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Hip & Low Back pain

In a recent study in the journal PMR, (June 2017) a Washington University School of Medicine team found links between the hip and the spine affecting pain and function. The key finding was that hip disease, before it was even evident on an MRI as osteoarthritis, could cause problems in the lower back.The hip was the true disguised pain generator in back pain patients. This is no surprise to me and my patients. Every patient in my office has had a hip evaluation if they present with low back pain. This truly is a case where the science is catching up with what active practitioners have known for years.

What is this research telling us? If you had an MRI of your hip, and nothing presented itself as obvious, then the doctor may chase something in the spine that is not causing the pain.

The link that the researchers are still missing is that tight and immobile hips cause increased dysfunctional motion in the lower lumbar spine and this causes excess rubbing and irritation in the low back.

The same team of researchers, publishing earlier in February 2017 were also able to conclude that physical examination findings indicating hip osteoarthritis (loss of range of motion and acute pain) are common in patients who also have low back pain. A patient presenting with low back pain should be examined for hip osteoarthritis).2

1 Prather H, Cheng A, May KS, Maheshwari V, VanDillen L. Association of Hip Radiograph Findings with Pain and Function in Patients Presenting with Low Back Pain. PM&R. 2017 Jun 16.

2. Prather H, Cheng A, May KS, Maheshwari V, VanDillen L. Hip and Lumbar Spine Physical Examination Findings in People Presenting With Low Back Pain With or Without Lower Extremity Pain. J Orthop Sports Phys Ther. 2017 Feb 3:1-36. doi: 10.2519/jospt.2017.6567.

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