Hip, spine? Where is the pain coming from?

For Dr. Gomez | Jan. 2, 2019

If you have been referred to a specialist for your hip or back pain, it is likely that pinpointing the source of your pain may take some time, and you’re not alone. Pain that seems to be in both the hip and spine is a common complaint, so much so it is sometimes referred to as “hip-spine syndrome.” (published site)

The challenge of differentiating between pain that originates in the hip from that which starts in the spine is the subject of a recent article in the journal of the American Academy of Orthopaedic Surgeons. In it the authors outline the sometimes extensive steps needed to ensure correct diagnosis and treatment.

The nature of pain is that it is both subjective, meaning you are the only one who knows where it hurts and how much it hurts, and it often radiates from one point through the nervous system to affect another place, resulting in overlapping or mixed symptoms.

If your pain occurs in the groin, or when putting on your shoes or getting in and out of a car is usually associated with a hip condition. Pain or tingling sensations in the buttocks or back most likely originate in the spine. Patients with mixed hip-spine syndrome, however have pain with no clear source of the discomfort.

Some conditions, like arthritis in the hip can cause pressure on the lower back resulting pain that feels like it is in the spine. Other conditions that can cause mixed pain signals include hip stress fractures, osteonecrosis or a blocked blood flow to the hip, a tear in the ligament or tendons of the hip, a herniated disc, pinched nerves, or narrowed spinal canal (stenosis) all can cause pain that can produce pain that radiates out to other parts of the body and may not be obvious on standard imaging.

So, if your specialist orders advanced imaging studies, asks you for a detailed health history including previous surgeries, gives you another comprehensive physical examination, he or she is following the recommended guidelines. The recommendations also include physical tests such as gait a walking assessment, hip and back range-of-motion tests together with an evaluation of posture, spinal alignment, muscle loss (atrophy), and limb measurements.

The goal is to eliminate as much as possible the risk of misdiagnosis by focusing on both spine and hip issues and to maximize the chances that your treatment will succeed in providing you with the best possible outcome for you.

At the Offices of Dr. Michael E. Gomez, we take an integrated approach working with partners in specialized physical therapy and other specialists in low back pain to fully explore and pinpoint the exact cause of your pain. Our foremost concern is that you get the best treatment for your condition, your lifestyle and your preferences.

We are happy to review your MRI and discuss your options and answer all your questions to ensure you get the best treatment for you. For more information contact us at: 786 456-4152 or mailto:office@DrMichaelGomez.com.