Hip Pain vs. Low Back Pain: How to Differentiate Between the Two

Originally published in Williamson Source

As people head outside to enjoy summertime weather and activities, hip and back injuries tend to increase. Whether you’re lifting a bag of mulch or carrying a cooler to a get-together, you should use care to protect your hips and back from common injuries.

Dr. Casey Davidson, an orthopaedic surgeon specializing in spine care at Bone and Joint Institute of Tennessee, shared his insights on recognizing the differences between hip and back pain and knowing how to treat each ailment.

Recognizing the Signs of Hip Pain vs. Low Back Pain

People can have a hard time differentiating between the two because the differences can be subtle. A good way of visualizing is to imagine that you are wearing a pair of pants with pockets. If the pain is near the front pocket of the pants near the thigh or groin area, typically that is coming from the hip joint itself. If the pain is near the back pocket of the pants near the outside of your hip or glute area, typically that is coming from the back, which could be coming from a pinched nerve.

What Are Some Common Treatments for These Pains?

Treatment for aches and pains often starts conservatively. If you have an acute onset or exacerbation of those pains, a specialist will start with activity modification. That includes rest to allow your body to calm down a bit. 

Treatment often includes physical therapy to do some gentle stretching exercises. An over-the-counter anti-inflammatory can also help in the initial treatment phase. These medications can include Advil, Aleve or Motrin.

Depending on how the pain evolves or progresses, your medical professional can build from there. The key is getting in to see the right provider who can help treat you quickly to avoid severe pain or further injury.

Common Hip and Back Pain Causes

The most common cause of hip pain is hip arthritis, which commonly affects people in their 50s and older. This pain can radiate down to the knee. There are times when patients think they have knee pain, and they really have what’s called referred pain from the hip.

In younger, active patients, Bone and Joint Institute often sees hip impingement in patients who are engaging in strenuous exercise or training. Often these are runners or cyclists and the hip is inflamed or irritated. These patients can also face a labral tear, which is almost like a meniscus tear, but in the hip. Trochanteric bursitis is another cause of pain in the hip. It occurs on the outside of the hip and is related to abnormal stress on the outside of the hip. It is a very common issue and with some stretching, patients often find relief. 

In contrast, back pain is often due to a pinched nerve coming out of the back and radiating down the back of the leg or even down into the foot. That can come from several different things such as arthritis or lumbar disc herniation, to name a few. Usually that pain calms down with rest, over-the-counter medications, and physical therapy.

However, a red flag to watch for is loss of bowel or bladder control, which might indicate something more serious. Patients should head to the emergency room in those instances because they could be experiencing an emergency that may require surgery.

Risks of Ignoring the Pain

When patients decide to keep going in their daily activities despite the pain, they can experience gait changes, which can affect other parts of the body. If your hip hurts, you can start wearing down your back more or if your back hurts, you can start using your hips differently and begin experiencing pain there, exacerbating the problem.

Ways to Prevent Hip and Low Back Pain

There are a few ways to prevent hip and low back pain. The first way is to maintain a healthy weight and exercise routine. Part of a good exercise routine includes maintaining good core strength with the abdominal muscles, obliques and back muscles, which minimizes the risk of hurting or straining the low back. Additionally, people should regularly stretch their hips and hamstrings, especially if they sit for long periods of time. 

If you are experiencing persistent or severe hip or back pain, visit the spine specialists at Bone and Joint Institute for an assessment.