Is the Pain in My Hip Coming From a Hip Problem or From My Back?

spinal stenosis

When a person has pain going into the hip area, it may not be emanating from the hip itself. The pain may actually be coming from a problem that is occurring in the low back and the resulting pain is radiating into a person's hip region. The problem may not be causing any low back pain so it can be difficult to delineate where the actual problem is coming from.

In order to treat the pain most effectively, it is necessary to figure out where the problem is emanating from. In the doctor's office a physical examination can show usually if the patient has arthritis of the hip. With hip arthritis often times range of motion of the hip is very painful and there are specific maneuvers which can show this. There are also additional physical exam maneuvers which can show a problem such as sacroiliac joint arthritis. Along with this, plain x-rays raise of the hip joint will typically show moderate to severe arthritis and people have pain in the area or potentially going down into the side.

Outside of hip arthritis pain, an individual might have some other derangement inside the hip joint including a cartilage tear otherwise known as a labral tear.

If the person's pain is not coming from the hip, there's a good chance it's coming from a problem in the low back. This may be from a nerve root compression or potentially several nerve roots are being pinched such as in spinal stenosis.

Spinal stenosis may cause no pain in the lower back itself, but radiating pain going down around the hip area. So the two may be mistaken for each other, or they may actually co-exist.

An MRI of the low back can show if nerve roots are being pinched. This may explain the patient's hip pain especially if there is is no evidence of arthritis and the exam does not display pain with hip range of motion.

One way to tell the difference is to have a pain management doctor do a diagnostic injection into the hip itself. This may be done with numbing medicine along with some steroid. The numbing medicine should kick in within just a few minutes so if the patient describes there being much less pain afterwards it probably was the hip being the culprit.

If the hip injection does not help, and the needle was reasonably assured of being inside the joint, then the next step would be an epidural injection to see if the pain was coming from the low back. This is done as an outpatient procedure, and can tell very nicely if the pain relief occurs into the hip area.

So between the two diagnostic injections, pain doctors can often get a very good picture of whether or not the pain is coming from the hip by itself, the spine by itself, or a combination of the two. Then treatment efforts can be catered towards the definitive diagnosis.