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HIP PAIN, LOW BACK PAIN, GROIN PAIN – WHAT IS THE CAUSE…

Hip pain, low back pain, groin pain – are they all connected to one condition or many conditions?

Anatomically, the hip and back connect through the sacroiliac (SI) joint. This joint connects the hip bones to your sacrum, the bone between your lumbar spine (lower back) and tailbone.

According to the Cleveland Clinic back problems can masquerade as hip problems. “There is a lot of overlap,” says hip specialist Trevor Murray, MD. Most pain from hip and back problems is due to ordinary wear and tear on the body. Hip problems usually produce groin pain on the affected side. That’s because the actual joint of the hip is near the spine.

Since the hips and lower spine are so close together, it’s easy to mistake back pain for hip pain or vice versa. It’s not uncommon to see people come in complaining of hip pain when, after doing an exam and listening to their symptoms, it’s a back problem or issue contributing to their overall pain. Unfortunately, the signs for each can be easily confused for one another.

One of the biggest signs that your pain is caused by a problem in your hip is the presence of groin pain. Your hip joint is located behind the groin, that’s why groin pain usually means the hip is the root cause of pain. In some cases, this groin pain will radiate downward toward your knee.

Another obvious sign that your hip is the source of your pain is pain around or over the hip joint. However, hip problems can also refer pain to your low back, contributing to the confusion over where the true source of the pain is located.

Hip symptoms are –

  • Pain is in your groin
  • Discomfort comes and goes, becoming more frequent over time
  • Pain worsens with standing, walking and activity, and is relieved by rest
  • You feel stiff
  • You walk with a limp

Back symptoms are –

  • Is limited to your back, buttocks or hip
  • Shoots down your leg
  • Worsens with sitting or bending
  • Improves when standing or walking

While osteoarthritis is the most common cause, hip pain may also derive from piriformis syndrome, avascular necrosis in the hip, and/or sacroiliac joint dysfunction. Sacroiliac joint dysfunction is the problem that I am suffering from at the moment and so I seem to suffering a double whammy and have problems with both your hip and my back.

Signs that Your Spine is the Source of your Pain…

Whereas groin pain is a telltale sign that the pain is linked to the hip, pain above the waistline that travels down the body typically indicates a low back issue. A low back problem may also be responsible for other types of lower body pain, including thigh, buttock, and below-the-knee pain.

Among the most common degenerative conditions that affect the lumbar spine are herniated discs, spinal stenosis, and spondylolisthesis. These conditions cause pain by irritating your low back nerves, resulting in pain that shoots down your legs (ie, sciatica), weakness, numbness, and reducing your range of motion.

The pattern of pain coming from the lumbar spine can be variable, depending of the specific issue causing the pain. Commonly, pain from arthritis of the spine occurs during transitions such as getting out of bed in the morning or raising up from sitting. It can often then improve after getting moving. In contrast, pain from spinal stenosis or nerve pressure (ie, compression) is often worse with prolonged standing or walking and relieved with sitting.

Once your pain is identified as truly originating in your hip or in your low back, your doctor will work with you to create a treatment plan to address it. In many cases, this will include medication to reduce inflammation and pain, and a specially designed physical therapy program to teach you movements, stretches, and physical activities to help alleviate symptoms and prevent them from returning. Depending on the nature of your pain, your doctor may also recommend lifestyle modifications (eg, losing weight or quitting smoking) to treat your pain. For both spine pain and hip pain, surgery is rarely necessary and viewed as a last-resort treatment option.

I have a meeting with my consultant next week to decide what can help my pain as I have tried the injections, physical therapy and lifestyle changes but they do not seem to have made much difference with my pain. Watch this space for my outcome.

Source: Spine Universe, Cleveland Clinic,

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