak. Again, the Thomas Test will help you identify if you’re maybe stretching something that actually needs strengthening.
Disc degeneration remains a key cause of chronic low back pain and the pain often persists despite surgery. NIH-funded basic science and preclinical studies are investigating molecular-level mechanisms that cause discs in the spine to degenerate, as well as protective mechanisms involved in disc remodeling that may diminish with advancing age. Such studies may help identify future therapeutic strategies to block degenerative mechanisms or promote remodeling processes. NIH also is funding early research on stem cell approaches to promote disc regeneration and rejuvenate cells of the nucleus pulposus, the jelly-like substance in the center of intervertebral discs that loses water content as people age.
Low back pain can be caused by tumors, either benign or malignant, that originate in the bone of the spine or pelvis and spinal cord (primary tumors) and those which originate elsewhere and spread to these areas (metastatic tumors). Symptoms range from localized pain to radiating severe pain and loss of nerve and muscle function (even incontinence of urine and stool) depending on whether or not the tumors affect the nervous tissue. Tumors of these areas are detected using imaging tests, such as plain X-rays, nuclear bone scanning, and CAT and MRI scanning.
Some of these red flags are much less red than others, especially depending on the circumstances. For instance, “weight loss” is common and often the sign of successful diet! (Well, at least temporarily successful, anyway. 😃) Obviously, if you know of a harmless reason why you have a red flag symptom, it isn’t really a red flag (duh!). But every single actual red flag — in combination with severe low back pain that’s been going on for several weeks — is definitely a good reason to get yourself checked out.