What causes pain in the hip and down the leg to foot. How to differentiate between sciatica and other conditions. What are the most effective treatments for hip and leg pain. How to prevent recurrence of hip and sciatic pain

Understanding Hip Pain: Beyond Bursitis

When it comes to hip pain, many people immediately think of bursitis. However, according to Dr. Lauren Elson, a physiatrist at Harvard-affiliated Massachusetts General Hospital, this assumption is often incorrect. In fact, she states that “90% of the time, it’s not bursitis.” This revelation opens up a new perspective on hip pain, urging us to look beyond the common diagnosis and explore other potential causes.

Common Causes of Hip and Leg Pain

Hip pain can stem from various conditions, each requiring a different approach to treatment. Let’s explore some of the most common causes:

• Tendinitis
• Overuse injury
• Tight muscles in the buttocks and hip
• Spine problems

Tendinitis: Inflammation and Muscle Imbalance

Tendinitis is an inflammation of the tendons connecting the gluteal muscles to the hip bone. This condition often develops due to muscle imbalance, which can be caused by various factors. Do you spend long hours sitting or frequently cross your legs? These habits could contribute to tendinitis development. Even something as seemingly innocuous as sitting on a wallet can lead to this painful condition.

Overuse Injury: The IT Band Connection

Overuse injuries often involve the iliotibial (IT) band, a long connective tissue running from the knee to the hip. When hip and buttock muscles are weak, they can tighten and irritate the IT band during activities like walking or running. This irritation can lead to persistent pain on the side of the hip.

Tight Muscles: Pulling at the Thighbone

Tightness in the gluteal muscles and IT band can cause pain by pulling at their attachment point on the thighbone. This tension creates discomfort on the side of the hip, which can be exacerbated by certain positions or movements.

Spine Problems: Referred Pain

Interestingly, hip pain doesn’t always originate from the hip itself. Dr. Elson explains that spine issues such as arthritis, pinched nerves, or bone friction can manifest as pain in the side of the hip. This phenomenon, known as referred pain, highlights the complex nature of our body’s pain signaling system.

Recognizing Symptoms and Seeking Diagnosis

Identifying the specific cause of hip pain can be challenging due to the similarity of symptoms across different conditions. However, certain patterns can help in recognition:

• Pain that lingers or worsens when lying on your side
• Discomfort when sitting with crossed legs
• Pain that may ease with activity
• Potential progression to severe pain affecting walking ability

Given the complexity of hip pain, it’s crucial to seek professional medical advice. A primary care physician, physiatrist, sports medicine specialist, or physical therapist can provide a comprehensive evaluation, interpreting your symptoms and imaging tests to determine the root cause of your hip pain.

Effective Treatment Strategies for Hip Pain

The good news is that most hip pain can be effectively managed with targeted exercises and stretching. Dr. Elson typically recommends a multi-faceted approach to treatment:

1. Massage therapy
2. Physical therapy focusing on stretching tight tissues
3. Strengthening exercises for core and hip muscles
4. Lifestyle modifications to avoid habits that exacerbate pain

The Role of Physical Therapy in Hip Pain Management

Physical therapy plays a crucial role in treating hip pain. The initial focus is on improving flexibility by stretching tight tissues, including:

• Hip flexors
• IT band
• Piriformis muscles in the buttocks

As flexibility improves, the focus shifts to strengthening exercises. Madhuri Kale, a physical therapist at Harvard-affiliated Brigham and Women’s Hospital, emphasizes the importance of strengthening core muscles, particularly the transversus abdominis. Why is core strength so crucial for hip health? A stronger core helps align the pelvis better, reducing stress on the hip during standing and walking. Additionally, it provides better support for the spine.

Strengthening Exercises for Hip Pain Relief

Once core strength is established, targeted exercises for hip muscles are introduced. These exercises aim to improve the range of motion and stability of the hip joint. Some effective exercises include:

• Side leg lifts
• Back leg lifts
• Resistance band exercises
• Clamshells

The clamshell exercise, in particular, is highly beneficial. To perform this exercise, lie on your side with your knees bent, then raise and lower only your top knee while keeping your feet together. This movement targets the hip abductor muscles, which play a crucial role in hip stability and pain reduction.

Lifestyle Modifications to Prevent Hip Pain

While exercises and physical therapy are essential components of hip pain management, certain lifestyle modifications can significantly contribute to pain relief and prevention:

• Avoid prolonged sitting
• Refrain from crossing legs when seated
• Use proper ergonomics at work and home
• Maintain a healthy weight to reduce stress on hip joints
• Wear appropriate footwear
• Practice good posture

By incorporating these changes into your daily routine, you can help prevent the recurrence of hip pain and maintain overall hip health.

The Connection Between Hip Pain and Sciatica

While our discussion has primarily focused on hip pain, it’s important to note the potential connection to sciatica. Sciatica refers to pain that radiates along the path of the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg. How does sciatica relate to hip pain? In some cases, what appears to be hip pain may actually be referred pain from sciatic nerve compression in the lower back.

Differentiating Sciatica from Hip Pain

Distinguishing between sciatica and hip pain can be challenging, as symptoms may overlap. However, there are some key differences:

• Sciatica typically causes pain that radiates from the lower back down the leg, potentially reaching the foot
• Hip pain is usually more localized to the hip and upper thigh area
• Sciatica often includes numbness, tingling, or weakness along the affected leg
• Hip pain may be more pronounced with certain hip movements or positions

If you’re experiencing pain that extends from your hip down your leg to your foot, it’s crucial to consult a healthcare professional for an accurate diagnosis. They can determine whether your symptoms are related to a hip condition or sciatica, ensuring you receive the most appropriate treatment.

Innovative Treatments for Persistent Hip and Leg Pain

While traditional treatments like physical therapy and lifestyle modifications are effective for many people, some may require additional interventions for persistent hip or sciatic pain. Several innovative treatments have emerged in recent years:

Platelet-Rich Plasma (PRP) Therapy

PRP therapy involves injecting a concentration of a patient’s own platelets to accelerate the healing of injured tendons, ligaments, muscles, and joints. How effective is PRP for hip pain? While research is ongoing, some studies have shown promising results for conditions like hip osteoarthritis and tendinopathy.

Regenerative Medicine Approaches

Stem cell therapy and other regenerative medicine techniques are being explored for their potential to repair damaged tissues in the hip and surrounding areas. These cutting-edge treatments aim to stimulate the body’s natural healing processes, potentially offering long-term relief for chronic hip and leg pain.

Minimally Invasive Procedures

For cases where conservative treatments haven’t provided sufficient relief, minimally invasive procedures may be considered. These can include:

• Radiofrequency ablation for nerve pain
• Endoscopic procedures for hip impingement
• Ultrasound-guided injections for precise medication delivery

These advanced treatments underscore the importance of a comprehensive, personalized approach to managing hip and leg pain. By combining traditional therapies with innovative techniques, healthcare providers can offer patients a wider range of options for achieving pain relief and improved function.

The Importance of Holistic Health for Hip Pain Management

While targeted treatments for hip pain are crucial, it’s equally important to consider overall health and wellness in managing and preventing hip issues. A holistic approach to hip health encompasses various aspects of lifestyle and well-being:

Nutrition for Joint Health

A balanced diet rich in anti-inflammatory foods can play a significant role in managing hip pain. Which nutrients are particularly beneficial for joint health? Consider incorporating the following into your diet:

• Omega-3 fatty acids (found in fish, flaxseeds, and walnuts)
• Antioxidants (present in colorful fruits and vegetables)
• Vitamin D and calcium (for bone strength)
• Collagen-rich foods (such as bone broth)

Stress Management Techniques

Chronic stress can exacerbate pain and tension in the body, including the hip area. Implementing stress-reduction techniques can complement physical treatments:

• Mindfulness meditation
• Yoga (with modifications for hip pain)
• Deep breathing exercises
• Regular relaxation practices

Sleep Hygiene for Pain Relief

Quality sleep is essential for the body’s healing processes. How can you improve your sleep to support hip pain management? Consider these tips:

• Use supportive pillows to maintain proper hip alignment
• Invest in a mattress that provides adequate support
• Establish a consistent sleep schedule
• Create a relaxing bedtime routine

By addressing these holistic aspects of health, individuals can create an environment conducive to healing and pain relief, complementing targeted hip pain treatments.

The Role of Technology in Hip Pain Management

As technology continues to advance, new tools and applications are emerging to assist in the management of hip pain and related conditions. How can technology enhance hip pain treatment and prevention?

Wearable Devices for Posture and Movement Tracking

Smart wearables can provide real-time feedback on posture and movement patterns, helping individuals identify and correct habits that may contribute to hip pain. These devices can track:

• Sitting time and reminders to move
• Gait analysis for walking and running
• Posture alignment throughout the day

Mobile Apps for Exercise Guidance and Pain Tracking

Numerous mobile applications offer guided exercise routines specifically designed for hip pain relief and prevention. These apps can provide:

• Step-by-step instructions for stretches and strengthening exercises
• Pain tracking features to monitor progress over time
• Reminders for regular movement and exercise

Telemedicine for Ongoing Care

Telemedicine platforms allow patients to consult with healthcare providers remotely, facilitating:

• Regular check-ins and progress assessments
• Adjustments to treatment plans as needed
• Access to specialists regardless of geographic location

By leveraging these technological advancements, individuals can take a more active role in managing their hip health, potentially improving outcomes and quality of life.

Think that hip pain is bursitis? Think again.

Pain on the side of your hip is more likely from tendinitis, tight muscles, or another condition.

 Image: © Jan-Otto/Getty Images

Hip bursitis — an inflammation between your thighbone and nearby tendons — is commonly diagnosed when patients have pain on the outer side of the hip. However, several other conditions can cause similar pain, and require different treatments. “Doctors often assume that pain on the outer side of the hip is due to bursitis. But 90% of the time, it’s not bursitis,” says Dr. Lauren Elson, a physiatrist with Harvard-affiliated Massachusetts General Hospital.

What’s causing the pain?

Dr. Elson says pain in the side of your hip most often results from one of the following conditions:

Tendinitis. This is an inflammation of the tendons (fibrous bands of tissue) that connect the gluteal muscles in your buttocks to the hip bone. “Tendinitis develops because of muscle imbalance. It could be from a lack of activity, crossing your legs, or even sitting on a wallet,” Dr. Elson says.

Overuse injury. When you walk or run, weak hip and buttock muscles can tighten and irritate the iliotibial (IT) band — a long band of connective tissue that runs from the knee to the hip. It merges with the gluteal muscles to stabilize the leg.

Tight muscles in the buttocks and hip. If the gluteal muscles and IT band are too tight, they pull at the thighbone where they attach, and that causes pain on the side.

Spine problems. “The body isn’t always smart in recognizing where the pain is coming from,” Dr. Elson explains, “and spine arthritis, a pinched nerve, or bones in the spine rubbing together can create pain in the side of your hip.”

Symptoms and diagnosis

With all of these conditions, the pain lingers or even worsens when you lie on your side, or when you sit and cross your legs. It may ease with activity. But left untreated, the pain can become so severe that you’re unable to walk.

You may need to seek treatment from a primary care physician or specialist (such as a physiatrist, sports medicine specialist, or physical therapist) who can interpret your symptoms and imaging tests to determine the cause of pain on the side of your hip.

Starting your treatment

The good news: “Pain almost always goes away with targeted exercise and stretching,” says Dr. Elson.

She typically recommends massage and a course of physical therapy, which focuses at first on easing tight tissues by stretching them. These include the hip flexors, the IT band, and the piriformis muscles in the buttocks.

It’s also important to avoid habits that can tighten muscles and add to pain at the side of the hip, such as crossing your legs or sitting too long.

Strengthening the muscles

Along with improving flexibility, physical therapy sessions aim to strengthen the abdominal or core muscles, such as the transversus abdominis muscle. “This helps align the pelvis better, so you won’t stress the hip when you stand or walk. Stronger abdominals also support your spine,” explains Madhuri Kale, a physical therapist at Harvard-affiliated Brigham and Women’s Hospital.

With a stronger core, you can then move on to strengthening the muscles at the hip that let you move your leg in various directions. “We may have you do side or back leg lifts, performed while standing, with a resistance band. And clamshells are also helpful,” Kale says. You do this exercise by lying on your side with your knees bent and raising and lowering only your top knee while keeping your feet together.

In time, you can restore balance to the body and reduce pain. “Pain comes on because of an imbalance from tight or weak muscles,” Dr. Elson says. “If you can restore balance, you can help the body function better and eliminate pain.” For more information, check out the Harvard Special Health Report The Joint Pain Relief Workout (/jprw).

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Piriformis Syndrome

If you’ve ever felt pain in the hip, pain in the center of the buttock, or pain down the back of the leg, you may likely be suffering (at least partially) piriformis syndrome that may cause sciatica symptoms. What is the piriformis muscle? It is located in the buttock region and runs from your sacrum (pelvis) to the outer hip bone (trochanter). The piriformis muscle works overtime especially in people who are runners. The muscles in and around the gluteal region help with 3 bodily movements:

1. Rotation of the hip and leg
2. Balance, while one foot is lifted off the ground
3. Stabilizing the pevlic region

Woman runner on the beach standing while stretching her knee to her chest. Photo Source: 123RF.com.

3 Piriformis Muscle Injury Symptoms

The piriformis muscle is a target for repetitive motion injury (RMI). RMI occurs when a muscle is driven to perform beyond it’s level of capability, not given enough recovery time and must perform again. The typical response from the piriformis muscle or any other muscle is to tighten—the muscle’s defensive response. In runners, piriformis muscle tightness can manifest itself in several ways.

The anatomy of the lower back/sacrum illustrates the piriformis muscle and sciatic nerve. Photo Source: Shutterstock.

Piriformis Syndrome Symptom #1

The first symptom suggesting piriformis syndrome is pain in and around the outer hip bone. The tight piriformis muscle can produce increased tension between the muscle’s tendon attachments at the front (anterior) of the sacrum and trochanter (hip bone). This can cause joint bursitis resulting in discomfort and pain. Bursitis is inflammation of the hip joint’s fluid filled sac that may develop in reaction to increased joint stress and tension.

Piriformis Syndrome Symptom #2

The second symptom of piriformis syndrome is pain or soreness felt in the center of one or both buttocks and may be brought about by compressing the buttock. This piriformis syndrome symptom may be caused by reduced muscular blood flow.

Piriformis Syndrome Symptom #3

The third symptom is sciatic neuralgia; low back pain that travels downward from one buttock into the back of the affected leg, sometimes below the knee. Piriformis syndrome may cause the muscle to compress the sciatic nerve creating pain and sensations such as tingling and/or numbness.

To learn more about the sciatic nerve and sciatica, visit SpineUniverse’s Sciatica Slideshow.

Piriformis Muscle Physiology and Recovery

Any muscle repetitively used needs an opportunity to recover. Muscle recovery can either be on Nature’s clock or can be facilitated and sped up with proper knowledge and treatment. Since the muscle is tightening due to overuse, continued use will only make it worse. The injured muscle needs to relax with increased blood flow for more rapid healing. Piriformis muscle tightness reduces normal blood circulation to the muscle and reduces the speed of muscle recovery. Circulation of fresh, oxygen-rich blood into the muscle is the most powerful way to encourage muscles to restore normal function. Multiple massages daily to treat the piriformis muscle is recommended.

Placing a tennis ball under the buttock and hip area is a good next recovery step. While sitting down on the floor, roll away from the side of involvement and place a tennis ball just inside the outer hip bone under the buttock area. As you begin to allow your weight onto the tennis ball, note areas of increased pain and soreness. Trigger points will tend to accumulate in a repetitively used muscle, and until these toxins are manually broken up and eliminated, the muscle will have an artificial ceiling with regard to flexibility potential and recovery potential. So, if it’s sore and hurts while you are sitting on it, you are doing a good job.

Let the tennis ball work under each spot for 15-20 seconds before moving it to another area. Once you’ve been on the ball for 4-5 minutes, move the ankle of the involved leg over the knee of the non-involved leg (crossing your legs). Now place the tennis ball just inside the outer hip bone again and work the tendon of the piriformis muscle. The pain is typically excruciating and takes some time to effectively reduce but the benefits are huge. Be patient, consistent and good things will happen.

Additional Treatments and Concluding Advice

Due to the fact that sciatic neuralgia, hip bursitis and/or tendonitis are inflammatory in nature, ice, or cryotherapy applied over the affected area 15-20 minutes at a time may be beneficial. This should be done multiple times per day.

Stretching the hip muscles should not be done until acute pain is gone. At that point in time, begin with gentle stretching, such as the cross-legged stretch while pulling up on the knee. The muscle should have increased flexibility before actively returning to running.

Finally, I’m always discouraging the use of anti-inflammatory medications. Not only do they greatly aggravate the intestines, but they also suggest an artificial wellness that can lead to bigger problems. Proteolytic enzymes, such as bromelain, are both natural and extremely beneficial with no side effects.

Conclusion–the piriformis muscle is pretty important for all of us. If you’ve been diagnosed with piriformis syndrome, check out our video series on pirifomis syndrome exercises.

Commentary by Edward C. Benzel, MD

Dr. Maggs presents a thorough but brief description of piriformis syndrome. It should be emphasized that piriformis syndrome is rarely a surgically treatable problem. It does, however, manifest itself commonly in runners and other active people. “Educated athletes” should be aware of this syndrome and treat it accordingliy. Dr. Maggs has provided the formula for doing just that.

Sciatica Ascension Seton in Central Texas

Sciatica is caused by compression or irritation of the sciatic nerve, which extends from the lower back down to the back of the legs. This area consists of one to five nerves, and provides feeling in the buttocks, lower legs, back of the thighs and the feet. If the sciatic nerve is irritated or inflamed, you can experience pain, weakness and numbness, typically on only one side of the lower body.

Wellness & Prevention

Sciatica can be caused by many conditions, including lumbar spinal stenosis, lumbar disc herniation, pregnancy, degenerative disc disease, obesity, neuromuscular disorders and more. It is not always possible to prevent sciatica. You can decrease your chances of developing the condition by:

• Exercising regularly, paying special attention to your core muscles.
• Practicing good posture, especially when sitting.
• Lifting objects safely (with the legs).
• Avoiding sitting for long periods of time.
• Sleeping on your side or back with a pillow under your knees.

Diagnosis

The first step in diagnosing sciatic nerve pain is a physical exam. The physical exam determines strength and reflexes, and is an especially helpful diagnostic method for testing the nerves.

In order to pinpoint the exact diagnosis, physicians may use a range of diagnostic tests following the physical exam:

• X-rays show the bones and tissues located in the back and can help pinpoint any fractures or bone abnormalities.
• Computed Tomography (a CT scan) uses an X-ray machine and computer to take pictures of the legs, thighs and hips.
• A myelogram is the only test that can show nerves in a standing posture. This is important if instability is a suspected symptom. This procedure involves an X-ray and the injection of a dye.
• Nerve conduction tests monitor how nerves near the surface of the skin and in related muscles respond to electrical stimulation. Small electrodes are placed on areas near the buttocks and legs for the most accurate readings.
• An electromyography (EMG) test measures muscle and nerve function. It uses electrodes to measure the electrical activity of the muscles in various situations.
• Magnetic resonance imaging (an MRI scan) uses radio waves and magnetic fields to take photos of the hips, legs and thighs. This tool can show damage in muscles, bones, nerves and blood vessels.

Symptoms

Common sciatica symptoms include:

• Pain in the buttocks area or leg that worsens with standing
• Weakness in the leg, knee or foot
• Numbness or difficulty moving the leg, knee or foot
• Burning or tingling sensation down the leg
• Continuous pain on one side of buttocks
• Pain that makes it difficult to stand up

Depending on which nerve is affected, the type of pain can vary. Sciatica from the L3 nerve root may result in pain and numbness. These symptoms are specifically in the front of the thigh. Someone experiencing this type of sciatica may have trouble getting out of a chair.

Symptoms of sciatica from the L4 nerve root are similar to those in the L3 nerve root. In addition to pain in the front of the thigh, people may experience pain or weakness in the inner thigh, the lower leg and foot area. Much like sciatica from the L3 nerve root, a person with this condition may have trouble getting out of a chair. If diagnosed with sciatica from the L4 nerve root, a person may experience ankle weakness, such as difficulty lifting the foot upward.

Sciatica from the L5 nerve root may reach to the top of the foot and result in pain and weakness of the big toe.

Sciatica from the S1 nerve root can cause pain and weakness in the calf or foot area. A person experiencing sciatica from the S1 nerve root may be unable to walk on tiptoes and suffer from reduced angle reflexes.

Treatments

Although severe pain can result from sciatica, most cases can be resolved with conservative treatments in just a few weeks. People are usually advised to alleviate pain with medications and practice physical therapy exercises. Certain types of stretching, strengthening and aerobic conditioning can help heal sciatica.

People who continue to suffer from severe sciatica after non-surgical treatments may benefit from surgery to relieve pressure on the affected sciatic nerve. However, it is rare that surgery is necessary to treat sciatica.

Aftercare

In most cases, the sciatic nerve pain will go away after about six weeks of care. To prevent sciatica from recurring, practice good posture and participate in gentle back strengthening exercises like walking or swimming. Always lift objects from a squatting position to avoid straining your back, and avoid sitting for extended periods of time.

Sciatica is a fairly common condition and can recur after healing. The best way to manage sciatic nerve pain is to practice protecting your spine and see your doctor if you begin experiencing symptoms.

Hip pain in adults – NHS

Most cases of hip pain in adults that are treated with surgery are caused by osteoarthritis, the most common type of arthritis in the UK.

This page aims to give you a better idea of whether osteoarthritis or something more unusual is causing your hip pain, and what you can do about it.

But do not try to diagnose the cause of your hip pain yourself. This should always be a matter for your doctor.

Find out more about hip pain in children

Osteoarthritis

The symptoms of osteoarthritis can vary greatly from person to person, but if it affects the hip, it’ll typically cause:

• mild inflammation of the tissues in and around the hip joint
• damage to cartilage, the strong, flexible tissue that lines the bones
• bony growths (osteophytes) that develop around the edge of the hip joint

This can lead to pain, stiffness and difficulty doing certain activities.

There’s no cure for osteoarthritis, but the symptoms can be eased using a number of different treatments. Surgery is not usually needed.

Find out more about treating osteoarthritis

Less common causes

Less commonly, hip pain may be caused by:

• the bones of the hip rubbing together because they’re abnormally shaped (femoroacetabular impingement)
• a tear in the ring of cartilage surrounding the socket of the hip joint (a hip labral tear)
• the hip joint is the wrong shape or the hip socket is not in the correct position to completely cover and support the top of the leg bone (hip dysplasia)
• a hip fracture – this will cause sudden hip pain and is more common in older people with weaker bones
• an infection in the bone or joint, such as septic arthritis or osteomyelitis – see a GP immediately if you have hip pain and fever
• reduced blood flow to the hip joint, causing the bone to break down (osteonecrosis)
• inflammation and swelling of the fluid-filled sac (bursa) over your hip joint (bursitis)
• a hamstring injury
• an inflamed ligament in the thigh, often caused by too much running – this is known as iliotibial band syndrome and is treated with rest (read more about sprains and strains)

When to get medical advice

Hip pain often gets better on its own and can be managed with rest and painkillers you can buy from a pharmacy, such as paracetamol and ibuprofen.  

But see a GP if:

• your hip is still painful after 1 week of resting it at home
• you also have a fever or rash
• your hip pain came on suddenly and you have sickle cell anaemia
• the pain is in both hips and other joints as well

Your GP may ask you the following questions:

• Where do you feel the pain?
• When and how did the pain start?
• Does anything make the pain worse?
• Does anything make the pain better?
• Can you walk and bear weight on it?
• Do you have any other medical problems?
• Do you take any medicines?

Go straight to hospital if:

• the hip pain was caused by a serious fall or accident
• your leg is deformed, badly bruised or bleeding
• you’re unable to move your hip or bear any weight on your leg
• you have hip pain with a temperature and feel unwell

Managing hip pain at home

If you do not need to see a doctor straight away, consider managing and monitoring the problem at home.

You may find it helpful to:

• lose weight if you’re overweight to relieve some of the strain on your hip
• avoid activities that make the pain worse, such as downhill running
• wear flat shoes and avoid standing for long periods
• see a physiotherapist for some muscle-strengthening exercises
• take painkillers, such as paracetamol or ibuprofen

Overactivity

If your hip pain is related to exercising or other types of regular activity:

Page last reviewed: 16 May 2019
Next review due: 16 May 2022

Causes, Treatment, and When to See a Doctor

Hip pain is a common symptom that can be described as aching, sharp, or burning and can range in intensity from mild to severe. There are many possible causes of hip pain, including serious ones, like a fracture or joint infection, and ones that are less so (though still potentially debilitating), like arthritis or bursitis. 

In order to get to the bottom of your pain, your doctor will perform a thorough medical history, physical examination, and possibly, order imaging tests. Once diagnosed, you and your doctor can work together to formulate a treatment plan—one that may entail surgery, but more commonly includes self-care strategies, like rest and ice, pain control with medication, and physical therapy.

Illustration by Alexandra Gordon, Verywell

Note: Hip pain in children is assessed differently than in adults. This article focuses on the latter.

Causes

The hip is a large “ball-and-socket” joint—the “socket” being a pelvic bone called the acetabulum and the “ball” being the femoral head, which is the upper part of the thighbone. Covering this ball and socket joint is cartilage—a smooth, white tissue that cushions the bones and allows the hip to move easily.

Problems within the hip joint itself tend to result in pain on the inside of the hip (anterior hip pain).  On the other hand, pain on the side of the hip (lateral hip pain) or pain on the outside of the hip, near the buttock region (posterior hip pain) is usually caused by problems with muscles, ligaments, tendons, and/or nerves that surround the hip joint.

Differentiating the various causes of hip pain by location—anterior, lateral, or posterior—is perhaps the best way to understand this somewhat complex symptom.

Anterior Hip Pain

Problems within the hip joint, such as inflammation, infection, or a bone fracture, may result in anterior hip pain—pain felt on the inside of your hip and/or within your groin area.

Osteoarthritis

Osteoarthritis of the hip occurs when the cartilage in the hip joint gradually wears away over time. As the cartilage frays and degenerates over time—often with increasing age or as a result of a prior hip injury—the joint space between the bones of the hip joint narrows, so bone may eventually rub on bone.

Depending on the degree of osteoarthritis, pain may be dull, aching, or sharp; although, in nearly all cases, the pain and stiffness of hip osteoarthritis worsen with activity and improve with rest.

Inflammatory Arthritis

Various types of inflammatory arthritis may affect the hip, resulting in dull, aching pain, such as rheumatoid arthritis, ankylosing spondylitis, and systemic lupus erythematosus. Unlike the pain of osteoarthritis, which is worsened with activity, hip pain from inflammatory arthritis is often eased with activity.

Fracture

A hip fracture, or a break in the upper quarter of the thigh bone, causes a deep, boring pain felt in the outer-upper thigh or groin area. A hip fracture may occur after a fall or direct blow to the hip. It may also occur as a result of a stress injury.

Stress fractures of the hip are most common in female athletes who have an eating disorder, menstrual irregularities, and bone weakening (conditions that, together, are known as the female athlete triad). 

Steroid use, a history of smoking, and medical conditions that weaken the bone (e.g., cancer or osteoporosis) are additional risk factors.

With a stress fracture, as opposed to a complete break from a fall, a person may experience more of a gradual onset of pain that worsens with weight bearing.

Iliopsoas Bursitis

Bursitis simply translates to irritation or inflammation of a bursa, which is a small, fluid-filled sac that serves as a cushion between joints, muscles, and tendons. One bursa, located on the inner or groin side of your hip—called the iliopsoas bursa—causes anterior hip pain if inflamed.

Iliopsoas bursitis, which is most common in runners or soccer players, causes anterior hip pain that may radiate to the front of the thigh area or into the buttock area. Sometimes, a snapping, catching, or popping sensation is felt in the hip with this type of bursitis.

Hip Flexor Strain

A hip strain refers to a stretching or tearing of a muscle or its associated tendon (or both).  Hip flexor muscles, like the iliopsoas muscle or rectus femoris muscle, are often involved in a hip strain.

A person may develop a hip flexor strain from overuse (e.g., cyclists, martial artists, or soccer players), or from some sort of trauma, such as a direct hit during a contact sport. In addition to anterior hip pain, hip flexor strains may result in swelling, restricted movement, and muscle weakness.

Osteonecrosis of the Hip

Osteonecrosis of the hip occurs when the hip bone does not receive a sufficient blood supply, which leads to the death of the bone cells and destruction of the hip joint. The vast majority of cases are due to corticosteroid use and excessive alcohol intake.

Besides anterior hip pain and groin pain that worsens with walking, a person may experience pain in the thighs, buttocks, and/or knees.

Hip Labrum Tear

Your hip labrum is a band of cartilage-like tissue that courses around the outer rim of your hip socket.  This labrum helps to support the joint and deepen the socket. Sometimes overuse or an injury to your hip can cause a tear in your labrum, prompting dull or sharp anterior hip pain that worsens with weight bearing.

Femoroacetabular Impingement (FAI)

In femoroacetabular impingement (FAI), bony growths develop around the hip joint. These growths can restrict movement and eventually cause tears of the labrum and hip osteoarthritis.

The symptoms of femoroacetabular impingement include an aching or sharp pain in the groin area that moves toward the outside of the hip. The pain is often felt once standing after sitting for a prolonged period of time. Stiffness and limping are also common.

Infected Hip Joint

Uncommonly, the hip joint may become infected (called a septic joint). In addition to severe anterior hip and/or groin pain, swelling, warmth, and restricted hip movement are typically present. Fever often also occurs, but may not be present in older individuals. 

Bone Cancer

Rarely, bone cancer (either primary or metastatic) may cause hip pain. Usually, the pain starts off being worse at night, but as the bone tumor progresses, the pain often becomes constant. Swelling around the hip area may also occur along with weight loss and unusual fatigue. Due to bone weakening from the cancer, a hip fracture may occur.

Lateral Hip Pain

Lateral hip pain refers to pain on the side of the hip, as opposed to the front or back of the hip.

Trochanteric Bursitis

Trochanteric bursitis causes sharp lateral hip pain that often spreads down into the thigh and knee. The pain is usually worse at night when sleeping on the affected hip and when engaging in physical activities like walking or running.

Over time, the pain may evolve into a deep aching pain that spreads over a larger area of the hip. Swelling and limping may also occur.

Snapping Hip Syndrome

Snapping hip syndrome causes a snapping or popping sensation and possibly lateral hip pain with walking or other movements, like getting up from a chair.  The actual “snapping” is due to one or more tight muscles, tendons, or other soft tissue moving over a bony structure within your hip.

One commonly affected “tight” or irritated tissue is the iliotibial band (IT band)—a thick collection of connective tissue that starts at the hip and runs along the outer thigh. The snapping sound results from the area where the IT band passes over the greater trochanter (the upper portion of the thigh bone).

This condition is most common in people who engage in sports or activities that cause them to frequently bend at the hip (one reason why it’s also referred to as “dancer’s hip.”)

Posterior Hip Pain

Posterior hip pain, which is pain felt on the outside of the hip or buttock area, is usually due to a problem with the muscles, tendons, or ligaments that surround the hip joint, as opposed to the actual joint itself.

Hamstring Muscle Strain

Muscle strains result from small micro tears in muscles caused by a quick twist or pull to the muscle. When this occurs to the hamstring muscles located around the hip joint, buttock pain and/or pain in the back of your hip occurs.

Sacroiliac Joint Problem

The sacroiliac (SI) joint connects the lower spine to the pelvis. You have one located on both sides of your body.

Various problems with the SI joint, including arthritis of the joint, infection of the joint, and injury to the joint ligaments, may result in posterior hip pain. The sharp and/or burning pain is often worse with standing and walking, and may radiate from the hip down the back of the leg.

Piriformis Syndrome

Piriformis syndrome—also called deep gluteal syndrome—occurs when the sciatic nerve (a large nerve that branches off from your lower back into your hip, buttock, and leg) becomes irritated or compressed by the piriformis muscle, which is located deep within the buttock, near the top of the hip joint.

The burning or aching pain of piriformis syndrome typically begins in the posterior hip and buttock region and moves down the back of the thigh.

When to See a Doctor

It’s important to seek immediate medical attention if your hip pain is sudden, severe, getting worse, or if you have fallen or experienced another form of trauma to your hip.

While not an exhaustive list, other symptoms that warrant immediate medical attention include hip pain associated with:

• Fever
• An inability to bear weight or walk
• Leg or foot weakness
• Swelling
• Bruising or bleeding
• Warmth over the hip

Diagnosis

A medical history and thorough physical exam by a primary care physician, sports medicine doctor, or orthopedic surgeon are essential to properly diagnosing the source of your hip pain.

Depending on your doctor’s underlying suspicion, imaging tests, like an X-ray or magnetic resonance imaging (MRI), may be ordered. Less commonly, blood tests are utilized in the diagnosis of hip pain.

Medical History

When you see your doctor for hip pain, he will likely ask you several questions, such as:

• Is your hip pain better with rest or exercise?
• Do you have any additional symptoms (e. g., fever, swelling, other joint pain, etc.)?
• Do you or any family members have arthritis or a history of joint problems?
• Have you experienced any recent trauma to your hip?

Physical Examination

During your physical exam, your doctor will inspect and press on various landmarks within your hip, leg, lower back, and abdomen. He may also perform a neurological exam to assess muscle weakness and reflexes.

In addition, he will maneuver your hip to evaluate its range of motion, examine your gait (how you walk), posture, and ability to bear weight.

Lastly, based on your doctor’s underlying suspicion for one or more hip pain diagnoses, they will perform certain hp “special tests.” One classic test commonly used to evaluate hip pain is the FABER test.

FABER Test

The FABER test (which stands for flexion, abduction, and external rotation) is used to diagnose hip pathologies, such as hip osteoarthritis, hip labrum tear, or femoroacetabular impingement. 

During the FABER test, while you are lying flat on your back, your provider will move your leg into flexion by 45 degrees and then place your ankle (from the affected side) just above the kneecap of the opposite leg. He will then press down on the knee from the affected side in order to lower the leg.

The test is positive if pain occurs at the hip joint or if the knee/leg from the affected side cannot be lowered so that it is parallel with the opposite leg.

Other tests include:

Imaging

Certain imaging tests may be needed to confirm or support a diagnosis for your hip pain. For example, an X-ray is the standard test in diagnosing a hip fracture. An X-ray may also reveal changes associated with hip osteoarthritis (e.g., joint-space narrowing and bony growths, called osteophytes).

An MRI may also be used to evaluate for a hip fracture, in addition to other conditions like hip osteonecrosis or an infected hip joint. A magnetic resonance arthrography is the test of choice for diagnosing a hip labral tear.  Finally, an ultrasound may be used to confirm a diagnosis of bursitis.

Blood or Other Tests

For certain suspected diagnoses, various blood tests may be ordered. For instance, if an infected joint is suspected, your doctor will likely order a white blood cell count, blood cultures, and inflammatory markers, like an erythrocyte sedimentation rate.

In addition, cultures from a hip aspiration (removing synovial fluid from the hip joint) are usually taken to both diagnose and treat septic arthritis.

Differential Diagnoses

While it is logical to think that hip pain is related to a problem within the actual hip joint, or the muscles or other soft tissues surrounding the joint, this is not always the case.

Here are some conditions that refer pain to the hip, meaning they do not originate within the hip joint or within structures that closely surround the hip:

Kidney Stone

Some lower abdominal processes may cause pain that feels like it is coming from the hip. For example, a kidney stone can cause severe pain in the flank area (between the top of your hip and the bottom of your ribcage in your back). The pain may radiate toward your groin or inner thigh.

Meralgia Paresthetica

Meralgia paresthetica refers to compression of a pure sensory nerve—called the lateral femoral cutaneous nerve—as it passes under the inguinal ligament. Besides a burning pain felt mainly in the upper-outer thigh, numbness and tingling are usually reported.

This condition is most common in older adults and those with diabetes mellitus. Obesity, pregnancy, and wearing tight pants or belts also increases your risk for developing this condition.

Aortoiliac Occlusive Disease

Aortoiliac occlusive disease, which refers to blockage of the aorta (the main blood vessel in your body) and iliac arteries (the two arteries that branch off from the aorta near your belly button), causes an aching, cramping pain in the buttock, hip, and/or thigh. 

This pain—termed claudication—is induced by exercise and relieved with rest. The blockages in these arteries are most commonly due to a condition called atherosclerosis, in which plaque builds up in the blood vessel walls, ultimately narrowing them enough that blood flow to the legs and groin area becomes insufficient.

Lumbar Radiculopathy

Sometimes, nerve pain (a burning or tingling sensation) felt in or around the hip joint may actually be referred from an irritated nerve in the lower spine. This condition, called lumbar radiculopathy, can be diagnosed with an MRI of the lower (lumbar) spine.

Treatment

While the treatment of your hip pain depends on the diagnosis made by your healthcare professional, it’s common for a patient’s therapy plan to involve a combination of self-care, medication, physical therapy, and less commonly, surgery.

Self-Care Strategies

Your doctor may recommend a number of self-care strategies—a way for you to take an active stance in managing your hip pain.

A few examples of these possible strategies include:

• Limiting or avoiding activities that aggravate your hip pain, like climbing stairs
• Using a walking assistive aid like a cane or walker to improve independence and mobility
• The R.I.C.E. protocol: If you experience hip pain while performing a sport or other activity, follow this progression of rest, ice, compression, and elevation until you can get in to see your doctor.

Medications

Various oral medications, such as Tylenol (acetaminophen) or an over-the-counter nonsteroidal anti-inflammatory (NSAID), are used to ease hip pain related to a number of conditions, including osteoarthritis, labrum tear, bursitis, or femoroacetabular impingement. Opioids, which are stronger pain medications, may be prescribed to treat severe pain from a hip fracture or an infected hip joint.

Depending on your diagnosis, other medications, like a disease-modifying anti-rheumatic drug (DMARD) to treat rheumatoid arthritis or intravenous (through the vein) antibiotics to treat an infected joint may be used. 

Physical Therapy

Physical therapy is an essential component to easing the pain of and treating most causes of hip pain. In addition to exercises to improve the strength, flexibility, and mobility of your hip, your physical therapist may use massage, ultrasound, heat, and ice to soothe inflammation within the hip. He may also offer guidance on when it is safe to return to sports or other activities (depending on your underlying diagnosis).

Surgery

Surgery may be required for certain hip pain diagnoses. For example, surgery is often used to repair a hip fracture. Likewise, for hip osteoarthritis that worsens despite conservative measures, a surgeon may perform a total hip replacement. Finally, a procedure called a hip arthroscopy may be used to correct a torn hip labrum.

Prevention

While you may not be able to prevent all causes of hip pain, there are several things you can do to be proactive in this regard:

• Lose weight if you are overweight or obese
• Eat a balanced, nutritious diet that contains sufficient vitamin D and calcium to maintain bone health
• Opt for low-impact activities like swimming or biking
• Stretch before and cool down after exercising
• Obtain a special shoe insert if you have leg-length inequality
• Wear properly cushioned, fitted shoes and avoid or limit running on hard surfaces like asphalt
• Discuss a daily exercise routine for maintaining muscle and bone strength with your doctor
• Considering yoga or tai chi to help prevent falls, one of the most common causes of hip fractures

A Word From Verywell

Hip pain is a disabling condition with many potential causes. While the diagnostic process can be challenging and a bit tedious at times, try to remain patient and proactive. Once diagnosed, your doctor may move forward with devising a treatment plan that suits your needs—one that uniquely addresses your pain and optimizes your healing.

Piriformis Stretches to Relieve Piriformis Syndrome

Discomfort from too much sitting? Inactive glutes? Buttock and leg pain? Though small in size, the piriformis could have a big impact on keeping the human movement system moving smoothly. Addressing an overactive piriformis may be part of the solution.

Within this article, you will find some valuable stretches to relieve piriformis syndrome.

For further validation on the effectiveness of stretching from a corrective exercise perspective, enroll in the Stretching and Flexibility Coach course by NASM.

What is the Piriformis? 

The piriformis is a tiny muscle that originates on the anterior surface of the sacrum, travels through the greater sciatic foramen, and attaches to the greater trochanter of the femur (1,2). It accelerates hip external rotation, abduction, and extension.

What is Piriformis Syndrome?

Piriformis syndrome has traditionally been described as a referred neural pain in the posterior hip and leg caused by hypertrophy or spasm of the piriformis. The pain is caused by pressure applied to the sciatic nerve by the piriformis due to the passage of the nerve through or under the muscle (2).

Pain associated with this problem often mimics the signs and symptoms of lumbar nerve root compression or sciatica in the buttock and posterior leg. The client will often report sciatica-type symptoms and experience tenderness in the piriformis fossa. Pain when sitting is common, as is pain with hip flexion, adduction, and internal rotation.

Signs and Symptoms of Piriformis Syndrome

The signs and symptoms of piriformis syndrome are: 

• Pain in the buttock
• Pain down the back of the hamstring, or posterior thigh
• Pain when sitting
• Pain when walking up stairs or inclines
• decreased range of motion of the hip joint

While the signs and symptoms of the syndrome may be similar to other lumbo-pelvic pathology, the cause of piriformis syndrome remains relatively undefined as to reasons for development of spasm or hypertrophy of the muscle.

See “Is The Piriformis Tight? Really?” for an additional perspective on symptoms, causes, and solutions of Piriformis Syndrome.

It is interesting to note that a description of the syndrome is found in most medical texts, yet the criteria for diagnosing piriformis syndrome and pathophysiology still remains a controversial issue (3,4).

However, the reason why the piriformis is hypertrophied or in spasm is often described as “undefined and confusing.” If the practitioner considers the principles of the kinetic chain and dysfunction of its linked components, it is not difficult to hypothesize why the piriformis may become involved in an impingement of the sciatic nerve. If the client has chronic tightness of the hip flexor, the gluteus maximus will become reciprocally inhibited (1).

This is significant because of the functional responsibility of the glute to decelerate medial femoral rotation during heel strike or functional movements. Since the piriformis is a primary external rotator of the femur, it becomes synergistically dominant in controlling the femur.

This type of dominant function has the potential for causing the spasm, hypertrophy, or tightness described in most texts. The external hip rotators have also been noted as being the least stretched muscles of the lower body (5).

Piriformis Syndrome Treatment and Therapy 

If a client complains of pain in their buttocks, hip rotators, or the lumbo-pelvic complex in general, the health and fitness professional should first instruct the client to visit their medical professional. If a client has been released from therapy or their doctor and the pain persists, an effective corrective exercise strategy for correcting this type of dysfunction would be to first release the hip flexor through appropriate integrated flexibility techniques, then implement reeducation of the gluteus maximus through isolated strength training.

Finally, recondition the lumbo-pelvic hip complex through integrated functional movements in the appropriate range of motion, plane of motion, and speed, specific to the needs of the client.

Piriformis Stretches

SMR Piriformis

Sit on top of a foam roll with the foam roll placed directly on the back of the hip. Cross one leg over the other, placing your foot onto the opposite knee. Slowly roll the back of the hip, applying prolonged pressure on tender spots for roughly 30 seconds.

SMR Quads

Lie on your stomach with a foam roll placed under the front of your thigh. Support your upper body on your forearms. Slowly roll the front of your thigh, applying prolonged pressure on tender spots for roughly 30 seconds.

SMR IT BAND

For the IT band, lie on your side with the foam roll placed under your hip. Cross your top leg over the leg on the foam roll and place your foot on the floor. The leg on the foam roll should be raised off the floor and remain that way during the exercise. Slowly roll from the hip to the knee, rolling along the outer thigh, slightly in front of the hip and knee, applying prolonged pressure on tender spots for roughly 30 seconds.

Static Stretch: Piriformis

Lie on your back with one foot placed on top of a stability ball and the other foot crossed over your knee. Pull the ball toward your body with your heel. Press the crossed knee away from you until a stretch is felt in the back of your hip. Hold for 30 seconds.

Static Stretch: Biceps Femoris

Lie on your back and bend one hip and knee 90-degrees. Leave the other leg extended on the floor. Hold your bent leg and extend at your knee, moving your lower leg straight into the air until a stretch is felt in the back of the upper leg. Hold for 30 seconds.

Static Stretch: Hip Flexors

Kneel on your back leg, bending your front leg 90-degrees. Contract your glutes and shift your body forward. Raise the arm that is on the same side as the knee that is on the ground, stretching to the opposite side until a stretch is felt in the front of your pelvis. Rotate backwards and hold for 30-seconds.

Leg Slides

Begin by lying on your back with your knees bent and your feet flat on the floor. Breathe normally as you gently draw-in your navel towards your spine. Hold the contraction and relax as you slowly extend one leg until it is completely flat against the ground. Remember to keep your navel pulled in and be careful not to move your spine. Slowly return your leg to the starting position and repeat with the opposite leg.

Floor Bridge

Lie on your back with your knees bent and place your feet flat on the ground, shoulder-width apart. Draw-in your navel and contract your glutes. Slowly push through your heels and lift your pelvis off the floor until your knees, hips and shoulders are in-line. Hold the top position for a few seconds and then slowly lower your pelvis back down to the floor.

Lateral Tube Walking 

Stand with feet placed hip-width apart, knees slightly bent. Place a piece of tubing around your ankles. Keeping your feet straight, take small steps to one side. After the recommended number of steps, repeat the exercise to the opposite side.

Ball Squats

Stand with your feet pointed straight ahead and placed shoulder-width apart. Rest your low back against a stability ball that is placed on a wall. Keep your feet under or slightly in front of your knees. Slowly squat, bending your knees and keeping your feet straight. Keep your chest up, contract your glutes and press through your heels as you return to the starting position.

Conclusion

In many cases, tightness in the piriformis can be alleviated with the proper steps (as noted above).  However, we must always remember that we are not licensed medical professionals, we should always consult a licensed practitioner to help understand our client’s problems and refer our clients out whenever necessary.

If you are interested in learning more about how to best utilize corrective exercise to alleviate inactive piriformis muscles and streamline your client’s movement, look to become a Corrective Exercise Specialist. 

For a 4-phase breakdown of the entire corrective exercise process, our Corrective Exercise Continuum is a great reference point.

And our blog post on whether or not you should foam roll the lower back will help guide your SMR programming. 

References

1. Clark MA, Lucett SC, Sutton BG. (2014). NASM Essentials of Corrective Exercise Training 1^st Edition Revised. Burlington, MA: Jones and Bartlett Learning.
2. Neumann DA. (2010). Kinesiology of the Musculoskeletal System, Foundations for Rehabilitation 2^nd Edition. St. Louis, MO: Mosby Elsevier.
3. Halpin RJ, Ganju A. (2009) Piriformis syndrome: a real pain in the buttock? Neurosurgery. Oct;65(4 Suppl):A197-202.
4. Hopayian K, Song F, Riera R, Sambandan S. (2010).The clinical features of the piriformis syndrome: a systematic review. European Spine Journal. Dec;19(12): 2095–2109.
5. Nelson AG, Kokkonen JJ. (2007). Stretching Anatomy. Champaign, IL: Human Kinetics.

Hip Pain: What Do Your Symptoms Mean?

Here are some common hip pain complaints and their symptoms.

Arthritis: With arthritis-based hip pain, it hurts to move your legs. That includes walking, climbing stairs, and bending down to pick things up. There are many reasons arthritis could be causing your hip pain:

Piriformis syndrome: With piriformis syndrome, moving the leg out or back from the body causes pain in the buttocks and lower back. “Your hip has some very powerful muscles. Among them is the piriformis,” explains Stuchin. “The piriformis is in the back of the hip and helps rotate the leg outwards.”

The sciatic nerve is just behind it; in some people, the nerve goes between the tendons of the piriformis muscle. When the muscle pulls, it acts like a pincer on the nerve, causing the pain you feel, explains Stuchin.

Snapping hip: A patient might tell her doctor: “When I move my leg, I feel a pop in my hip at the top of my thigh.” The snapping sound is a tendon, explains Stuchin. Some people are born with a tendon that “snaps” over the top of the femur, the bone that makes up your thigh. “As your leg moves, if that sheath of stuff catches on that bony projection, you’ll get a ‘snap.’”

Stress fracture of the femoral neck: A stress fracture of the femoral neck starts as a dull ache in the groin and gets progressively worse. The femoral neck is the region between the ball at the top of your femur (thigh bone) that moves in the socket of your pelvis bone and the rest of the femur. This can also feel like a pulled muscle, but unlike a muscle, it won’t respond to taking a break from exercise. There are two common reasons for a stress fracture to this area:

• A fall
• A repetitive stress injury as a result of vigorous exercise

Trochanteric bursitis: A patient might tell his doctor: “It’s painful to lie on my hip and at other times, I feel pain on the outside of that hip and upper thigh.” Trochanteric bursitis is an inflammation of the bursae, the fluid filled sacs that act as a cushion, located over the greater trochanter (a bony prominence next to the femoral neck).

If these hip pain descriptions do not perfectly explain your hip pain, don’t worry. Through the right diagnostic tests, your doctor probably still will be able to help identify and treat your pain.

Lumboishalgia – treatment, symptoms, causes, diagnosis

Lumboishalgia 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 area of ​​the sciatic nerve innervation. The term lumboishalgia (synonym for lumbosacral sciatica) refers only to pain and is not a diagnosis.

One or more symptoms are characteristic of lumboishalgia:

• Persistent pain only in the buttock or thigh on one side (less often in both legs)
• Pain increases when sitting
• Burning or tingling sensation that extends down the leg
• Weakness, numbness or movement disorder in the leg
• Constant pain on one side
• Acute pain that can make it difficult to get up or walk

Pain syndrome in lumbar ischalgia can be of varying intensity, depending on the underlying disease, which led to the development of lumbar ischalgia.Symptoms for lumboishalgia 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 begin in the lumbar spine (at the 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 lumbosacralgia (sciatica) such as leg pain, numbness, tingling, weakness may vary depending on where the nerve is being compressed.

The incidence of lumboishalgia (lumbosacral radiculitis) increases in middle age. Lumboishalgia 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 lumboishalgia decreases.

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

Reasons

There are 6 most common causes of lumboishalgia:

Herniated disc in the lumbar spine.

A herniated disc occurs when the soft inner disc nucleus (nucleus pulposus) protrudes through the fibrous outer annulus, affecting nearby nerve roots.

Osteochondrosis

Degenerative changes in the intervertebral discs are 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 arches of a vertebra are damaged (spondylolysis), as a result of which one vertebra slides in relation to another. The displacement of the 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.

Stenosis of the spinal canal of the lumbar spine

This condition usually causes inflammation of the sciatic nerve due to narrowing of the spinal canal. Stenosis of the spinal canal in the lumbar spine 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 factors: enlargement of the facet joints due to bony growths, overgrowth of soft tissues (ligamentous apparatus), and protrusion of the disc (disc herniation).

Piriformis syndrome

Irritation of the sciatic nerve can occur in the area of ​​passage in the buttock under the piriformis muscle. If there is 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 syndrome. And although this syndrome is an independent disease, pain in the leg can be similar to lumboishalgia.

Sacroiliac joint dysfunction

Irritation of the sacroiliac joint can also cause irritation of the L5 root, which extends into the upper part of the sacroiliac joint, and if there are problems in this joint, inflammation of the sciatic nerve and pain can occur. Leg pain can be similar to that of lumboishalgia (sciatica).

Other causes of lumboishalgia

A number of other conditions and diseases can cause inflammation of the sciatic nerve, including:

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

Symptoms

As a rule, with lumboishalgia, the symptoms are on one side, and the pain starts from the lower back and goes down the back of the thigh down to the foot.

• Lower back pain is usually less intense than leg pain.
• Pain, usually on one side of the lower back, radiating to the buttock or thigh along the sciatic nerve – along the back of the thigh, lower leg and foot.
• The pain is relieved when the patient is lying down and when walking, and worse when standing or sitting.
• The pain is acute, burning.
• Some patients may describe 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 localization of the effect on the sciatic nerve, pain can be in the foot and toes.

Symptoms of lumboishalgia depend on where the root compression occurs.

For example:

• L4 root – Symptoms will usually show on the thigh. Patients may feel weak when straightening the leg and possibly a decreased knee reflex.
• L5 root – Symptoms may appear in the big toe and ankle. Patients may feel pain or numbness in the upper part of the foot (between the big and second toe).
• S1 root – symptoms may appear on the outer part of the foot, radiating to the toes and little toe. Patients may feel weak when raising the foot or trying to stand on tiptoe, and there may be decreased reflexes at the ankle.

When multiple root compression occurs, a combination of symptoms is possible.

There are a number of symptoms that deserve special attention, as they require urgent medical attention, sometimes up to surgery.These symptoms are as follows:

• Symptoms that continue to progress rather than diminish, which may indicate possible nerve damage, especially if neurologic symptoms progress (eg, weakness in the leg).
• Symptoms of lumboishalgia are present in both legs and there are signs of bowel or bladder dysfunction, which may be a sign of cauda equina syndrome. With cauda equina syndrome, emergency surgery is indicated.

In the presence of such symptoms, urgently seek medical attention.

Treatment

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

Drug 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 the pain is severe, 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 is usually temporary, but it helps to relieve severe pain syndrome quickly enough.

Manual therapy

Modern soft manual therapy techniques allow restoring the mobility of the motor segments of the spine, removing muscle blocks, improving the mobility of the facet joints and sometimes significantly reducing the compression of nerve fibers.

Acupuncture also helps to reduce pain and allows you to restore conduction along nerve fibers.

Massage

Therapeutic methods of massage can improve microcirculation, relieve muscle spasm, and also increase the production of endorphins by the body.

Physiotherapy . The 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 used after reducing pain manifestations, allow you to restore the muscle corset and normalize the biomechanics of the spine, and improve blood circulation in the motor segments.Physical exercise includes both mechanotherapy (training on simulators) and gymnastics, which allows you to develop both muscles and strengthen the ligamentous apparatus. Exercises for lumboishalgia must be selected with a doctor (instructor) exercise therapy, since independent exercises often lead to a relapse of symptoms.

Surgical treatment

Indications for surgical treatment are the following factors:

• Severe leg pain that persists for more than 4 to 6 weeks.
• Lack of effect from conservative treatment and preservation or enhancement of neurological symptoms.
• Pain syndrome 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 neurologic symptoms (increasing weakness in the legs or sudden bowel or bladder dysfunction).

Drawing pain in the thigh, buttock and groin

Free admission and diagnostics of a chiropractor, osteopath, neurologist

Pulling pain in the hip

Free appointment
and diagnostics

Pain relief
for 1-2 sessions

Author’s method
treatment

Internships in the USA,
Israel, Germany

Pain in the thighs, buttocks, groin is a manifestation of such a wide range of traumatological, neurological, rheumatological, vascular and infectious diseases that only an experienced doctor can understand this variety and make the correct diagnosis.

one

Positive dynamics in 97% of cases

The results of the treatment course are confirmed by control MRI scans.

2

No side effects

The methods used in our clinic are safe and have no side effects.

3

Long-term effect

Treatment minimizes the risk of new hernias in other segments, as well as hernia recurrence.

Main causes of pulling pain in the leg due to damage to the musculoskeletal system

Most often, pain in the thigh, buttocks, groin is accompanied by many diseases with damage to the spine, muscles, tendons, nerve trunks and blood vessels of the lower extremities.

Osteochondrosis of the lumbosacral spine

In dystrophic processes in the cartilaginous tissue that occur with osteochondrosis, there is a decrease in the height of the intervertebral discs. As a result, the pressure on the radicular nerve trunks, which unite into the sciatic nerve, increases. Since the nerve runs along the back of the buttocks and thighs, its irritation leads to unpleasant sensations in this area in the form of pulling pains and cramps in the leg. The pain increases with walking and exertion.

Compression pressure on the sciatic nerve can be exerted by disc protrusion and intervertebral hernia.

Osteoarthritis of the hip joint

Deforming osteoarthritis – coxoarthrosis appears in old age as a result of degenerative changes in the cartilage tissues of the hip joint. Women suffer more often.

A characteristic sign of coxoarthrosis is the limitation of the motor activity of the affected limb. The pain increases with active movements, calming down at rest.

Hip arthritis

Disease in the hip joint is rare, is autoimmune in nature and is secondary against the background of ongoing rheumatism or psoriasis. The pain is severe and, as a rule, bilateral.

Trochanterite

This is an inflammation or injury to the tendons surrounding the hip joint. The most common cause of the disease is trauma or overloading of the legs (being overweight, carrying weights, running). Pain during movement is characteristic, localized on the outer surface of the thighs – the “breeches” area.Pain is constant aching, but unlike coxoarthrosis, there is no limitation in leg mobility.

Aseptic necrosis of the femoral head

The symptoms of this pathology are in many ways similar to the manifestations of coxoarthrosis – the only significant difference is the duration of the development of the disease. With coxoarthrosis, the symptomatology develops gradually – over the years, and with necrosis, the pathological process progresses rapidly, in a few days the intensity of pain increases rapidly, haunting the patient even at night.In addition, aseptic necrosis of the femoral head often affects young men 20-45 years old, and women suffer from this pathology 7-8 times less often.

Piriformis Syndrome

Manifestations of this syndrome are associated with compression of the sciatic nerve trunk and blood vessels as they pass through the opening in the ilium. Compression occurs by contraction of the piriformis muscle.

The disease develops as a complication of previous injuries, with incorrect injections into the buttock or as a result of hypothermia.The main symptom of nerve compression is constant pulling pain (sometimes with lumbago), which is localized along the back of the thigh from the buttock to the foot. The pain may be accompanied by a feeling of numbness or weakness in the leg.

Potential causes of pulling pain in the hips, not associated with damage to the musculoskeletal system

• Feverish syndrome with hyperthermia accompanying colds, bacterial and viral infections.
• Iron deficiency and hemolytic anemia.
• Cerebral circulation disorders occurring with paralysis of the lower extremities.
• Lesion of blood vessels in the pelvic area and soft tissues of the thigh: varicose veins, obliterating endarteritis, atherosclerosis of the vessels of the legs.
• Lymphostasis and secondary damage to the lymph nodes.
• Complications of diabetes mellitus in the form of angio- and neuropathies.
• Migration of intestinal parasite larvae in the muscles.
• Diseases affecting the arachnoid (arachnoid) membranes of the brain and spinal cord: tick-borne encephalitis, poliomyelitis and other infections.
• Muscle dystrophy as a result of prolonged lack of motor activity (immobility).
• Lack of essential microelements in nutrition: potassium, magnesium, calcium.
• Fibromyalgia.
• Convulsive syndrome.
• Tumors of the small pelvis.
• Pain in the hip in pregnant women is physiological in nature due to deformation of the axial skeleton and resolves on its own after childbirth.

The success of treatment is 90% dependent on experience
and the qualifications of the doctor.

Free consultation and diagnostics of a doctor

• Chiropractor
• Vertebrologist
• Osteopath
• Neurologist

During the consultation, we carry out a thorough diagnosis of the entire spine and each segment. We for sure
determine which segments and nerve roots are involved and causing pain symptoms. Following the consultation
we give detailed recommendations for treatment and, if necessary, prescribe additional diagnostics.

one

We will carry out functional diagnostics of the spine

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We will perform a manipulation that significantly relieves pain

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We will compose an individual treatment program

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Diagnostics

In the clinic of Doctor Length, the following examination methods are prescribed for a patient with complaints of pain in the hips, buttocks and groin to make the correct diagnosis:

• Collecting anamnesis.
• External examination with an assessment of the neurological status.
• Analysis of biomechanics of the musculoskeletal system: range of motion in the joints, movement restrictions.
• Kinesiological testing of joints and musculo-ligamentous apparatus.
• General and biochemical blood tests, rheumatic tests.
• Instrumental methods: X-ray, ultrasound, CT, MRI.

Since pulling pains in the hips, buttocks and groin can be caused not only by the pathology of the musculoskeletal system, but also by other diseases, the patient is assigned a number of additional studies and consultations from various specialists within the framework of differential diagnosis.

Treatment

Pain serves as a signal for the development of pathological changes in the body. If a patient ignores the growing symptoms for a long time, tries to get rid of pain with the help of various painkillers and does not turn to specialists in time, this can lead to serious consequences in the form of disability with loss of independent movement.

Doctors of the clinic of Doctor Length successfully treat diseases of the musculoskeletal system with conservative methods that not only relieve the symptoms of the disease, but can also slow down the further progression of the pathological process.

The scheme of complex therapy is compiled for each patient individually, depending on the diagnosis, stage of the disease, clinical manifestations.

The clinic of Doctor Length, specializing in the treatment of the spine and joints, includes both traditional methods of therapy (medication) and innovative methods of manual therapy.

Taking as a basis the achievements of foreign and Russian scientists in the field of manual therapy, Dr. Dlin developed the author’s method of Di-Tazin therapy, consisting of three components: soft manual technique, multicomponent electrophoresis and photodynamic laser therapy.

Applying the Di-Tazin therapy method, the doctor achieves the following results in the treatment of patients:

• the intensity of pain decreases;
• removes inflammation;
• increased microcirculation of blood, and, consequently, trophism of damaged tissues;
• the outflow of lymph improves;
• metabolic processes are normalized;
• further destruction of cartilage and bone tissue is suspended;
• , regenerative processes in the area of ​​damage are activated;
• local immune defense links are stimulated.

The therapeutic effect of mild manual therapy is that painfully changed muscles and ligaments do not stretch , as in the classical technique, but come closer together, which leads to a quick cessation of pain, relieving muscle spasm, and eliminating restrictions in the movement of joints.

Due to electrophoresis, pharmacological preparations are injected into the lesion through intact skin, and the therapeutic effect of the drug lasts for several days.

Photodynamic phototherapy is performed in the form of application to the skin of a special substance (photoditazine) in the area of ​​pain localization. This photosensitive drug, being activated by a certain spectrum of waves emitted by the LED installation, penetrates deep into the tissues and acts at the cellular level, accelerating the regeneration processes.

The technique has proven its effectiveness, has no contraindications , can be used in the treatment of pregnant women, children and the elderly.

In addition, the active rehabilitation program includes physiotherapy exercises, massage, kinesiotherapy.

94% of patients recommend us.
Thank you for your trust and your choice.

Video reviews of patients

Hernias in the lower back and neck

I came to the clinic of Doctor Length with spinal problems. With two intervertebral inferior hernias and two intervertebral hernias in the neck. I was assigned a comprehensive 10 step program. In 4 months, the lower vertebrae completely disappeared and the crunches in the neck disappeared…

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Lumbosacral hernia

“After the first time, my back stopped hurting. I felt relieved. Now I have already passed 7 sessions and my back really does not hurt. I began to forget about it. And at first it hurt badly. ”

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Inflammation of the sciatic nerve

“For 4 months I suffered from severe inflammation of the sciatic nerve on the right side. After the first visit, relief came immediately within six hours.After 6 courses, the pain practically disappeared. ”

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Pain in the lower back and leg

Yakovleva Natalya Mikhailovna
Head of the department, surgeon of the highest category, doctor oncologist-mammologist
I would like to express my deep gratitude for the fact that they put me on my feet in the literal sense of the word. I came to the clinic a month and a half ago with severe pain in the lower back and leg. These complaints were of a rather prolonged nature and the ineffective treatment that I used in the past.Fortunately, I ended up at the clinic of Dr. Length and his team of super professionals!

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Osteochondrosis of the cervical spine

“Appealed 2 months ago with osteochondrosis of the cervical spine. I have a sedentary job and my neck muscles cramped very badly. It was impossible to work. Before that I turned to other doctors, but this did not solve my problem. For 2 months I have quite positive dynamics. It gets better and better every week. ”

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Ankylosing spondylitis

“I have had ankylosing spondylitis for 10 years.The vertebrae began to move out, I began to slouch. I have consulted other chiropractors, very famous media therapists. As a result, I did not get the result. After 2 sessions, I felt much better. Now nothing hurts me. ”

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Pain in the spine

“I came with problems in the back, cervical, thoracic and lumbar spine. I was prescribed procedures, had a massage, and was assigned to do physical education at home. This made me feel much better.I’m already turning my head. I have no pain. ”

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Shoulder-scapular periarthrosis

I went to the clinic with severe pain in my shoulder. My hand did not rise, I could not sleep at night, I woke up in pain. After the first session of procedures, it became much easier for me. Somewhere in the middle of the course, my hand began to rise, I began to sleep at night.

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Arthrosis of the knee joint of the 2nd degree

She came with a very serious illness.I could not walk, I have arthrosis of the 2nd degree of the knee joint. I underwent a course of treatment in the Clinic and now I am going 100%.

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Herniated disc

“I came to the clinic after I had back pain and there was a herniated disc. I went to other places, but there they only removed the attacks of pain. Only Sergei Vladimirovich, his golden hands, gave the hope for a return to ordinary life! ”

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Scoliosis

“From adolescence I was worried about scoliosis in the thoracic region.I felt a feeling of discomfort, tension, periodic pain in the spine. I turned to various specialists, a masseur, an osteopath, but I did not feel a strong effect. After treatment at Length S.V. I almost have an even spine now. Currently I don’t feel any problems or discomfort. ”

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Herniated disc

“On the 5-6th session, there was an improvement. I felt much better. The pain was gone. The improvement progressed more and more each time.Today is the 10th lesson. I feel great.”

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Pain in the lumbar and cervical spine

“I am 21 years old. I went to the clinic with discomfort in the lumbar and cervical spine. I also sometimes had sharp pains. After undergoing therapy, I felt a significant improvement in my back. I have no pain. The general condition has improved. ”

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Back pain

“At the beginning of the treatment, my back ached very badly.I could no longer walk. I will take 5 steps and stop. My whole journey consisted of such stops. During the first procedure, I left the office with no pain in the spine. ”

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Hernia of the cervical spine

“I came up with a problem in my neck and my right arm was very sick. The neck did not turn, the hand did not rise. After the 3rd session I felt better. After the 5th, all this pain began to decrease. It turns out that I have 2 hernias in my cervical vertebra. After the sessions, I did an MRI and one hernia decreased.Now I started to move, my hand started working. ”

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Neck pain

“I went to Dr. Long because my neck was very painful on the right side. I fell on a snowboard 5 years ago, even went to an osteopath, but somehow it didn’t help much. Now everything is fine, there were some consequences, the muscles were spasmodic. When I came there were steel muscles, now my neck is very soft. ”

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Pain in the thoracic region

“I went to the clinic with pain in the back, namely in the thoracic region.After 10 sessions of treatment, I could calmly do my usual things, sit at work until lunchtime, without howling in pain. Now I have already come for the correction after 2 months. I’m fine, my back doesn’t hurt. ”

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Hernia and protrusion

“I came to the clinic with hernia L4-L5 and protrusion L5-S1. The course of treatment ended today. The lower back hurt, it was difficult to bend over. After completing the course and receiving instructions in the form of physical exercises, it became much easier.After a month of treatment, I do not feel any stiffness of movements. ”

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Pain in the lower back and hip joint

“From a young age I was worried about back pain. When they became unbearable, I went to the clinic of Dr. Length. After the first procedure, pain disappeared from the hip joint. After the third procedure, the shooting pains in the lower back stopped. ”

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Very effective procedures

The procedures turned out to be very effective.I used to go to other clinics and absolutely did not relieve my pain, they bothered me. After this specialist, after three or four sessions, my functions recovered, the pain in my joints went away.

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Turning today will help

avoid surgery tomorrow!

Relieve pain and inflammation

After 2-3 treatments, the exhausting pain goes away, you feel better.

Eliminate the cause of the disease

Complex improvement of the spine improves well-being: you feel a surge of strength and energy.

Start the regeneration process

The process of repairing damaged tissues begins, hernias and protrusions are reduced.

Strengthen the muscle corset

Strong back muscles support the spinal column, preventing recurrence of the disease.

90,000 Neuropathic Disorders | Stimsmart

Problems arise gradually – at first, an unpleasant tingling sensation, burning sensation, even touching the blanket on the skin causes discomfort… Restful sleep becomes a “deficit”. Over time, the functions of the nervous system are disrupted – a decrease in sensitivity to touch begins, a feeling of warmth (fever) and pain appears, mainly in the extreme parts of the lower extremities. Without treatment, the affected area expands. The infected person loses the ability to coordinate movements (loss of dexterity, stumbling, staggering when walking) …

The nervous system consists of a network of nerve fibers that conduct signals (impulses) from the brain and spinal cord to other peripheral parts of the body.The transmission of nerve impulses can suffer from damage to certain parts of this network. Consequently, the ability to correct the movement of our muscles and joints is impaired, the functions of the skin and internal organs are impaired.

Loss of sensation of nerve endings is often due to peripheral neuropathy. The first symptoms usually appear in the legs, in the form of gradual numbness, tingling, or pain. Eventually, it can easily expand to the upper limbs or parts of the torso.Another sign of peripheral neuropathy may be extreme sensitivity to touch. Numbness and tingling of the skin is known as paresthesia.

A serious complication, especially in the case of a combination of neuropathy and diabetes, can lead to loss of sensation in the legs. Any blisters and sores on the legs can then quickly develop and go unnoticed. Subsequent injuries and infections (formation of inflamed wounds) can spread to deeper tissues, and even bones! The consequences can be dire – amputation of

will be required

Most common neuropathic problems:

• Sensory disturbance (especially in the lower extremities)
• tingling
• sensation of coldness in the limbs
• intense pain at rest (mostly at night)
• loss of full sensation in the limbs

Stimsmart therapy helps restore the sensitivity of your limbs

For the Stimsmart therapy, the causes of neuropathy are not important, only its manifestation and the time required to completely eliminate it.Neuropathic problems are not just limb problems. Fatigue and poor sleep, as their consequences, affect the general psychological state of the patient. Stimsmart therapy helps to solve these problems in a comprehensive manner.

90,000 causes and treatment, what to do with aching pain in but

Causes of the disease Blocks What to do?

Leg pain is a very common symptom that can be caused by many pathological processes in the vascular, nervous, musculo-articular systems and bones ¹ .

Infectious and inflammatory causes

With the development of inflammation or infection, pulsating pain in the legs appears, the skin around the site of inflammation turns red and swells. A rash may appear, the temperature rises. The area of ​​the leg with the focus of inflammation increases in size, which limits movement ² .

Such manifestations may indicate an inflammatory process in the pelvic organs (the inner surface of the thighs hurts), gout, rheumatoid and reactive arthritis, erysipelas of the skin of the thighs and legs and other problems ² .

Degenerative-dystrophic diseases of the joints

This group of diseases includes osteoarthritis, or osteoarthritis. In this case, as a rule, severe pain in the legs occurs when moving. Joint mobility is sharply limited, in the morning stiffness can disturb. Symptoms usually develop over a period of several years, during which time cartilage changes and deformities of the joints develop. There is a connection between the onset of pain and the change in weather2.

Central neuralgia and pain

If sharp, shooting, burning pains in the legs in the absence of external injuries bother you, this is a sign of diseases of the nervous system, for example, neuralgia ³ .

When the spinal roots of the lumbosacral region are pinched, pain in the legs may accompany weakness, up to paresis ⁴ . The sensations intensify when the trunk is raised in a sitting and lying position ⁵ .

Vascular pain

Pain in the legs of vascular origin is most often associated with obliterating endarteritis, varicose veins of the lower extremities, thrombophlebitis.

With endarteritis, pain occurs during exertion, disappears after rest, or if the legs are lowered.Approximately the same symptoms accompany atherosclerosis of the vessels of the lower extremities, when the lumen of the vessels narrows and the tissues suffer from a lack of oxygen ⁶ .

Thrombophlebitis and varicose veins often accompany each other. Due to the weakness of the vascular wall, the veins expand, deform, and the movement of blood is disrupted in them. There is pain, sensations of “buzzing”, heaviness in the legs. By the end of the day, the legs become swollen, but when they are lifted up, it becomes easier ⁷ .

Thrombophlebitis is an acute dangerous condition in which pain in the leg arises sharply and has a bright, burning, pulsating character.At the site of the appearance of a blood clot inside the vein, a dense formation is felt. The temperature may rise, the leg area turns red. In this condition, you urgently need to contact the angiosurgeon ⁸ .

Muscle pain

Muscle pains are familiar to those who train intensely. They can occur after hypothermia, be pulling, twitching, and intensify when moving. If such pains are associated with excessive exercise and there are no contraindications, for example, vascular diseases, then warming procedures can be used for such pains.And, of course, at first, rest is necessary ⁹ .

Pain caused by metabolic disorders

Pain can occur with osteoporosis (leaching of calcium from the bones) – with cramps and a pulling sensation in the calves.

With diabetes mellitus pain in the legs is often accompanied by edema, dry skin, numbness ² .

Post-traumatic leg pain

Aching pains in the legs that occur when the weather changes, at the site of old fractures.
Heel spurs can also cause pain in the legs ¹⁰ , flat feet and other conditions.

What to do in case of leg pain?

Since there are a lot of causes of pain in the legs, first you need to see a therapist. He will help you navigate the symptoms, diagnose and refer you to the right specialist.

If the doctor has established that the pain is associated with osteoarthritis, he can prescribe

Teraflex

The drug helps to reduce inflammation, and

promotes the renewal of cartilage tissue due to the presence of chondroitin and glucosamine in the composition

of chondroitin and glucosamine

to achieve a stable therapeutic effect – from 3 to 6 months.

For more prompt relief of joint pain,

Teraflex Chondrocrem Forte was created

Its special composition ¹¹ improves the penetration of the anesthetic component Meloxicam, which helps to reduce pain and inflammation in the joint. Teraflex Hondrocrem Forte is used for osteochondrosis, osteoarthritis and other joint diseases that accompany severe pain.

Treatment of the hip joint in Voronezh

Pain in the hip joint: causes of deviation

Hip pain is a common condition associated with constant exertion.The reasons due to which the hip joint hurts are associated with pathologies in the joint itself or the tissues surrounding it. Without diagnostics, it is impossible to determine the source of the deviation, the occurrence of pain syndrome requires a doctor’s consultation.

Pathological sources of discomfort

Pain in the hip joint occurs for a variety of reasons, the main ones are:

1. Fracture of the hip bone tissue – often diagnosed in elderly patients.Recovery requires a long period of time, the pathology can be complicated by the formation of blood clots and the penetration of infection into the problem area. The entire recovery period takes place with limited range of motion in the affected limb.
2. Aseptic necrosis – observed in the femoral head, arises from the destruction of the joint under the influence of insufficient blood circulation. It is characterized by progressive and severe pain syndrome, discomfort increases when trying to lean on a sore leg or while walking.
3. Pathologies of the lumbar spine – the hip joint can hurt due to diseases of the spine. The deviation causes the irradiation of unpleasant sensations to the affected lower limb.
4. Osteoarthritis – is formed when the structural units of the joint are destroyed. In addition to pain in the hip joint, there is discomfort in the groin and thigh. An increase in discomfort is noted when moving and leaning on the problem leg.
5. Bursitis – inflammation in the acetabular capsule causes soreness in the buttock.The sensations intensify when the patient tries to lie on the sore side.

Traumatic causes

The hip joint can hurt if you have:

1. Congenital dislocation of the hip – pathology occurs in difficult labor or at the time of intrauterine development. The main symptom of the disease in children is the shortening of one of the legs, a pinched nerve. Without treatment, there is a risk of complications of the injury that remain with the patient for life.
2. Traumatic dislocation – pain in the hip joint can occur when trying to move, being in a sitting or standing position.Redness and hematoma appear over the problem area. Attempts to go in for sports lead to a deterioration in the condition, the further development of pathological changes.
3. Fracture of the femoral neck – the disease is often recorded in women over 60 years of age. The source of the problem is an accidental fall, blow. With a fracture, severe pain occurs, the condition worsens when trying to move. A hematoma forms at the site of the lesion, tissue swelling, the damaged limb is shortened, the patient begins to limp.Trauma leads to pinching of the nerve, loss of sensitivity and extraneous clicks in the joint.
4. Bruises – pain in the area of ​​the hip joint is moderate, aggravated by walking. In a horizontal position, unpleasant symptoms disappear. Pathology develops in people prone to falls. The lameness that occurs with a bruise passes quickly. The condition is rare.

Any of these conditions requires a visit to a medical center. The doctor will determine the source of the pain syndrome, select the best therapy regimen.Self-healing in most cases is impossible, and ignoring the pathological process can cause serious complications and the need to replace your own joint with an artificial analogue with a long rehabilitation process.

Number for appointment and consultation:

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Medical myths: is it harmful to sit with your legs crossed?

• Claudia Hammond
• BBC Future

November 11, 2015

Photo author, Getty

How do you usually sit? Many people like to sit with one leg crossed.Does this pose threaten our health?

BBC Future .

In the 1980s, British comedian Kenny Everett made this pose his trademark – he sat in a skirt and high-heeled shoes, extravagantly crossing, crossing and then crossing his legs again. This, he said, was a manifestation of “the best possible style.”

Others prefer not to cross their legs at all – right up to sitting upright, like men who spread their legs wide on public transport and at the same time crush their neighbors.

Men like this would love The Great Cross-Out, which launched in 1999 in the United States. The nutritional supplement company encouraged people to move away from head-to-toe and thus maintain their health.

But can you get healthier by giving up crossing your legs?

A list of the alleged consequences of sitting in a cross-legged position includes high blood pressure, varicose veins and nerve damage.

However, all these assumptions need to be properly studied.

Of course, this is true – if you sit in one position for too long, your leg or foot may become numb.

This is due to the fact that when the legs are crossed, the pressure on the peroneal nerve under the knee increases (it is he who is responsible for the sensitivity in the lower leg and in the foot). But the numbed limb stabbing sensation will be temporary and will go away quickly as soon as you take a different position.

However, maintaining the same posture for many hours can cause paralysis of the peroneal nerve.It manifests itself as a “dangling foot” in which people are unable to lift the back of the foot and toes.

However

In a South Korean study, sitting on a chair in a leg-to-leg position was not mentioned as the main cause of this type of paralysis. On the other hand, it mentions sitting for many hours with crossed legs on the floor.

In reality, long-term numbness is still an unlikely consequence of crossing our legs, as we tend to change posture as soon as we become uncomfortable.

What about the blood pressure? When your blood pressure is taken, the doctor or nurse asks you to place your hand on the table and sit down with both feet on the floor.

Photo author, SPL

Photo caption,

Cross-legged increased pressure on the peroneal nerve under the knee

This requirement is explained by the fact that crossed legs can distort the measurement result, temporarily increasing the pressure level.

By 2010, as many as seven studies showed that throwing one leg over the other increased blood pressure; however,

another study says there really is no difference.

However, the scope of many studies was very modest; the pressure in them was measured only once.

More

a large study was conducted at a hypertension clinic in Istanbul. There, scientists measured the pressure several times – with crossed legs and with legs in a normal position.

Again, the blood pressure was higher in those cases when the subjects crossed their legs, but within three minutes after the change of position, the pressure returned to normal values.

Photo Credit, iStock

Photo Caption,

Long periods of meditation can lead to leg numbness

There are two possible reasons why crossing your legs can cause a temporary rise in blood pressure.

According to one of them, the blood rushes to the chest at the moment when you lift one leg to throw it over the other. As a result, the heart has to pump more blood, and the pressure rises.

According to an alternative version, blood pressure rises due to the fact that isometric exercises on the legs (this is called physical exercises in which the joints do not move)

increase resistance to blood flow in the vessels.

To figure out which of these explanations is most likely, scientists from the city of Nijmegen in the Netherlands conducted a study that included several physiological measurements.

It was found that the resistance to blood flow in the vessels in people with crossed legs did not increase with a low pulse, but the amount of blood flowing from the heart itself increased.

Photo Credit, iStock

Photo Caption,

Crossing ankle legs does not increase blood pressure

So crossing your legs does cause a temporary increase in blood pressure, but there is no evidence of long-term change.

There is one exception. People with a high risk of blood clots are advised not to cross-legged for long periods of time, as obstructing normal blood flow can increase the risk of deep vein thrombosis.

Crossing your legs may not raise your blood pressure in the long run, but what about varicose veins?

To prevent blood from flowing in the opposite direction, there are tiny valves in the blood vessels. If these valves stretch and weaken, there is an outflow of blood, which leads to enlarged veins or, as it is also called, varicose veins.

Until now, it has not been proven that crossing the legs is a decisive factor for the appearance of varicose veins. Whether your veins will enlarge over the years or not depends on

from genetic predisposition (at least to some extent).

So, the condition of the veins, blood pressure and nerves from sitting cross-legged does not worsen in the long term.

It remains only to understand the effect of such a fit on the joints.

One study found that people who sat cross-legged for more than three hours a day were more likely to slouch.

However, in this study, people were asked to independently estimate how long they sat cross-legged.

I am writing this text at the table, also with my legs crossed, but I would not be able to say how many hours I spent in this position.

Of course, it is still a big question whether you will maintain the correct posture when there is no scientist standing over you.

By the way, the number of people who said that they keep their right foot over their left,

it turned out to be twice as many as those who throw the left over the right.

Photo author, iStock

Photo caption,

If you like crossing your legs, you will not harm your health

There is nothing pleasant in stooping, but if you like to sit cross-legged, you may be interested in a curious study of the University Medical Center of Rotterdam … Scientists at the center have found that there is even a benefit from such a pose.

Young men and women took part in the study; they sat with their legs crossed, crossed at the knees or at the ankles, as well as at the knees and at the ankles.

Then the scientists reproduced the features of the postures taken on the embalmed fragments of the human body. This made it possible to understand exactly how the muscles change when crossing the legs.

It was found that crossing the legs at the knees lengthened the piriformis muscle, located behind the hip joint, by 11% compared to the legs set straight, and by 21% compared to the legs in a standing position (interestingly, the tension was slightly less if legs crossed twice – both at the knees and at the ankles).

The authors of the study believe that this enhances the stability of the pelvic joint – in the same way as tightening the abdominal muscles.

In general, if you like crossing your legs like Kenny Everett, you will not harm your health (of course, if you do not stay in the same position until your legs become numb).

And whoever is sitting next to you on the bus or on the train – he will be grateful to you for the fact that you take up less space than those who like to sit in a raskoryak.

Many Russians play sports incorrectly, harming themselves

Before any exercise, it is imperative to warm up and stretch. Warming up should take at least 7-10 minutes. Stretch out immediately after warming up. When running, if you feel pain or tightness in the lower leg area, you need to stop and stretch the lower leg, as well as the thigh muscles in the front and back. There is a venous pump in the lower leg – a pump that pumps blood up through the body – so the lower leg should never be left “stone”.

Today, thousands of men and women jog, wind kilometers on bicycles and swing abs on horizontal bars. But even with the naked eye it is clear that many of them play sports incorrectly and harm themselves. How to avoid injury?

If in my youth I knew about the correct running technique, muscle pumping and other nuances of physical education, says a professional fitness trainer, Honored Master of Sports, multiple champion of Russia and European champion (1996) in triple jump, European champion in pentathlon, as well as master of sports in rugby and football Elena Lebedenko – then today I would have my menisci and knees, a healthy back and so on.Unfortunately, some things people find out too late. And this is why I train in order to teach my wards not to get injured and to increase their health ”.

According to Elena, the most traumatic amateur sport is running.

First, when running, a person receives a serious shock load on the orthopedic apparatus, knees and lower legs. The body of a 20-year-old runner will cope with this load on its own, but if you are

30 or more, the joints need to be spared in order to maintain their working resource as long as possible.“I often see large men and women running in marathons (competitive sneakers with a thin heel. – Ed.), Or even not in running shoes at all, besides on asphalt,” says Elena. – This is a direct path to serious knee injury. To avoid unpleasant consequences, sneakers should be chosen with the thickest and softest soles and, if possible, not save too much on them. It is also advisable to select sneakers with the correct pronation for each particular runner (pronation, or inversion, of the foot is an internal eversion of the foot while walking or running.- Approx. ed.) and just comfortable, for a specific foot. And you need to run along a gravel path or, even better, along a tartan, forest path or grass. This is especially true for runners weighing more than 80 kg for men and 60 kg for women. I will say more, in the gym, during workouts, I forbid running even on an automatic treadmill – there is only race walking on it. The point is that the treadmill gives a strong kickback when the foot is positioned and the shock load on the knees increases. ”

Secondly, you need to run correctly.The expert emphasizes that the foot should be placed softly, as if it were made of papier-mâché, not jump high, but “creep” over the path so that the head always remains at the same level. It is better to run slowly, since a fast run does nothing to health, but only takes away from him. For health, it is better to run longer and slower, and it is easier to follow the technique when running slowly. And it’s even better to walk with sticks for a long time and quickly.

“You have to show your running technique, it’s really difficult,” continues Elena Lebedenko.- But all the same I will try in words. You need to run not with your shins – we call it “gluing your legs” – but with your thighs and buttocks. The thigh should be extended forward of the pelvis and during the push pass through the pelvis back. The leg should be lifted off the ground at the last moment, and not in the middle of the trajectory. It is necessary to put your foot under the center of gravity, and not try to bring it forward. And do not jump in any case – otherwise you will be left without a foot, knees, lower leg and lower back! The groin and chest must be in front. If a runner’s butt is “off”, it’s wrong, no longer running, but, as we say in internal slang, “pushing a car”.

Further – also extremely important – elbows and shoulders. We often tell clients that elbows are running. When running, the shoulders should be relaxed and lowered, the arms should be bent at the elbows at about 90 degrees. The elbows should move in parallel planes and work like pendulums – with each step, move a little forward and wind up all the way back. Improper use of the arms while running leads to injuries to the neck and ribs. If you learn how to run correctly, you can do it even with overweight, and everything will only be a plus ”.

A separate running technique, quite complex, but minimizing the load on the legs, is toe running. Without experience, it is unlikely that you will be able to immediately run “to the tip”. It is necessary to introduce this technique into use gradually, at first for the first 5 minutes of jogging, after a couple of weeks for 10 minutes, and so on. The point is that after the flight phase the runner should land not on the heel or even on the entire foot, but on the toe. Then the foot rolls onto the heel, or rather, the weight is transferred to the entire foot, followed by the traditional push.It should be noted that running “to the toe” is not equally physiological for all runners – it is easier for someone, harder for someone. In any case, it is necessary to start running “on the toe” at an extremely slow pace.

The main mistakes when cycling are completely different, for example, a low saddle, continues Elena. A large load on the bent legs is extremely unphysiological, since the cartilage at this moment has a small area of ​​contact with the joint. The saddle must be positioned so that the leg is straight at the bottom of the trajectory.

Further – the swing of the press. Only dry and short people can afford to lean back and sit on a special device. For heavy and even people with an average weight, this exercise will lead to lower back injuries, warns Lebedenko. “The abs should be pumped like this: lie down on the floor at home, put your outstretched legs with your heels on the sofa, relax your legs, put your hands behind your head and twist your torso into a roll until your shoulder blades are off the floor.” For a start, 30 times is enough.

The next exercise on the press – lie on the floor, put your legs bent at a right angle on the sofa so that the buttocks are close to the sofa.Then relax your legs, put your hands behind your head and in this position do another 30 twists, trying to tear your shoulder blades off the floor.

Further, the number of twists in both positions can be increased.

Horizontal bars and parallel bars are very good for men of short stature with short arms, emphasizes Lebedenko. People whose arms are longer than average should approach strength exercises on horizontal bars and uneven bars carefully, gaining the load gradually. It is also worth remembering that excessive diligence when working on the uneven bars and horizontal bar, especially in people with a large weight and age over thirty, can lead to serious complex injuries of the elbow and (or) shoulder joints, which are difficult and long to heal.

“Alas, a person is strong in hindsight,” Elena Lebedenko repeats her main idea. – Most of my clients came to me after knee surgery, spinal disc replacement and other unpleasant operations. Now they know for sure that they need to play sports correctly.