People who suffer from chronic Hip and buttock pain often believe that lower back disc bulging issues or simple arthritis is the cause of their problem. Indeed this can be correct in many cases. This week I will discuss a case of a Patient with common symptoms of Hip and Groin pain and explain what is causing them. The Patient’s job involves long periods of standing and driving. Although his lower back has been stiff and achy over the past year, he has started to experience pain into his left buttock and hip region.
Signs & Symptoms that he experiences:
Occasional sharp shooting pain into his left buttock
Stiffness & Soreness in his lower back
Occasional referral of sharp shooting pain down the outside of left leg & back of his thigh area
Can experience twinges of a dart of pain in his lower back when lifting items from his car.
Occasionally experiences a weakness in his left leg.
Buttock and hip pain are aggravated by bending down to lift bags and sometimes when driving.
He cannot sleep comfortably on his left side at night due to pain.
So what is causing the shooting pain into Hip & buttock?
Sharp shooting pain commonly points to nerve root impingement and possible Disc Herniation. Giving the presence of the long-term long back stiffness & soreness that the patient has experienced we can assume that the nature of job has caused Disc bulging in his lower back possibly at the L2-L4 vertebrae blocks. The disc is subsequently bulging to the left side and pressing on a nerve root causing pain into the buttock and into the Hip region. It is important for the Physical therapist to examine for Sacroiliac Joint Dysfunction and Osteoarthritis changes to the Hip joint as these can mimic some of the symptoms mentioned in this case.
Treatment & Management
The goal of treating these symptoms is to stop the bulging disc from pressing on nerve root and hence preventing the referral pain into left hip and outside buttock region. This can be achieved through physical therapy techniques such as Traction and slow graded mobilizations so that painful lumbar spinal movement restrictions are mobilized to painfree full movement. Advice & education on Painfree standing, lifting and sitting postures are necessary in order to take pressure away from the Disc bulge. A program of stretching & strengthening of the lumbar and pelvic muscles are then necessary for prevention of hip and buttock pain.
Next week I will discuss problems of the groin region.
Tomás Ryan is a Registered Physical Therapist with The Irish Association of Physical Therapy and is based in Thurles.
Contact Number: 0504 26672
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Injury Solutions Clinic
Physiotherapy & Injury Rehabilitation Clinic in Tipperary