What are the main causes of lower back and hip pain. How can you identify and treat conditions like piriformis syndrome, sacroiliac joint dysfunction, and herniated discs. What are the best ways to manage chronic lower back pain.

Understanding the Connection Between Lower Back and Hip Pain

The lower back and hip are intricately connected, sharing multiple muscle groups and working together to support our body’s movements. When pain or discomfort arises in one area, it often affects the other. This interconnectedness means that addressing issues in either region requires a comprehensive approach that considers both the lower back and hip.

Many people experience simultaneous pain in their lower back and hip, which can significantly impact their quality of life. Understanding the underlying causes of this pain is crucial for effective treatment and management.

Sharp Pain in the Lower Back and One Side of the Hip

A common complaint among patients is a sharp, shooting pain that affects one side of the lower back and hip. This type of pain can be attributed to various factors, including muscle spasms, joint dysfunction, or nerve compression. Two conditions that frequently cause this type of pain are piriformis syndrome and sacroiliac joint dysfunction.

Piriformis Syndrome: A Hidden Cause of Hip and Back Pain

Piriformis syndrome occurs when the piriformis muscle in the buttocks goes into spasm. This condition can cause moderate to severe pain in the lower back, hip, buttocks, and even extend to the back of the thigh. Patients with piriformis syndrome often experience:

• Pain typically on one side of the body
• Discomfort that worsens with hip movement
• Difficulty sitting for extended periods
• Pain when getting out of bed

The overactivity of hip rotator muscles or prolonged sitting on hard surfaces can trigger piriformis syndrome. Treatment often involves stretching exercises, physical therapy, and sometimes medication to reduce inflammation and muscle spasms.

Sacroiliac Joint Dysfunction: When Your Spine and Pelvis Don’t Align

Sacroiliac joint dysfunction is characterized by inflammation in the joint connecting the lower spine to the pelvis. Patients with this condition may experience:

• Sharp, stabbing pain in the lower back, hip, and buttocks
• Pain that may extend down the back of the thigh
• Discomfort that worsens with movement (standing, sitting, or climbing stairs)

This condition is more common in pregnant women, individuals with arthritis, or those who have experienced trauma or constant stress on the joint. Treatment options may include physical therapy, pain management techniques, and in some cases, corticosteroid injections.

Chronic Lower Back Pain: Causes and Concerns

When lower back pain persists for more than a few months, it is classified as chronic. Chronic lower back pain often involves disc problems, joint issues, or irritated nerve roots. Three common causes of chronic lower back pain are lumbar herniated discs, spinal stenosis, and scoliosis.

Lumbar Herniated Disc: When Cushioning Goes Wrong

A lumbar herniated disc occurs when the inner gel-like substance of a spinal disc protrudes through the outer ring, putting pressure on surrounding nerves. This condition can result from trauma or gradual wear and tear due to aging. Symptoms of a lumbar herniated disc may include:

• Lower back pain that may radiate to the buttocks, legs, and feet
• Numbness or tingling in the legs or feet
• Muscle weakness in the affected area

Treatment for a herniated disc may involve conservative methods such as physical therapy, pain medication, and lifestyle modifications. In severe cases, surgery may be necessary to remove the protruding disc material.

Spinal Stenosis: When Your Spinal Canal Narrows

Lumbar spinal stenosis is a condition where the spinal canal in the lower back narrows, putting pressure on nearby nerve roots. This condition is often associated with age-related degenerative changes and is more common in individuals over 60 years old. Symptoms of spinal stenosis may include:

• Pain or cramping in the legs, especially when walking or standing for long periods
• Numbness or weakness in the legs
• Lower back pain
• In severe cases, problems with bladder or bowel function

Treatment for spinal stenosis may include physical therapy, pain management techniques, and in some cases, surgical intervention to relieve pressure on the nerves.

Scoliosis: When Your Spine Curves Sideways

Scoliosis is a condition characterized by an abnormal sideways curvature of the spine. While many cases of scoliosis are mild and don’t require treatment, severe curvature can lead to significant back pain and other complications. Symptoms of scoliosis may include:

• Uneven shoulders or waist
• One hip higher than the other
• Back pain, especially in adults with severe curvature
• Difficulty breathing in severe cases

Treatment for scoliosis depends on the severity of the curve and the patient’s age. Options may include bracing for adolescents with moderate curves, physical therapy, and in severe cases, surgical intervention to correct the spinal curvature.

Spondylolisthesis: When Vertebrae Slip Out of Place

Spondylolisthesis occurs when one vertebra slips forward over the one below it. This condition is often caused by spondylolysis, a stress fracture in the vertebra. Spondylolisthesis can cause significant pain in the lower back and legs due to nerve irritation. Symptoms may include:

• Lower back pain that worsens with activity and improves with rest
• Pain that radiates down the legs
• Tightness in the hamstrings
• Changes in gait or posture

Treatment for spondylolisthesis may involve physical therapy, pain management techniques, and in severe cases, surgical intervention to stabilize the affected vertebrae.

Seeking Professional Help for Lower Back and Hip Pain

Back pain is one of the most common reasons for doctor and emergency room visits in the United States. It’s a leading cause of lost workdays and long-term disability. Ignoring persistent back pain can lead to worsening conditions and reduced quality of life.

When experiencing chronic lower back and hip pain, it’s crucial to seek medical attention from specialists who can provide an accurate diagnosis and appropriate treatment plan. Board-certified spine specialists are equipped to diagnose and treat a wide range of back and hip conditions, offering personalized care to help patients regain function and improve their quality of life.

Comprehensive Diagnosis and Treatment Approaches

Receiving an extensive spinal examination and accurate diagnosis is the first step in resolving lower back and hip pain. Spine specialists use various diagnostic tools and techniques to identify the underlying cause of pain, including:

• Physical examination
• Imaging studies (X-rays, MRI, CT scans)
• Nerve conduction studies
• Diagnostic injections

Once a diagnosis is established, specialists can develop a personalized treatment plan tailored to the patient’s specific condition and needs. Treatment options may include:

1. Conservative treatments:
   • Physical therapy
   • Pain management techniques
   • Medications
   • Lifestyle modifications
2. Minimally invasive procedures:
   • Epidural steroid injections
   • Radiofrequency ablation
   • Spinal cord stimulation
3. Surgical interventions (when necessary):
   • Microdiscectomy
   • Laminectomy
   • Spinal fusion

Preventing and Managing Lower Back and Hip Pain

While not all cases of lower back and hip pain can be prevented, there are steps individuals can take to reduce their risk and manage existing conditions:

• Maintain good posture
• Exercise regularly to strengthen core and back muscles
• Practice proper lifting techniques
• Maintain a healthy weight
• Use ergonomic furniture and equipment
• Take regular breaks when sitting for long periods
• Manage stress through relaxation techniques

By incorporating these preventive measures and seeking timely medical attention when experiencing persistent pain, individuals can improve their overall spinal health and quality of life.

Lower back and hip pain can significantly impact daily activities and overall well-being. Understanding the various causes and available treatment options is crucial for effective management. Whether dealing with acute pain from conditions like piriformis syndrome or chronic issues stemming from herniated discs or spinal stenosis, seeking professional help is essential for accurate diagnosis and appropriate treatment.

Remember that each case of lower back and hip pain is unique, and treatment plans should be tailored to individual needs. By working closely with spine specialists and following recommended treatment protocols, patients can find relief from pain, improve function, and enhance their quality of life. Don’t let lower back and hip pain control your life – take the first step towards recovery by consulting with a qualified spine specialist today.

6 Causes of Lower Back and Hip Pain

Published by AtlanticSpine.Breezy
January 16, 2022

Category: Back Injuries

Your lower back and hip are co-dependent on each other. They share many muscle groups, so it’s no wonder that disruption or pain in one tends to cause problems in the other. If you suffer from lower back pain or hip pain, you risk experiencing abnormalities in muscle function or movement.

Let’s take a look at 6 causes of lower back and hip pain:

Sharp Pain in the Lower Back and One Side of the Hip

It’s common to experience a sharp, shooting pain on one side of your lower back and hip. This pain can be caused by muscle spasms, joint dysfunction, or nerve compression. Conditions that can cause this are:

 Piriformis Syndrome

Piriformis syndrome causes a spasm of the piriformis muscle in the buttocks. It can cause moderate to severe pain in the lower back, hip, buttocks, and extend to the back of the thigh. This condition can make it hard to sit at times. You’ll find this pain typically on one side and movement of the hip can worsen it. Even getting out of bed can prove to be problematic. 

This condition is caused by the overactivity of the hip rotator muscles or sitting on hard surfaces for long periods. 

 Sacroiliac Joint Dysfunction

Sacroiliac joint dysfunction is brought on by inflammation with the joint that connects your lower spine to your pelvis. This condition will cause you to feel a sharp, stabbing pain over the lower part of your back, hip and buttocks. That pain could extend down the back of your thigh. Constant movement, like standing, sitting, or climbing stairs, may cause the pain to worsen. 

The sacroiliac joint can become common in pregnant women or with someone who suffers from arthritis, trauma, or constant stress within the joint. Pain can affect both sides of the lower back and hip, but most often it’s only problematic on one side.

Chronic Lower Back Pain

Pain that lasts for more than a few months is considered chronic. Chronic pain in the lower back usually involves a disc problem, a joint problem, or an irritated nerve root. Some common causes for this type of pain are:

Lumbar Herniated Disc

Our lumbar spine is made up of about 17 bones stacked on top of one another, that consist of the vertebrae. A disk lies between each set of vertebrae to absorb pressure placed on the bones. Each disk is made up of an outer ring and an inner gel. When the inner gel of one of the disks in your lumbar spine slips or squishes beyond the outer ring, the inner gel presses on surrounding nerves. This causes pain known as a herniated disk. As for the slippage, that can be due to trauma or gradual, age-related wear and tear.

Spinal Stenosis

Lumbar spinal stenosis occurs when the spinal canal in your lower back narrows and places pressure on nearby nerve roots. This condition is associated with degenerative changes that occur as a result of aging, being more common in individuals over 60 years old. Initially, symptoms include pain or cramping in the legs. Over time it can become more constant or severe. Additional symptoms such as numbness and weakness may occur.

Scoliosis

The spine area is naturally curved. The upper back curves backward; the lower back curves forward. A side view will show this perfect curvature of the bone structure. If your spine curves sideways when viewed from behind, that’s not perfect. It’s called scoliosis, and it’s a deformity that can lead to back pain.

Although the majority of scoliosis cases don’t require treatment, severe curvature can place significant stress on the lower back and lead to more pain.

Spondylolisthesis

Spondylolisthesis, often caused by Spondylolysis, occurs when one vertebra slips forward over the one below it. This condition typically causes pain in the low back and leg due to the disks irritating the nerves closest to them.

How We Can Help

Back pain is one of the most common reasons for doctor and emergency room visits in the U. S. It’s a leading cause of lost workdays and long-term disability. Not seeking medical attention and allowing the pain to persist will only cause the condition to worsen. 

Atlantic Spine Specialists are board-certified and specialize in the diagnosis and treatment of back pain. We are dedicated to relieving and restoring function to help our patients have the best quality of life. No matter what the cause of your pain, receiving an extensive spinal examination and accurate diagnosis are the first steps to resolving the issue. At Atlantic Spine Specialists our doctors will prescribe the best treatment plan for you.  

To learn more about diagnosis and treatment, request a consultation at Atlantic Spine Specialists in Morristown, New Jersey. Or call us at (973) 971-3500 to schedule your appointment.

How to Treat Your Lower Back and Hip Pain

If you feel like your low back and hip started aching at the same time, it’s likely not your imagination. The back and hips are often partners in pain. According to the 2019 National Health Interview Survey, some 39% of U.S. adults reported having lower back pain over the last few months, while 36.5% had pain in their hips and lower limbs. 

The hips and spine are connected by muscles, ligaments, and nerves, which create common pathways to pain. Lower back and hip pain may range from a dull soreness to tingling, radiating pain. It often stops you from doing the daily activities you need to thrive. However, back and hip pain usually is not serious and can be treated and prevented with conservative and holistic practices. 

Here are some common causes of back and hip pain, signs to seek medical care, and lifestyle changes to help treat pain and keep it from returning, including simple at-home exercises recommended by our physical therapists.  

What Causes Lower Back and Hip Pain?

Pain in these areas may involve an injury to the soft tissues or an underlying issue with the bones or joints. Sometimes, though, there is no obvious reason for your pain, especially if it persists for more than three months. In this case, it’s much less important to focus on the why of what’s causing your pain. Rather, it’s better to think about how to get relief. Regular gentle movement is often the best thing you can do for chronic back and hip pain.

Even if your doctor finds a structural cause, the majority of people heal without surgery, using at-home remedies such as activity modifications, ice/heat therapy, physical therapy exercises, and over-the-counter medications. 

Here are some of the most common reasons you may experience pain in your lower back and hips.

Muscle strain. The back and hips share a mission: to be a strong anchor for your legs. “If your back and hips are not strong and stable as your leg moves, then they are going to move, too, and that can lead to overuse issues,” says Lori Walter, PT, DPT, a physical therapist at Hinge Health. There are countless ways you might strain your back or hips, from lifting a heavy load to a traumatic fall or injury to sitting for hours at a time. Weak core muscles may also lead to strain, as your back muscles will engage to compensate for underperforming ones. Muscle strain often heals on its own in a few days. 

Pinched nerve. When muscle, bone, or tissue presses down and compresses a nerve, the result is pain, tingling, numbness, and weakness. A pinched nerve in the lower back can cause these symptoms in the back, hips, buttocks, and lower legs. There are many reasons a nerve may become pinched, including arthritis, a herniated disc, a sports injury, repetitive motion, pregnancy, or excess weight. Pinched nerves often heal over four to six weeks with rest, ice/heat therapy, and over-the-counter medications. 

Arthritis. The cartilage that facilitates smooth motion of the small joints in the back of the spine can become worn over time. This can lead to osteoarthritis in the facet joints that support motion of the vertebrae. They may rub together, causing pain and stiffness. Similarly, osteoarthritis of the hip occurs when the cartilage that cushions the hip joint wears away. This can lead to pain, stiffness, and limited range of motion in the hip.

Herniated disc. This is another problem that can be caused by common changes in the spine. As the discs compress, the jelly-like center can push out, causing the disc to press into sensitive spinal nerves. You may feel a sharp or burning pain, along with numbness, tingling, and weakness. Depending on which lumbar nerves are irritated, the pain may radiate through your hip into the front thigh or all the way down to your toes. The majority of herniated discs heal over several weeks without surgery, with physical therapy and non-steroidal anti-inflammatory drugs (NSAIDs like ibuprofen) as first-line remedies. 

Sacroiliac joint pain. The sacroiliac (SI) joint connects the lower back to the pelvis. The joint can become inflamed due to arthritis or injury, leading to sharp, stabbing or dull, aching pain in the back, hip, and buttocks. Sacroiliac joint pain may be involved in 10-25% of lower back pain cases.  

Pelvic floor muscle imbalance. The pelvic floor muscles line the bottom of the pelvis and connect to the back through the tailbone. If the pelvic floor muscles become tight or tense, this can lead to pain (often a dull ache). Pelvic floor pain is frequently mistaken for back pain, says Dr. Walter. As pelvic floor muscles struggle to support the internal organs of the pelvis, the back muscles work harder to compensate, leading to overuse and strain. 

What About Sciatica?

You may be wondering if your low back and hip pain could be due to sciatica. This term describes pain that originates in an irritated nerve of the lower back that travels down the sciatic nerve, which runs down the buttock and lower leg. The pain can feel sharp, burning, cramp-like, or like a “pins and needles” tingling. Sciatica is usually caused by a condition that pinches the nerves, such as arthritis (particularly in older adults) or a herniated disc (typically in those under age 40).

When to See a Doctor

Most of the time, pain that’s affecting your low back and hip will improve within a few days to a few weeks, with conservative approaches like ice/heat, over-the-counter medication, and gentle exercise. However, it’s a good idea to see a doctor if you notice any of the following:

• You experience weakness in your lower extremities.

• Your pain is severe, unrelenting, does not improve with time and home remedies, or interferes with your daily activities. 

• You’ve had a traumatic fall or injury.

• Your pain occurs with signs of more serious illness such as fever, chills, unexplained weight loss, or loss of bowel or bladder control.

Holistic Treatments for Back and Hip Pain

For long-term relief and prevention of future pain episodes, pain management experts recommend a holistic approach that treats the biological, psychological, and social/spiritual roots of chronic pain. Studies have shown that people’s reported pain levels often do not correspond to structural causes (like herniated discs) seen on imaging studies. Experts now believe this is because ongoing pain actually changes how our nervous system interprets pain. Chronic pain can make people more sensitive to pain. People with chronic pain often develop emotional distress that makes pain worse.

Holistic practices — exercise, stress management, healthy eating, and other lifestyle changes — can bring relief by addressing physical causes as well as psychological and emotional ones. Truly holistic pain management may involve different approaches and providers, including doctors, physical therapists, nutritionists, and mental health professionals. Consider these:

Physical therapy. Physical therapists can help diagnose and treat musculoskeletal imbalances that cause pain. They can design a customized exercise plan to strengthen, stretch, and stabilize muscles and joints to relieve and prevent pain. “Physical therapy also helps desensitize the nervous system to pain,” says Dr. Walter. “By guiding people to move up to the point of pain, and then come out of it, and then moving a little further next time, the brain starts to learn, ‘okay, that movement is safe. ’”

You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

Personal training. “After people complete physical therapy, I sometimes recommend personal training to help them stay motivated to exercise or to continue to build strength,” says Dr. Walter.   

Clean diet. European researchers analyzed 10 years of studies on eating patterns and chronic pain. They found that certain diets helped improve pain and quality of life by reducing inflammation or providing important nutrients, including antioxidants and prebiotics. Experts recommend that you reduce your intake of pro-inflammatory foods, such as added sugar, processed meat, and refined grains. Fill up on anti-inflammatory choices such as fruits and vegetables, whole grains, fish, and olive oil.  

Stop smoking. Smoking accelerates disc degeneration of the spine, according to the American Academy of Orthopaedic Surgeons.  

Massage. An analysis of 60 studies showed that massage therapy helped people manage their pain better than people who received only sham or placebo treatments.  Experts believe that massage helps people lower stress and deal with the emotional distress of pain better, and also soothe the physical discomfort of tight muscles. 

Meditation. Research shows that women with lower back pain who practiced mindfulness meditation reported lower pain and better quality of life and mental health after eight sessions, compared to those who received standard care. The women learned mindfulness techniques such as body scans and walking and sitting meditations.

Lifting and sitting mechanics. Asking your body to lift or carry more than you’re used to, or to sit in one position for too long are common causes of muscle strain, says Dr. Walter. Avoid lifting when you are tired, and don’t lift much more than what you practice lifting regularly. Bring the object as close to your body as possible and exhale as you lift, using a wide stance for stability.  

When sitting, try to keep your sit bones (the bottom of your pelvis) higher than your knees. Use pillows or rolled-up towels for support if needed. Your computer screen should be at eye level and you want your feet flat on the floor with elbows bent and supported at 90 degrees. Feel free to adjust how you sit, and take regular posture breaks to stretch every 30 minutes. 

Counseling. In a study of adults who participated in an eight-session telehealth counseling program that emphasized that pain is a non-dangerous brain activity rather than physical tissue injury, 66% reported being pain-free or nearly pain free after one month. This suggests that helping patients understand and conceptualize their pain could bring significant relief. Psychological counseling can also help people learn coping skills (such as cognitive behavioral therapy) to combat the depression, anxiety, and emotional distress that develops when chronic pain limits your life and continues without relief.  

While all of the above steps can help lower back and hip pain, one of the most effective is regular exercise therapy. Hinge Health recommends these moves to reduce and prevent back and hip pain as part of a holistic health routine. Those moves are safe to do daily. Start slowly, aiming to do them once or twice a week, and build from there. If you’re wondering if these moves are right for you, check with your healthcare provider.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

PT Tip: Use a Stool During Standing Chores

When you’re standing at a counter for a long time, such as while cooking or cleaning, put one foot up on a stool, as if you are about to step up. “This puts the back in a more neutral position and rotates the pelvis,” says Dr. Walter. “This increases comfort and allows you to tolerate standing longer.” If you don’t have a stool, open a low cabinet and put your foot on the floor of the cabinet.

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

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Lumbar ischalgia – treatment, symptoms, causes, diagnosis

Lumbar ischalgia is a term for lower back pain radiating to the buttock, leg, back of the leg. The pain may be accompanied by numbness and tingling in the zone of innervation of the sciatic nerve. The term lumboischalgia (synonymous with sciatica) refers only to pain and is not a diagnosis.

Lumbar ischialgia is characterized by one or more symptoms:

• Constant pain only in the buttock or thigh on one side (rarely in both legs)
• Pain worse when sitting
• Burning or stinging down the leg
• Weakness, numbness or movement problems in the leg
• Constant pain on one side
• Sharp pain that may make it difficult to get up or walk

Pain in lumbar ischialgia can be of varying intensity depending on the underlying disease that led to the development of lumba ischialgia. Symptoms of lumbar ischialgia are caused by irritation of the sciatic nerve.

The sciatic nerve is the largest nerve in the trunk and consists of individual nerve roots that originate in the lumbar spine (at L3 level) and collectively form the “sciatic nerve”. The sciatic nerve runs from the lumbar spine to the leg. Parts of the sciatic nerve then branch out in each leg and innervate certain parts of the leg – the buttocks, thighs, calves, feet, toes.

Symptoms of sciatica (lumbosacral sciatica) such as leg pain, numbness, tingling, weakness may vary depending on where the nerve compression has occurred.

The incidence of sciatica (lumbosacral sciatica) increases in middle age. Lumboischalgia rarely occurs before the age of 20 years, such pain syndromes are most likely at the age of 40-50 years, and in the older age group the likelihood of lumbarishalgia decreases.

Often, specific events or injuries do not cause sciatica, but over time, damage leads to the development of sciatica. In overwhelming patients, conservative treatment can be quite effective, and the pain syndrome is significantly reduced within a few weeks, but in a certain number of patients, the pain syndrome may be persistent.

Causes

There are 6 most common causes of lumbar ischialgia:

Herniated disc in the lumbar spine.

A herniated disc occurs when the soft inner core of the disc (nucleus pulposus) bulges through the fibrous outer ring resulting in nearby nerve roots being affected.

Osteochondrosis

Degenerative changes in the intervertebral discs is a natural involutionary process that occurs as the body ages. Degenerative changes in the discs can lead to irritation of the roots and the development of pain.

Spondylolisthesis

This condition occurs when the vertebral arches are damaged (spondylolysis), as a result of which one vertebra slips in relation to another. Displacement of a vertebra causes damage and displacement of the intervertebral disc, which together can lead to irritation of the nerve roots and irritation of the sciatic nerve.

Spinal stenosis lumbar spine

This condition usually causes inflammation of the sciatic nerve due to narrowing of the spinal canal. Spinal stenosis in the lumbar region is most often associated with natural involutional changes in the spine and occurs in patients over 60 years of age. The condition usually results from a combination of one or more of the following: facet joint enlargement due to bony growths, soft tissue overgrowth (ligamentous apparatus), and disc protrusion (disc herniation).

Piriformis syndrome

Irritation of the sciatic nerve can occur in the area of ​​passage in the buttock under the piriformis muscle. In the presence of a spasm of the piriformis muscle or other changes in this muscle, it is possible to affect the sciatic nerve with the development of pain. And although this syndrome is an independent disease, pain manifestations in the leg can be similar to lumbar ischialgia.

sacroiliac joint dysfunction

Irritation of the sacroiliac joint can also cause irritation of the L5 root, which exits at the top of the sacroiliac joint, and if there is a problem in this joint, inflammation of the sciatic nerve and pain can occur. Pain in the leg may be similar to that of lumbar ischialgia (lumbosacral sciatica).

Other causes of lumbar ischialgia

A number of other conditions and diseases can cause sciatica, including:

• Pregnancy. The bodily changes that occur in the body during pregnancy, including weight, center of gravity, and hormonal changes, can cause sciatica during pregnancy.
• Presence of scar tissue. If the scar tissue compresses the nerve roots, it can irritate the sciatic nerve
• Muscle strain. In some cases, the inflammation associated with muscle strain can put pressure on the nerve roots and cause sciatica.
• Tumors of the spine. A tumor in the spine (most often of metastatic origin) can have a compressive effect on the sciatic nerve.
• Infections. Infections rarely occur in the spine, but can also be the cause of the impact on the roots with the development of inflammation of the sciatic nerve.

Symptoms

Lumboischalgia is usually symptomatic on one side and the pain starts from the lower back and runs down the back of the thigh down to the foot.

• Lower back pain is usually less intense than in the leg.
• Pain, as a rule, on one side of the lower back radiating to the buttock or thigh along the sciatic nerve – along the back of the thigh of the lower leg and foot.
• Pain is relieved when the patient is lying down and when walking and worsens when standing or sitting.
• The pain is of an acute burning character.
• Some patients may describe a feeling of tingling, numbness, or weakness in the leg.
• Weakness or numbness when moving the leg.
• Severe or shooting pain in the leg, which may make it difficult to stand or walk.
• Depending on the location of the impact on the sciatic nerve, pain can also be in the foot and toes.

The symptoms of lumbar ischialgia depend on where the root compression has occurred.

For example:

• L4 root – symptoms will usually appear on the thigh. Patients may feel weak when straightening the leg and possibly a decreased knee jerk.
• L5 root – Symptoms may be in the big toe and ankle. Patients may feel pain or numbness in the top of the foot (between the big toe and the second toe).
• S1 root – symptoms may appear on the outside of the foot, radiating to the toes and little toe. Patients may experience weakness when lifting the foot or attempting to stand on their toes. There may also be decreased ankle reflexes.

When several roots are compressed, a combination of symptoms is possible.

There are a number of symptoms that deserve special attention because they require emergency medical attention, sometimes even surgery. These symptoms are as follows:

• Symptoms that continue to progress rather than improve, which may indicate possible nerve damage, especially if there is progression of neurological symptoms (eg weakness in the leg).
• Symptoms of lumbar ischialgia are present in both legs and there is evidence of bowel or bladder dysfunction, which may be a sign of cauda equina syndrome. With cauda equina syndrome, emergency surgical intervention is indicated.

Seek immediate medical attention if these symptoms are present.

Treatment

In most cases, conservative treatment of lumbar ischialgia is effective. The range of therapeutic methods for lumbar ischialgia is wide and is aimed at reducing the compression of the nerve roots and reducing pain manifestations. The most effective is the use of an integrated approach to the treatment of lumbar ischialgia and the use of a combination of various treatment methods (physiotherapy, massage, manual therapy, drug treatment, acupuncture and exercise therapy).

Medical treatment . The use of anti-inflammatory drugs (ibuprofen, naproxen, voltaren), COX-2 inhibitors (Celebrex) can reduce inflammation, which leads to a decrease in pain.

Epidural injections . If there is severe pain, an epidural steroid injection may be given. Epidural steroid administration differs from oral steroid administration in that the drugs are injected directly into the painful area around the sciatic nerve, which can quickly reduce inflammation and relieve pain. The effect of such a procedure, as a rule, is temporary, but it helps to relieve severe pain syndrome quickly enough.

Manual therapy

Modern soft manual therapy techniques allow restoring mobility of spinal motor segments, removing muscle blocks, improving facet joint mobility and sometimes can significantly reduce nerve fiber compression.

Acupuncture also helps reduce pain and restores conduction along the nerve fibers.

Massage

Therapeutic massage techniques improve microcirculation, relieve muscle spasm, and increase the body’s production of endorphins.

Physiotherapy . Existing modern methods of physiotherapy (cryotherapy, laser therapy, ultrasound electrophoresis) can reduce inflammation, improve blood circulation and thus reduce pain.

LFK . Physical exercises, which must be connected after the reduction of pain manifestations, allow you to restore the muscle corset and normalize the biomechanics of the spine, improve blood circulation in the motor segments. Physical exercises include both mechanotherapy (exercise on simulators) and gymnastics, which allows you to develop both muscles and strengthen the ligamentous apparatus. Exercises for lumbar ischialgia must be selected with a doctor (instructor) of exercise therapy, since self-study often leads to a relapse of symptoms.

Surgical treatment

Indications for surgery are the following factors:

• Severe leg pain that persists for more than 4 to 6 weeks.
• No effect of conservative treatment and persistence or increase in neurological symptoms.
• Pain significantly impairs the patient’s quality of life, the patient’s ability to participate in daily activities

Urgent surgery is usually only necessary if there is progressive neurological symptoms (increasing weakness in the legs or sudden bowel or bladder dysfunction).

How to relieve pain in the hip joint. Causes and treatment

Hip pain symptoms

Hip pain can radiate to adjacent areas – thighs, groin, buttocks and hip joint.

Sometimes the only symptom of hip problems is knee pain. Such pain is called reflected; it occurs quite often.

Pain in the hip may worsen with physical exertion, such as after sports, long walks and runs.

With pain in the hip, it becomes more difficult for a person to move the leg in the hip joint, the range of motion decreases. In severe cases, lameness develops.

How does hip pain affect us?

The hip joints provide mobility to the body, so pain in this area can make daily activities difficult. With hip pain, even getting out of bed, climbing stairs, and walking, not to mention jogging, is a problem. In severe cases, a person cannot move the leg at the joint and transfer body weight to it. In such cases, you should consult a doctor.

Relieve pain

Blood vessels and nerves are located in the thigh area, in particular the sciatic nerve (on the back of the thigh) and the femoral nerve (on the front of the thigh) *

86% of the people surveyed noted that pain in the joints, associated with Osteoarthritis affects their lives the most**

Relieve Pain

* Hip Anatomy http://www.arthritis.org/about-arthritis/where-it-hurts/hip-pain/hip-anatomy. php (checked 03/26/2019)
** According to the Global Pain Index 2018 survey, 86% of pain sufferers said that OA-related joint pain is the biggest impact on their lives

Why does hip pain occur?

The design of the hip joint allows for smooth movement and the ability to perform repetitive movements such as running or jumping. But due to constant stress over the years, the muscles, nerves, ligaments and tendons of the thigh can become inflamed, resulting in pain.

Determine the cause of the pain

Pain can be felt in various parts of the thigh. Localization of pain helps to understand its causes. Pain in the groin and inner thigh area can be a sign of hip problems. Hip pain outside the hip joint, in the upper thigh and buttocks, usually indicates a soft tissue problem.

More serious causes of hip pain

Serious causes of hip pain include osteoarthritis, fractures, dislocations due to trauma, and bursitis (inflammation of the joint capsule). In these cases, you should consult a doctor.

Treatment

If you have hip pain due to muscle or tendon injury or tendon inflammation (tendonitis), over-the-counter medications can help relieve pain and swelling. You can relieve pain and improve joint mobility with the help of therapeutic exercises.