Low and lower back pain can vary from dull pain that develops gradually to sudden, sharp or persistent pain felt below the waist. Unfortunately, almost everyone, at some point during life will experience low back pain that may travel downward into the buttocks and sometimes into one or both lower extremities. The most common cause is muscle strain often related to heavy physical labor, lifting or forceful movement, bending or twisting into awkward positions, or standing in one position too long.
Recovering from a hip flexor injury can take time, but proper supervision and guidance from a musculoskeletal professional can minimize downtime and pain. Additionally, there are a few stretches you can do at home to recover from a hip flexor injury. The following stretch increases hip flexor dexterity, while helping alleviate pain in and around the hip and upper thigh.
It’s a common issue, says Prevention advisor Rob Danoff, director of family and emergency medicine residency programs at Aria Health in Philadelphia. "For people who sit a long time at work, the hip flexors and rotators become tight, and the gluteal muscles become weak," he says. "This combination negatively affects our ability to walk, maintain proper posture, and the stability of our spine."
The treatment of lumbar strain consists of resting the back (to avoid reinjury), medications to relieve pain and muscle spasm, local heat applications, massage, and eventual (after the acute episode resolves) reconditioning exercises to strengthen the low back and abdominal muscles. Initial treatment at home might include heat application, acetaminophen (Tylenol) or ibuprofen (Advil, Motrin), and avoiding reinjury and heavy lifting. Prescription medications that are sometimes used for acute low back pain include anti-inflammatory medications, such as sulindac (Clinoril), naproxen (Naprosyn), and ketorolac (Toradol) by injection or by mouth, muscle relaxants, such as carisoprodol (Soma), cyclobenzaprine (Flexeril), methocarbamol (Robaxin), and metaxalone (Skelaxin), as well as analgesics, such as tramadol (Ultram).
Epidural steroid injections are a commonly used short-term option for treating low back pain and sciatica associated with inflammation. Pain relief associated with the injections, however, tends to be temporary and the injections are not advised for long-term use. An NIH-funded randomized controlled trial assessing the benefit of epidural steroid injections for the treatment of chronic low back pain associated with spinal stenosis showed that long-term outcomes were worse among those people who received the injections compared with those who did not.
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.
Arthritis: The spondyloarthropathies are inflammatory types of arthritis that can affect the lower back and sacroiliac joints. Examples of spondyloarthropathies include reactive arthritis (Reiter's disease), ankylosing spondylitis, psoriatic arthritis, and the arthritis of inflammatory bowel disease. Each of these diseases can lead to low back pain and stiffness, which is typically worse in the morning. These conditions usually begin in the second and third decades of life. They are treated with medications directed toward decreasing the inflammation. Newer biologic medications have been greatly successful in both quieting the disease and stopping its progression.
I’m not endorsing or saying these stretches are a miracle cure, but I definitely think they’ve helped. I’ve even started to add a few gentle yoga poses and pilates moves which I could so easily do, back in the day, when I was 63 kilos and participated in the greatest oxymoron ever named … a thing called the Fun Run. If I’m not careful, and I keep stretching away each day, I could end up with a 6 pack and back to my 5′ 7″ instead of 5′ 5″.
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.
Why is back pain still a huge problem? Maybe this: “It is extremely difficult to alter the potentially disabling belief among the lay public that low back pain has a structural mechanical cause. An important reason for this is that this belief continues to be regularly reinforced by the conditions of care of a range of ‘hands-on’ providers, for whom idiosyncratic variations of that view are fundamental to their professional existence.”
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.
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.
Start kneeling on your mat with knees hip-width apart and hips directly over knees. Press your shins and the tops of your feet into the mat. Bring your hands to your low back, fingers pointing down, and rest palms above glutes. Inhale and lift your chest, and then slowly start to lean your torso back. From here, bring your right hand to rest on your right heel and then your left hand to your left heel. (If you can't reach your heels, turn your toes under; it will be easier to reach your heels in this modification.) Press your thighs forward so they are perpendicular to the floor. Keep your head in a relatively neutral position or, if it doesn't strain your neck, drop it back. Hold for 30 seconds. To come out of the pose, bring your hands to your hips and slowly, leading with your chest, lift your torso as you press the thighs down toward the floor.
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.
^ Jump up to: a b c d e f g Hughes SP, Freemont AJ, Hukins DW, McGregor AH, Roberts S (October 2012). "The pathogenesis of degeneration of the intervertebral disc and emerging therapies in the management of back pain" (PDF). J Bone Joint Surg Br. 94 (10): 1298–304. doi:10.1302/0301-620X.94B10.28986. PMID 23015552. Archived from the original (PDF) on 4 October 2013. Retrieved 25 June 2013.
En español | You probably know someone who’s traded a worn-out hip bone for ceramic or cobalt chrome. Some 370,000 Americans undergo hip-replacement surgery each year (the average age for this is 65). But the operation isn’t a cure-all: At least 1 in 10 hip-replacement recipients will need a second procedure to repair a dislocation, mechanical failure or infection. And hip pain, with or without surgery, can be a struggle. Chronic hip pain was a factor in the accidental opioid overdoses that claimed the lives of musicians Tom Petty, 66, and Prince, 57.
Back “spasms” are a largely a myth — there’s no such thing a sustained painful contractions of muscles in otherwise healthy people (see Cramps, Spasms, Tremors & Twitches) — but the kernel of truth in the idea of “spasms” may be the idea of trigger points, which are hypothetical “micro cramps,” tiny patches of painfully contracting muscle. Although this idea is controversial, it is nevertheless one of the most likely explanations for common aches and pains that mostly stick to one area (especially the back) and have no other obvious cause. See Back Pain & Trigger Points. BACK TO TEXT
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
Backpack overload in children: Low back pain unrelated to injury or other known cause is unusual in pre-teen children. However, a backpack overloaded with schoolbooks and supplies can strain the back and cause muscle fatigue. The American Academy of Orthopaedic Surgeons recommends that a child’s backpack should weigh no more than 15 to 20 percent of the child’s body weight.
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”).
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.
When your body comes under stress it can stimulate a reaction from your central nervous system, flooding your body with inflammatory chemicals – definitely not what you want if inflammation is the root of your suffering. Instead try to focus on what you can do and make sure you set aside time to rest. Don’t make the mistake of pushing yourself too hard or trying to do too much at once!