How Lower Back Pain Affects Your Hips


Your body isn’t just a set of unrelated systems that operate independently. Your spine and bones, muscles and other soft-tissues, and your nerves all affect one another. When you have lower back pain, for instance, it changes the way you hold and distribute your body weight, which alters the way you hold and use your hip joints, too. 

 

Brian J. Fuller, MD, a Harvard-trained, triple-board certified physician and founder of Mountain Spine & Pain Physicians in Denver, Colorado, believes in healing the underlying problems that cause your pain. Here he discusses how untreated, unhealed lower back pain can hurt your hips, too.

The kind of referral you don’t want

When your hips and upper legs are stiff and painful, the problem might not originate in your hip joint at all. If you have sacroiliitis — an inflammation in one or both of your sacroiliac joints (i.e., the joint that connects your lower back to your pelvis) — the pain can radiate downward toward your hip joint. Pain that’s felt away from the origin of the injury or problem is known as “referred pain.” 

 

Pain doesn’t just affect your comfort level. Pain is often accompanied by inflammation. Although inflammation is a healthy and important tool that your immune system uses to fight pathogens, chronic inflammation degrades your soft tissues, including the protective cartilage in your hip joints.

Sciatica has a long reach  

Your sciatic nerve is larger than any other nerve in your body and runs from your lower back all the way down both of your legs in two separate branches. At around the level of your knee, the sciatic nerve splits again and runs down your calf and into your ankle. If you have sciatica — an impingement or inflammation of the sciatic nerve — the pain can travel from your back to your hips and even affect your legs and feet.

 

Most cases of sciatica are caused by problems in your lower back (i.e., the lumbar spine), specifically at the L4 and L5 vertebrae, and in the sacrum at the S1 vertebra. When a disc that cushions one of those vertebrae deteriorates, slips, or herniates, it can press on one of the sciatic nerve roots, causing pain and inflammation that radiates to your hips and beyond. Even if the disc doesn’t actually touch the nerve, a degraded disc can release inflammatory proteins that irritate your sciatic nerve and make your hips and legs painful, too.

Your grade-school teacher was right

When you were a child, you probably heard the admonitions to “sit up straight” and “stand up straight” more than once. Slouching or standing with your hips at an angle isn’t just unflattering. The unbalanced posture puts stress on your muscles, tendons, and ligaments in both your back and your hips. The extra stress actually does “stress out” those tissues, making them weaker over time.

 

If your lower back hurts, you might also start to clench muscles only on one side of your body, which can cause pain in the hip area. You might also shift your weight to rest more on one leg than the other, putting extra pressure on that hip joint. The extra pressure, like extra weight, can stress your joint and wear down the protective cartilage, leading to osteoarthritis in your hip joint. 

Long-term steroids affect your hips

You may use steroids to control your chronic lower back pain, but long-term, high doses of steroids like prednisone come with a serious downside. Over time, steroids can cause a condition called avascular necrosis, which slows down blood circulation to your hip and causes your hip-bone tissue to die. 

A solution for your pain alone

Dr. Fuller doesn’t believe in cookie-cutter solutions to lower back or hip pain. He conducts a thorough investigation of your discomfort with a physical examination, medical history, and advanced imaging studies. Depending on his findings, his treatment recommendations could include:

 

  • Improving your posture
  • Strengthening lower back, legs, and hips with physical therapy
  • Platelet-rich plasma (PRP) and stem cells to heal cartilage
  • Joint and tendon injections for pain and swelling
  • Spinal cord stimulation to block painful nerve signals
  • Radiofrequency neurotomies to dull pain


Whether you have lower back pain, hip pain, or both, Dr. Fuller helps heal the underlying causes so you can stand, walk, and sit without pain again. To protect your hips and heal your pain, contact us for an appointment today by calling or using the convenient online booking form.

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