How do I know? My hip or back?

Invigorate Health and Performance, Hip and back pain

Treatment of hip and lower back pain is not black and white. Instead, it can vary drastically.

The hip and lower back region are comprised of numerous structures that can be damaged through acute injury or wear and tear. Many problems that arise in these areas can display similar symptoms or pathologies.

Sometimes hip pain can come from the hip, but often it can come from the back. Back pain can come from the back, but can often come from the hip. Therefore, you can find yourself in a tricky situation when trying to find the root of your pain.

Treating hip and lower back pain is not always straight forwards and often, there can be more than one diagnosis. However, an early physical assessment of all areas that could be the root of your pain is key to finding the correct diagnosis.

Symptoms of hip conditions:

  • Pain in the front of the hip.
  • Pain in the groin area.
  • Pain radiating down front of the thigh but rarely travels past the knee.
  • Painful to walk after sitting for long periods (pain is worse initially but improves after a couple of steps).

Symptoms of lower back conditions:

  • Pain in the back of the hip near the buttocks.
  • Pain travels down the back of the leg, past the knee and sometimes all the way down to the foot.

If the pain is persistent with conservative treatment, then imaging may be utilised to find the source of the pain. X-rays and MRIs are commonly used to identify hip and/or lower back pathologies and can give us an insight into the anatomy of the hip and lower back in order to find any abnormalities. However, relying on imaging alone can often be misleading as imaging can often find asymptomatic, normal degenerative changes which do not attribute to your pain at all.

Key take home message to differentiate between hip and lower back pain:

  • If the pain is in the front of the hip and/or groin region, and radiates down the front of your thigh to the knee, it is most likely a hip issue.
  • If the pain is in the back of the hip near the buttock and radiates down the back of the leg past the knee, it is a likely a lower back (spine) issue.

Written by Nicholas Dimos (Physiotherapist)