Could it be your hip or your back?

Symptoms people mistake for a bad back and what to do about it

By Leslie Budzynski DC ~ BCA Registered Chiropractor (BCA Reg. No. 0072) since 1987 & GCC Registered Chiropractor (GCC Reg. No. 00043) since 1999 | Bournemouth Chiropractic explains why hip pain is so often mistaken for a back problem and how the right hip pain treatment starts with getting the diagnosis right.

Hip pain treatment is usually sought when the symptoms become debilitating and symptoms can come from all sorts of places. Often, I will treat a patient who has been managing what they believe is a back problem, when the real issue has been their hip all along.

It is an easy mistake to make. The hip and the lower back are closely connected. They share muscles, nerves and movement patterns and pain from one can radiate convincingly into the territory of the other. Shall we call it trespassing! If you have been nursing your back without improvement, it is worth exploring the possibility that your hip might be part of the story. This is where a chiropractor may have the key to the diagnostic door for you and where the correct back and hip pain treatment can make all the difference.

Misdiagnosed or self-diagnosed back and hip issues are something I do see at my clinic on Branksome Hill Road. Getting the story straight from the beginning will lead, without doubt, to better outcomes.

Why is Hip Pain so Easy to Mistake for a Back Problem?

The ball and socket hip joint sits deep in the body, surrounded by large, powerful ligaments and muscles. When something goes wrong in this region, the pain does not always settle neatly in the hip itself. Discomfort and sensations of pain can travel into the lower back, the buttock, the groin or down the front of the thigh and even as far as the knee and top of the shin. These are all places we tend to associate with back trouble. 

Add to that the fact that many people have both hip and back problems at the same time and it becomes clear why the hip so often gets overlooked and things get confused by patients.

Lumbar spine and pelvis

How to Tell if your Pain is Coming from your Hip or Back

Sufferers are widely varied but most pain comes to light when your daily habits and hobbies become inhibited by any persistent discomfort. For keen walkers this can  often be the case and be a real nuisance, particularly for people who walk long distances on a regular basis. On our doorstep here on the South Coast, we have the most beautiful cliff paths and promenade walks to take advantage of, particularly between Bournemouth and Sandbanks. Everyone is walking in one form or another here and nothing should get in the way of that. Equally, golfers at local courses like Parkstone Golf Club, Meyrick Park and Broadstone Golf Club, to name a few, can be victim to repetitive hip loading that builds gradually until something starts to protest. These hobbies and pastimes are amongst a plethora of activities that can cause or exacerbate symptoms.

Common Causes of Hip Pain by Age Group

Sport and age may not be the only culprit for hip pain. Below is a quick reference table for some of the more common issues and conditions for different age groups as a guide.

Quick Reference Table

DDH : Developmental Dysplasia of the Hip, SCFE : Slipped Capital Femoral Epiphysis, FAI : Femoroacetabular Impingement, OA : Osteoarthritis GTPS : Greater Trochanteric Pain Syndrome

Hip Pain Symptoms that are often Mistaken for Back Pain

The following descriptions of pain are the presentations I see regularly in clinic that often turn out to be hip driven rather than spinal:

Pain felt deep in the groin or front of the thigh

Back problems cause pain in the groin to a lesser degree. If you have a deep aching sensation in the crease of the hip or the inner thigh, that is a strong indicator the hip joint itself is involved.

Pain that worsens when putting on shoes or socks

This requires bending and rotating the hip and these are movements that load the joint directly. If this is consistently uncomfortable, the hip is likely the culprit. This, for a lot of patients, is the first sign that something isn’t as it should be because everyone should be able to put their own socks on.

Reduced range of movement in the leg

Difficulty crossing your legs, sitting cross-legged or getting in and out of the car with one particular leg is more characteristic of hip restriction than a back problem.

Stiffness after sitting that will ease with movement

This is a classic pattern for hip osteoarthritis. Back stiffness after sitting tends to ease more slowly. Hip-related stiffness often loosens up within a few minutes of walking, so something that eases quickly still needs attention.

Pain or aching in the outer thigh or buttock

The area around the side of the hip is a common site for a condition called trochanteric bursitis or can generate gluteal tendon problems. Both are hip conditions that are frequently labelled as sciatica or back pain, probably because they are more familiar conditions. We need to look at things in more depth though, not just presume a diagnosis. 

A clicking, catching or giving way feeling in the hip

These mechanical symptoms are characteristic of hip joint or labral problems. You would not typically expect these from a spinal cause. That hip needs attention if you are experiencing this.

Pain that reproduces when the hip is moved, not when the spine is tested

In my clinic this is often the clearest sign of a patient needing hip pain treatment. If rotating, extending or compressing the hip reproduces your familiar pain, the hip is the source.

My advice to you is that you need to get booked in for a Chiropractic assessment to discuss any of these symptoms. Getting the diagnosis right is the first step towards effective hip pain treatment.

The Sacroiliac (SI) Joint: Another Common Source of Confusion

Worth a mention here is the sacroiliac joint (SI joint) which is the joint between the base of the spine and the pelvis. SI joint problems cause pain very low down in the back, often one-sided and typically into the buttock. Mention the buttock and patients connect it to hip pain and label it as such. Patients can often describe it as “my bad hip”, when in fact the pain is coming from the junction between the pelvis and sacrum. Proper chiropractic assessment will clarify what is to blame.

A thorough assessment is needed to distinguish between the two, clarifying the source of the pain makes a major difference when it comes to treatment.

When the Back is More Likely to be the Problem

There are clear patterns that would more strongly suggest a lumbar spine, low back origin to your pain:

• Pain that runs down the back of the leg below the knee which is more typical of sciatica from a disc or nerve problem
• Pain that changes with posture changes, especially sitting, bending forward or lying flat
• Pins and needles, numbness or weakness in the leg or foot
• Pain that is worse with coughing or sneezing

These do not rule out a hip contribution, but they are indications that it may have spinal involvement and make the spine the priority to assess first.

Hip Pain Treatment in Bournemouth: What to Expect

If any of the hip pain and symptom pattern descriptions listed above resonate with you, the first step is a proper chiropractic assessment. An assessment that looks at both the hip and the lumbar spine together, rather than in isolation. This is important because the two areas influence each other. A stiff hip changes the way you load your spine. A restricted lumbar segment, your lower back, changes how the pelvis moves, which in turn affects hip bio-mechanics. Hip pain treatment that focuses on one without considering the other often gives incomplete results.

At Bournemouth Chiropractic, assessment always includes:

• A thorough history of your symptoms and how they behave
• Orthopaedic and neurological testing of both the hip and lumbar spine
• Observation of how you move, stand and walk
• An explanation of what we find in plain language, before any treatment is discussed

From there, hip pain treatment may involve manipulation or mobilisation of the hip joint itself, work on the lumbar spine and pelvis, soft tissue release of the surrounding muscles and a rehabilitation programme to restore strength and movement.

Here is what one patient said after coming to see me with hip pain:

In a patient’s own words, “I had been suffering from a very painful hip for three weeks after returning to running. I tried various exercises gleaned from online videos, but none seemed to work. I made an appointment with Leslie. After three treatments I am now fully recovered. He is excellent. He took my medical history, carefully examined me, and soon diagnosed the problem. He explained it in terms I could easily understand and gave me loads of information about how I can avoid a recurrence of the injury.

I have no hesitation in recommending him – richly deserving of the 5 stars.”  William, Google Review

Hip Pain Assessment in Bournemouth: Stop Guessing and Start Recovering

Could it be your hip? If you have been managing what feels like a back problem and not making the progress you expected, it might well be your hip instead.

Hip pain symptoms get misread more often than you would think. People put up with them for months, treating the wrong joint and getting nowhere. A proper clinical assessment, one that looks at both the hip and the lumbar spine together, can sort that out quickly and gets hip pain treatment pointed in the right direction.

Here at my clinic, I see patients from across Bournemouth, Westbourne, Poole including Ashely Cross, Whitecliff, Branksome Park, Parkstone and Penn Hill and Branksome. and further afield, many of whom have been managing the wrong area for months without realising it. Whether you have been referred by your GP or you have just had enough of waiting, a thorough examination here takes around 45 minutes and covers both the hip and lumbar spine together. I always finish with a clear explanation of what I have found before any treatment is discussed. Appointments are usually available within 48 hours.

Let’s start at the beginning and work out where the problem is actually coming from.

Book an Appointment | Learn more about Hip and Pelvic Pain

Further reading: If low back pain is also part of your picture, our guide to low back pain covers how the lumbar spine works and what the evidence says about treatment. If restricted movement is a concern, our post on maintaining mobility is a useful companion read. We also answer lots of questions you might have about chiropractic treatment in our frequently asked question page, take a look. Finally, more specialist is our scoliosis conditions page which explains a lot about asymmetric SI loading.

Frequently asked Questions about Hip Pain

Can hip problems cause lower back pain?

Yes, hip problems often cause low back pain and it happens more than most people realise. The hip and lumbar spine share muscle attachments, nerve supply and movement patterns, so when the hip is not working properly it changes how the spine is loaded. The result is often pain in the lower back, buttock or thigh. Most patients assume that is a back problem. Understandably so, but it is worth questioning.

How do I know if my pain is coming from my hip or my back?

There are some useful clues to telling the source of your pain and whether it stems from your hip or back. Pain deep in the groin, trouble putting on shoes or socks, stiffness that sometimes loosens up quickly once you get moving or pain that comes on when the hip is rotated or compressed, these point more towards the hip. Pain running below the knee or pain that changes when you cough or sneeze, is more likely to be spinal. The honest answer though is that you often cannot tell from symptoms alone. The overlap between hip and back pain is too great. A clinical assessment is the only way to be sure.

What does hip pain actually feel like?

Hip pain dies not present where most people expect it to. Hip pain commonly sits deep in the groin or the front of the thigh rather than on the outer side of the hip. It can show up as a catching or clicking in the joint, aching down the outer thigh or that familiar stiffness getting out of the car or standing up from a low chair. The location confuses people and that is exactly why it gets presumed to be back pain so often.

What is the sacroiliac joint and can it cause hip pain?

The SI joint sits right at the base of the spine where it meets the pelvis, there are two, one is one on each side of the pelvis. When it plays up, the pain tends to be low in the back, usually it is one-sided, and radiates into the buttock. Patients almost always call it their hip. It is easy to see why, but the SI joint is a completely different structure to the hip joint and needs a different treatment approach. Working out which one is actually causing the problem is a routine part of what I do during a chiropractic assessment.

Is hip pain common in people who walk, run or play golf?

Hip pain is very common in people who enjoy sport. Walking, running and golf all involve repetitive loading through the hip, walking builds it up over distance and golf puts a rotational force through the joint with every swing and running causes mechanical loading. The problem is that symptoms tend to creep up gradually. Most people put the early ache down to tiredness or a stiff back and by the time they come to see me they have been managing the wrong thing for quite a while.

What age group is most likely to suffer with hip pain?

Which age group suffers hip pain most is broad. It depends on what is causing it. In younger, more active people in their 20s, 30s and 40s the common culprits are labral problems, bursitis, gluteal and quadricep tendinopathy and the cumulative effects of doing a lot of sport. From the mid-40s onwards, osteoarthritis starts to become more common and this is the age group where hip pain most often gets confused with back pain because it builds so gradually. People write it off as stiffness or just getting older. That is one of the more common mistakes I see. Hip pain at any age is worth getting properly assessed.

Where can I get hip pain treatment in Bournemouth

As a chiropractor, I see people with hip and back problems very often. Here at Bournemouth Chiropractic I offer thorough clinical assessments for hip and lower back pain, looking at both conditions together in one appointment of around 45 minutes. I have been in practice for 39 years, registered with both the BCA and GCC. Parking is right outside, very convenient and appointments are usually available within 48 hours.