If the pain is still not managed adequately, short term use of opioids such as morphine may be useful.[73][13] These medications carry a risk of addiction, may have negative interactions with other drugs, and have a greater risk of side effects, including dizziness, nausea, and constipation.[13] The effect of long term use of opioids for lower back pain is unknown.[74] Opioid treatment for chronic low back pain increases the risk for lifetime illicit drug use.[75] Specialist groups advise against general long-term use of opioids for chronic low back pain.[13][76] As of 2016, the CDC has released a guideline for prescribed opioid use in the management of chronic pain.[77] It states that opioid use is not the preferred treatment when managing chronic pain due to the excessive risks involved. If prescribed, a person and their clinician should have a realistic plan to discontinue its use in the event that the risks outweigh the benefit.[77]
Prolonged sitting and activities like running or cycling can lead to tight hip flexor muscles and a variety of skeletal imbalances. Think: if you only cycle for exercise, certain muscles in your legs will get stronger (in a lot of cases you overwork these muscles) yet your core and outer hip muscles might get weaker from lack of engagement. So what? Well, these muscle imbalances often lead to skeletal imbalances and injuries down the line. If you have particularly tight hip flexors, your body will start to create an anterior pull on the pelvis (anterior pelvic tilt). You can identify an anterior pelvic tilt if your belly protrudes slightly in the front while your butt sticks out in the back (what some people refer to as “duck butt”).
There are many additional sources of pain, including claudication pain (from stenosis) myelopathic pain, neuropathic pain, deformity, tumors, infections, pain from inflammatory conditions (such as rheumatoid arthritis or ankylosing spondylitis), and pain that originates from another part of the body and presents in the lower back (such as kidney stones, or ulcerative colitis).

A pinched nerve causes pain, numbness, or tingling in the affected area due to pressure on a nerve. Caral tunnel and sciatica are two examples of conditions caused by a pinched nerve. A pinched nerve is diagnosed by taking a patient history and performing a physical examination. Electromyography may be performed. Treatment for a pinched nerve depends on the underlying cause.
Intradiscal electrothermal therapy (IDET) is a treatment for discs that are cracked or bulging as a result of degenerative disc disease. The procedure involves inserting a catheter through a small incision at the site of the disc in the back. A special wire is passed through the catheter and an electrical current is applied to heat the disc, which helps strengthen the collagen fibers of the disc wall, reducing the bulging and the related irritation of the spinal nerve. IDET is of questionable benefit.
If you have hip arthritis, work on building up the muscles in your outer thigh for added support. Lie on your pain-free side and lift the leg with arthritis up about six inches, hold for two or three seconds, and lower it again, Humphrey says. Start with one set of 10 repetitions and build up to three sets. Repeat on the other side unless it is too painful. This exercise can aggravate your symptoms if you have hip pain from bursitis.

If low back pain occurs after a recent injury — such as a car accident, a fall or sports injury — call your primary-care physician immediately. If there are any neurological symptoms, seek medical care immediately. If there are no neurological problems (i.e. numbness, weakness, bowel and bladder dysfunction), the patient may benefit by beginning conservative treatment at home for two to three days. The patient may take anti-inflammatory medications such as aspirin or ibuprofen and restrict strenuous activities for a few days.


Eleven updates have been logged for this article since publication (2009). All PainScience.com updates are logged to show a long term commitment to quality, accuracy, and currency. more When’s the last time you read a blog post and found a list of many changes made to that page since publication? Like good footnotes, this sets PainScience.com apart from other health websites and blogs. Although footnotes are more useful, the update logs are important. They are “fine print,” but more meaningful than most of the comments that most Internet pages waste pixels on.
To ease the pain and lower your odds of an injury, don’t try to do too much at once. “Start with just 10 minutes,” says Arina Garg, MD, a rheumatology fellow at The Center for Excellence for Arthritis and Rheumatology at the Louisiana University Health Sciences Center. “Every few days, increase that time by 5 to 10 minutes.” Your goal is to work up to 30 minutes of aerobic exercise, 5 days a week.
The hip flexors play an important role in everyday mobility and exercise. Involved in pulling the knee toward the hip, most movements either directly or indirectly use the hip flexors. That’s why even the slightest injury can cause great discomfort. Learn how you can recover from a hip flexor injury, and what precautions can be taken to avoid them.
Walking is an easy way to strengthen your bones and muscles, burn calories, and lift your mood. If you don't currently walk for exercise, try walking for five to 10 minutes every day. Gradually build up to 30 minutes a day. It's easy to sneak walking into your day. Take up golf, window-shop at a large mall, or visit a walking-only destination, such as a museum or botanical garden.
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
In the vast majority of patients with low back pain, symptoms can be attributed to nonspecific mechanical factors. However, in a much smaller percentage of patients, the cause of back pain may be something more serious, such as cancer, cauda equina syndrome, spinal infection, spinal compression fractures, spinal stress fractures, ankylosing spondylitis, or aneurysm.
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).
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.
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.
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.
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.
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.
For example, your quadriceps muscles are a group of four that are located at the front of the thigh; one of the group members, the rectus femoris flexes the hip, which brings your lower extremity (thigh, lower leg, and foot) forward, in front of you. On the other hand, your hamstring muscles are located at the back of the thigh. When they contract, they extend the lower extremity, bringing it behind you.

Everything you need to know about osteoarthritis Osteoarthritis is a potentially painful condition that leads to inflammation, loss of cartilage, and bone damage. Read our article to find out how it happens and what treatments can help. Also, see a fully interactive 3-D model that you can explore to look inside a joint when signs of osteoarthritis begin to appear. Read now
Sit in a chair with good lumbar support and proper position and height for the task. Keep shoulders back. Switch sitting positions often and periodically walk around the office or gently stretch muscles to relieve tension. A pillow or rolled-up towel placed behind the small of the back can provide some lumbar support. During prolonged periods of sitting, elevate feet on a low stool or a stack of books.
Sit on floor with knees bent and shins stacked with right leg on top. Use your hand to position right ankle on left knee. Ideally, the right knee will rest on the left thigh, but if your hips are tight, your right knee may point up toward the ceiling (overtime, as your hips become more open, your knee will lower). Keeping your hips squared to the front of the room, hinge at the hips and slowly walk hands slightly forward. If this is enough of a stretch, hold here, or fold your torso over your thighs to go deeper. Hold for at least 30 seconds, then repeat on opposite side.

Chronic back pain is defined as pain that persists for 12 weeks or longer, even after an initial injury or underlying cause of acute low back pain has been treated. About 20 percent of people affected by acute low back pain develop chronic low back pain with persistent symptoms at one year. In some cases, treatment successfully relieves chronic low back pain, but in other cases pain persists despite medical and surgical treatment.
How to: Stand tall, feet slightly wider than shoulder-width apart, toes pointed out at 45-degree angles (a). Keep your back straight, knees over toes and your weight in the heels of your feet (b). Engage your glutes and thighs as you lower into a deep squat until thighs parallel to the ground (or as close as you can get them) (c). Powering through your heels, push up to return to starting position (d). Repeat.
Nonsteroidal anti-inflammatory drugs (NSAIDS) relieve pain and inflammation and include OTC formulations (ibuprofen, ketoprofen, and naproxen sodium). Several others, including a type of NSAID called COX-2 inhibitors, are available only by prescription. Long-term use of NSAIDs has been associated with stomach irritation, ulcers, heartburn, diarrhea, fluid retention, and in rare cases, kidney dysfunction and cardiovascular disease. The longer a person uses NSAIDs the more likely they are to develop side effects. Many other drugs cannot be taken at the same time a person is treated with NSAIDs because they alter the way the body processes or eliminates other medications.

While leg lifts, certain ab exercises, and even hula hooping can all help work the hips, the hip flexors can still be a tricky part of the body to stretch Kinetics of hula hooping: An inverse dynamics analysis. Cluff, T., Robertson, D.G., and Balasubramaniam, R. School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada. Human Movement Science, 2008 Aug; 27 (4): 622-35.. To get them even stronger and more flexible, try these five simple hip flexor stretches:


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.

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