Thirteen Factors Contributing to Low-Back and Hip Pain

Low-back and hip pain commonly exhibits unilateral symptoms. Nevertheless, it is plausible to encounter pain on both sides contingent upon the root cause or in cases where the pain is either radiating or pervasive.

Low-back pain is a prevalent cause for individuals seeking healthcare services and experiencing work absenteeism. Hip pain is a common occurrence, however, there are instances where back pain may be misinterpreted as hip pain. The proximity of the hip joint to the lumbar spine (specifically, the low back region) accounts for this phenomenon. A hip injury has the potential to present symptoms that resemble those of back pain.

Hip and back pain may also manifest in conjunction with the following conditions:

• The phenomenon of referred back pain
• The individual is experiencing pain in the groin area on the same side.
• The presence of stiffness and tenderness
• Individuals may experience discomfort or pain when engaging in physical activities or walking.
• The individual experiences pain in the lower extremity on the side that is affected.

Referred back pain is characterized by the sensation of pain originating from the lumbar region and radiating towards the upper thigh, buttock, and groin. Referred pain originating from the back is generally not observed beyond the knee region and may manifest in conjunction with certain etiologies, such as kidney stones and gallstones.

Pain experienced on the right side of the body may be associated with certain etiologies, including renal and biliary pathologies. Nevertheless, it is plausible to encounter discomfort on either side, contingent upon the kidney that is afflicted, or experience pain that extends from the back to the abdominal region.

Unilateral back and hip pain can manifest on either the left or right side and is associated with various etiologies, such as muscular strains, nerve impingement, arthritic conditions, intervertebral disc herniation, and sacroiliac (SI) joint dysfunction. Certain causes of low-back and hip pain may exhibit a higher prevalence among individuals assigned female at birth, including factors such as pregnancy and gynecological issues.

Fortunately, the management and treatment of hip and back pain, along with their underlying causes, are within reach. The utilization of surgical interventions for the management of pain and other associated symptoms is infrequent.

This article aims to discuss the etiology of unilateral low-back and hip pain, strategies for pain management, emergency medical interventions, and recommendations for individuals coping with persistent back and hip pain.

What are the factors contributing to unilateral low back and hip pain?

Injuries, arthritis, and disc problems are widely recognized as the primary etiological factors contributing to hip and back pain. It is plausible that individuals may also encounter this phenomenon as a consequence of an underlying medical ailment. Several etiologies of unilateral back pain may also impact bilateral regions of the body.

Overuse Injury 

Overuse can lead to the development of strains in the back and hip, whereby the repetitive nature of certain movements gradually damages the muscles. The repetitive and stressful nature of certain movements can lead to stiffness and discomfort in the muscles of the lower back. In addition, these activities may potentially result in the overextension of muscles and the occurrence of minor tears in the affected muscle regions.

Sports such as baseball, tennis, and golf have the potential to induce strain due to the inclusion of abrupt and vigorous movements.

Over an extended period, the presence of a persistent low back strain can result in considerable discomfort. Additionally, it is possible to experience intense pain in a muscular region that is already inflamed and subjected to heightened levels of stress.

Vertebral Fracture

A vertebral spine fracture is characterized by the compression or cracking of one or more vertebrae, which are the individual bones comprising the spinal column. Vertebral fractures are frequently observed among the elderly population, individuals diagnosed with osteoporosis, which is characterized by a reduction in bone density, or those who have experienced a significant traumatic event such as a motor vehicle collision or a fall.Symptoms indicative of a vertebral fracture encompass the occurrence of an abrupt audible popping sound in the lumbar region, accompanied by back pain that extends to the hip, buttocks, and lower extremities.

Arthritis

Arthritis frequently presents as unilateral pain in the back and hip region, although certain variations of the condition can manifest as bilateral discomfort affecting the entirety of the lower back and both hips. Chronic back pain that is linked to arthritis is widely recognized in academic circles. Arthritis has the potential to induce intermittent radiating pain in the back, along with stiffness, discomfort in the hips, and diminished physical mobility.

Axial spondyloarthritis (axSpA) is classified as an inflammatory arthritic condition that predominantly impacts the spinal region, resulting in pronounced discomfort in the lower back and hip areas. In addition to the aforementioned symptoms, individuals may also experience fatigue, joint pain, heel pain, and inflammation of the eyes.

Additional arthritis types that might lead to low-back and hip pain are:

• • Psoriatic arthritis (PsA) is classified as an inflammatory form of arthritis characterized by joint and skin inflammation. Approximately 20% of individuals diagnosed with Psoriatic Arthritis (PsA) experience spinal involvement, which may result in the fusion of one or multiple vertebrae.
  • Osteoarthritis (OA) is widely recognized as the prevailing form of arthritis. When the spinal region is impacted, it can result in the degradation of cartilage within the facet joints, which are the points of articulation between the vertebrae. This deterioration can give rise to discomfort and the development of osteophytes, or bone spurs, which have the potential to exert pressure on adjacent nerves, thereby exacerbating the experience of pain.
  • Reactive arthritis, also known as Reiter’s syndrome, is a form of arthritis that manifests subsequent to an infection in the genital, urinary, or gastrointestinal systems. Inflammation of the joints, such as the sacroiliac joint, can result in the manifestation of pain in the lower back and hip region. The human body possesses a pair of sacroiliac (SI) joints, which serve as the articulation points between the sacrum and the pelvis.
  • Enteropathic arthritis, a form of arthritis that is occasionally associated with inflammatory bowel disease, typically manifests in the sacroiliac joint, resulting in bilateral or unilateral low-back and hip pain.
  • Spinal stenosis is a medical condition characterized by the narrowing of the spinal canal, which is primarily caused by the excessive growth of the vertebrae and the thickening of ligaments. This pathological process can result in various symptoms, including but not limited to low-back pain, hip pain, pain and numbness in the legs, as well as complications related to bladder and bowel function. It is possible that it may arise as a consequence of alterations associated with osteoarthritis (OA) and other forms of arthritis.

Disc Injury

Low-back and hip pain can be attributed to a disc injury, which may manifest as a tear or herniation. The outer portion of the disc may experience a small tear as a result of the natural process of aging. In the event of this circumstance, it is possible to encounter a significant degree of discomfort that may persist for a duration of several weeks or even months.

The potential for the development of a herniated disc exists when engaging in activities such as lifting, bending, or twisting. A herniated disc is characterized by the protrusion of the nucleus, the gel-like center of the intervertebral disc, against its outer layer. The displacement of the nucleus may occur in cases where the intervertebral disc undergoes substantial degeneration or is subjected to traumatic events.

In the event of a disc bulge or protrusion, commonly referred to as a bulging disc, there is potential for the compression of spinal nerves, resulting in the experience of pain. The application of pressure in this context has the potential to induce discomfort in the lower back region, which may subsequently radiate towards the hip, buttock, and leg.

Degenerative Disc Disease 

The intervertebral discs located between adjacent vertebrae within the vertebral column have the potential to undergo degeneration and reduction in size. In the event of such occurrences, there is a possibility of structural collapse, which may subsequently result in the manifestation of facet joint pain. The facets are situated in the posterior region of the spine, specifically between each vertebra. Pain can be experienced when there is friction between the intervertebral discs and the articular facets.

The manifestation of pain resulting from degenerative disc disease is observed in the lumbar region and the hip joints, either unilaterally or bilaterally. The pain has the potential to extend towards the buttocks and hips, and its intensity may increase during activities involving lifting, bending, and twisting. The potential for enhancement may be observed through engagement in physical activities such as walking and running.

Piriformis Syndrome

Piriformis syndrome is a pathological condition resulting from the compression of the sciatic nerve. The piriformis muscle is located in the gluteal region, specifically in the deep layers of the buttock. The occurrence of spasms in the affected area has the potential to exert pressure on the sciatic nerve, leading to the manifestation of symptoms that extend along the leg. Nerve compression may occur as a result of various factors, including injury, muscle spasms, or inflammation.

This particular medical condition has the potential to induce unilateral pain in the lumbar region, hip, gluteal area, and posterior aspect of the lower limb. Additionally, it has the potential to induce sciatic nerve pain, commonly referred to as sciatica, which manifests as intense and radiating pain in the leg.

Sciatica pain arises due to the inflammation of the sciatic nerve, the largest nerve in the human body, originating from the lumbar region and extending all the way to the foot. The human body possesses a pair of sciatic nerves, with one located on each lateral side of the body.

Sciatica may manifest concomitantly with a range of low-back pain conditions. Back pain is not directly causative, but rather can manifest as a symptomatic indication of an underlying cause of back pain.

A Pinched Nerve 

The manifestation of low-back and hip pain can be attributed to the occurrence of a pinched nerve in the posterior region of the body. This particular form of pain is frequently characterized by its intensity and concurrent sensation of numbness.

The manifestation of pain in individuals with a pinched nerve can occur abruptly and intensify over time. It is possible for pain to extend into the lower extremities. Individuals may potentially encounter a sensation of diminished strength in their lower limbs.

A pinched nerve can arise due to multiple factors. The causes of this condition encompass peripheral neuropathy, disc herniations, or arthritic changes in the spine.

Sacroiliac Joint Dysfunction

Sacroiliac joint dysfunction has the potential to induce pain in the lower back and hip regions. Low-back pain associated with sacroiliac dysfunction is characterized by a dull and achy sensation, predominantly localized on one side. The potential for dissemination exists towards the pelvic region, gluteal muscles, and inguinal region.

Sacroiliitis, characterized by inflammation of the sacroiliac joints, has the potential to induce both low-back pain and hip pain. Prevalence of this condition is frequently observed among individuals diagnosed with inflammatory arthritis, such as ankylosing spondylitis and rheumatoid arthritis. The condition frequently exhibits unilateral manifestation, although bilateral involvement may occasionally occur.

Infection 

Infections have the potential to manifest in various regions of the spinal column, encompassing the intervertebral disc space, the spinal canal, and adjacent tissues. A spinal infection may also manifest subsequent to a spinal trauma or surgical intervention on the spinal column.

Potential manifestations associated with a spinal infection encompass intense dorsalgia, elevated body temperature, shivering, myalgia, muscular spasms, diminished muscular strength, paresthesia in the extremities, as well as urinary or fecal incontinence.

Poor Posture 

The adoption of a suboptimal body position and the act of slumping can result in the development of discomfort in the lower back and hips, either unilaterally or bilaterally. Individuals may encounter discomfort during periods of sitting, however, it is noteworthy that pain can also manifest during instances of standing and walking, particularly following prolonged periods of sitting.

Kidney Pain

Sensations of pain can be experienced in the region of the posterior torso where the kidneys are anatomically situated. Renal pain has the potential to manifest unilaterally or bilaterally in the dorsal region. However, the presence of pain in the bilateral regions adjacent to the kidneys does not necessarily indicate the presence of a renal issue in either or both kidneys. The challenge in identifying the cause lies in the complex anatomical proximity of numerous muscles, bones, and organs in the vicinity of the kidneys, necessitating the use of diagnostic testing for accurate determination.

Pelvic Floor Dysfunction 

The pelvic floor refers to a collection of muscles located in the pelvic region, which serve to provide support for the various organs situated within the pelvis, such as the bladder, rectum, and uterus. The pelvic floor muscles are responsible for regulating urinary function, defecation, and sexual activity.

Pelvic floor dysfunction refers to the impaired ability to regulate the muscles of the pelvic floor, resulting in symptoms such as urinary incontinence and difficulty in achieving satisfactory bowel movements. Additionally, it has the potential to induce pain in the lower back, hips, and pelvis, affecting either one or both sides of the body.

Gynecologic Conditions 

The experience of back and hip pain has the potential to impact individuals across various demographics. However, individuals who are assigned female at birth are more likely to experience back pain compared to individuals who are assigned male at birth. For a considerable period of time, scholars have held the belief that disparities in body structure and hormonal composition may be the underlying cause.

There are several gynecological conditions that have been associated with the occurrence of low-back and hip pain. These conditions exclusively impact individuals who were assigned female at birth. Pain may manifest unilaterally or bilaterally within the body.

Gynecologic conditions that can lead to back pain that affects one side or both include:

• Premenstrual syndrome (PMS) refers to a collection of psychological and physiological alterations that manifest in the days or week preceding a woman’s monthly menstrual cycle.
• Endometriosis is a medical condition characterized by the presence of endometrial tissue outside The aforementioned medical condition involves the presence of abnormal tissue growths resembling the endometrium, which is typically found lining the uterus. These growths occur within the abdominal and pelvic regions, leading to symptoms such as intense menstrual pain, excessive menstrual bleeding, and complications related to fertility.
• Dysmenorrhea, also known as painful periods, refers to the condition characterized by menstrual pain experienced by individuals during their menstrual cycle.
• Premenstrual dysmorphic disorder (PMDD) is characterized as a heightened manifestation of premenstrual syndrome (PMS).
  Adenomyosis is a medical condition characterized by the presence of endometrial tissue within Dysmenorrhea and menorrhagia arising from endometrial hyperplasia
• Polycystic ovary syndrome (PCOS) is a hormonal disorder characterized by the development of multiple small cysts on the ovaries. This condition has been associated with the occurrence of low-back and sacral pain, which is localized in the region at the base of the lumbar spine.
• Ectopic pregnancy, along with other complications related to pregnancy: Ectopic pregnancy is a medical condition characterized by the implantation of the embryo outside the uterine cavity.
• The phenomenon of pregnancy: A frequently observed phenomenon that can be attributed to hormonal fluctuations, weight gain, alterations in the center of gravity, modifications in posture, and physical strain on the body.

Different Ways to Manage Low-Back and Hip Pain

The management of symptoms associated with low-back and hip pain may involve the prescription of various treatments by a healthcare provider, contingent upon the underlying cause.The potential treatment options that may be considered include:

Emergency Low-Back, Hip, and Pelvic Symptoms 

Individuals who encounter a sudden onset of pain that rapidly intensifies may potentially be afflicted with a severe ailment necessitating immediate medical intervention.Emergency care is necessary for individuals experiencing symptoms related to the lower back, hip, and pelvis.

• The individual is experiencing pain radiating down one leg below the knee.
• Individuals may experience pain in the back or hip region subsequent to a fall or injury.
• The presence of a fever in conjunction with pain in the back or hip region.
• The sensation experienced is characterized by a sudden, intense pain as opposed to a lingering, mild discomfort.
• The individual experiences an abrupt onset of muscular debilitation in the lower extremities.
• The condition of experiencing involuntary loss of control over the bladder or bowel functions.
• Saddle anesthesia refers to a condition characterized by the absence of sensory perception in the anatomical regions encompassing the buttocks, groin area, and inner portions of the thighs.

The presence of leg weakness, saddle anesthesia, and incontinence may indicate the presence of a serious medical condition known as cauda equina syndrome (CES). Carpal tunnel syndrome (CTS) is a medical condition that arises due to the compression of nerves. The situation at hand is a critical medical emergency necessitating urgent surgical intervention for nerve decompression in order to mitigate the risk of irreversible harm.

Tips for Living With Chronic Low-Back and Hip Pain

The presence of chronic pain in the lower back and hip region can have implications beyond physical discomfort. Chronic inhibition can impede engagement in pleasurable activities and contribute to the development of depressive symptoms. Fortunately, there exist various strategies that can be employed to effectively manage pain and enhance one’s emotional and physical well-being.

Tips for managing chronic low-back and hip pain include:

• • Maintaining an active lifestyle is crucial for the effective management of chronic back pain, as exercise plays a pivotal role in any comprehensive treatment regimen. It is often among the initial therapeutic interventions recommended by healthcare professionals. A physical therapist possesses the ability to customize a comprehensive plan that is specifically tailored to address your individual health circumstances, while also providing recommendations on how to incorporate regular exercise into your daily regimen.
  • Enhancing Posture: Foster Consciousness of Posture and Implement Measures for its Enhancement. It is imperative to maintain proper posture during periods of sitting, standing, and walking, acquire the necessary knowledge on correct techniques for lifting heavy objects, and refrain from prolonged periods of sitting.
  • This paper aims to discuss the issue of sleep problems and explore potential strategies for addressing them. According to scientific research, it is recommended that adults obtain a sufficient amount of sleep, ranging from seven to nine hours, during the nocturnal period. There are several strategies that can be employed to enhance the quality of one’s sleep. These include ensuring that the sleeping surface is adequately comfortable, refraining from bringing smartphones and other electronic devices into the bedroom, and maintaining a dark and appropriately temperate sleeping environment. It is advisable to consult a healthcare professional if persistent sleep difficulties persist despite implementing measures to improve sleep hygiene.
  • Managing stress can potentially impact one’s ability to effectively cope with back and hip pain, particularly in cases where the stress is substantial. Various techniques for relaxation can be explored, including mindfulness, meditation, deep breathing, and yoga. Smartphone applications have the potential to serve as valuable tools for individuals seeking guidance in relaxation and meditation practices.
  • Utilize analgesic topicals: A wide range of non-prescription pain-alleviating creams and ointments can be procured from nearby pharmacies and online platforms. Several of these substances exhibit cooling and numbing properties that can alleviate pain. Certain contemporary creams incorporate cannabidiol (CBD) as an active ingredient. Studies conducted on CBD ointments and creams have demonstrated their efficacy in the management of post-spinal surgery back pain.
  • It is worth considering alternative therapies. Acupuncture, massage therapy, laser therapy, and electrical nerve stimulation have demonstrated significant efficacy in the management of chronic back and hip pain. It is advisable to consult with your healthcare provider in order to ascertain which alternative therapies may be beneficial for your specific needs.
  • It is advisable to modify one’s dietary choices, as the consumption of foods known to possess inflammatory properties may potentially contribute to heightened discomfort in the back and hip regions. This encompasses substances such as trans fats, refined sugars, and processed foods. It is advisable to consult with a healthcare professional in order to determine whether dietary modifications may potentially alleviate symptoms of hip and back pain. Maintaining an optimal body weight may potentially yield benefits in alleviating back and hip discomfort, as it has the potential to mitigate spinal pressure.

Summary 

Low-back and hip pain are frequently encountered issues. The occurrence of back and hip pain can be attributed to the fact that the back muscles and spine bear a significant portion of the body’s weight during various activities such as walking, standing, and sitting.

Back and hip pain can arise from various factors, such as injuries, arthritis, inadequate posture, or repetitive strain on the lumbar region. Certain factors contributing to low-back and hip pain are unique to individuals assigned female at birth, encompassing conditions such as pregnancy, premenstrual syndrome (PMS), endometriosis, and dysmenorrhea.

Chronic back pain is defined as lasting for a duration of three months or longer. Chronic back pain has the potential to induce supplementary symptoms, such as pain in the hip, leg, and buttock regions. The occurrence of back and hip pain commonly manifests unilaterally, although it is plausible for individuals to experience pain that extends across the entirety of the lumbar region and impacts both hip joints.

Low-back and hip pain can be effectively managed through the implementation of lifestyle modifications and self-care strategies. Healthcare providers have the ability to prescribe supplementary therapies that can assist individuals in effectively managing the root causes of their condition and addressing intense pain. The utilization of surgical interventions for the treatment of back and hip pain is infrequently warranted.

It is advisable to seek consultation with a healthcare professional in the event that there is no improvement or a worsening of back and hip pain. It is advisable to promptly seek urgent medical attention for the manifestation of back and hip pain accompanied by leg weakness, saddle anesthesia, and incontinence. The following manifestations are indicative of cauda equina syndrome, a condition that necessitates immediate medical attention.