Understanding lower back anatomy is key to understanding the root of lower back and hip pain. The human spine is composed of 4 sections of vertebrae. These sections are cervical (neck), thoracic (upper and middle back), lumbar (lower back), and sacrum (tailbone). The lumbar and sacrum region make up the bone of the lower back anatomy. The spinal cord is contained within the spine's vertebrae, running through the vertebral foramen and branching out to the peripheries through the intervertebral foramen. Lower back muscle anatomy includes the Multifidus, Longissimus, Spinalis, and Quadratus Lumborum. The muscles of the low back work together with the transverse abdominal muscles to increase intra-abdominal pressure. The pelvic floor muscles also help increase this pressure, which provides stability to the spine and trunk. Common hip and back pain causes include injury to muscles from overuse, disc injury/degeneration, or spinal stenosis. To learn more about the lower back anatomy of the spine, please watch this video
Muscle injuries of the lower back are commonly caused by an improper lift, lifting while twisting, or a sudden movement or fall, which may cause lower back pain. The multifidus muscle keeps the back straight and stable. Multifidus issues usually lead to other problems due to improper recruitment of other muscles to avoid pain. Signs that a muscle might be injured include sudden onset of pain, soreness, limited range of motion, swelling, muscle spasms, stiffness, and weakness. Muscle injuries may also occur due to prolonged improper posture, such as a forward flexed posture, which stretches out the back muscles. So always be aware of the positioning of your lower back anatomy. Proper lifting procedures and keeping a proper posture will reduce pressure to the hip and lower back structures and musculature. In Physical Therapy, a therapist will determine if you need to stretch the lower back muscles and other muscles such as the piriformis or hamstrings.
Another common cause of lower back and hip pain is disc injury. A disk injury such as a disc herniation would be similar to the jelly filling of a donut pushing out the side. This “jelly filling” may press on a nerve and cause either muscular weakness or discomfort, such as sciatica. Degenerative Disc Disease, or DDD, may also lead to the lower back and hip pain. This is basically where the disk shrinks and decreases the space between each vertebrae. This may lead to arthritis in the spine. Bone spurs and nerve compression may result from degenerative changes.
Lower back and hip pain may also be caused by stenosis in the spine. Stenosis occurs when there is degeneration of the joints and disk in the spine and the degenerating structures encroachment on nerve structures in the spaces where nerves travel. This may lead to possible nerve compression. A patient may experience radiating pain and tingling down the legs and localized hip and back pain. Some patients may find relief with flexion exercises, reducing the pressure on the nerve structure being compressed.
True muscle strains (pulled muscles) are rare. Most muscle pain in the lower back is due to muscle spasms from other Lumbar spine injuries. Disk injuries are more likely. If there is muscular pain, consider trying a warm shower or even an ice pack initially. Gentle movement exercises may help, such as lying on the back, bending both knees, and gently rotating them together to each side, without pushing into pain. Start with 5 to 10 reps. Gentle yoga may be helpful once the acute symptoms improve.
Much of the time, Pain in the lower back is better in standing. If your pain decreases with standing, a light walk may also be beneficial. It is best to start with a short distance and see how the pain responds. Sometimes, inflammation and pain increase several hours after an activity. So, it is best not to overdo it initially, even if there is no initial increase in pain. If pain increases in standing, it would be best to consult a physician or physical therapist before beginning a walking program.
Yoga can be a helpful form of exercise to improve muscles' strength and flexibility in the lower back. It is important to start slow and not push into positions that increase pain in the lower back. Some yoga poses may irritate symptoms. If you have low back pain, it may be necessary to consult a physical therapist before beginning a yoga exercise program.
Yoga has other benefits, as well. Yoga can help with focus, relaxation, and balance.
Pilates is a beneficial form of exercise for increasing control and strength in the lower back muscles. Pilates engages core muscles and increases strength throughout the movements of the body. As with yoga, in Pilates, you should start slow and work up to increase difficulty levels. A skilled instructor is helpful when beginning a Pilates program. If you have low back pain, consulting a physical therapist may be helpful before beginning a Pilates program.
Typically, back pain is caused by structures in the back. There are rare cases when pain in the back can be a symptom of another part of the body. Pain from cancer typically presents differently than pain from structures in the lower back. Consider the following:
These are signs that you should consult a medical professional to evaluate to determine whether the pain is mechanical, such as DDD (degenerative disc disease), systemic, such as rheumatoid arthritis, or something more sinister.
Low back pain can be caused by muscle strains, disc injury/degeneration, spinal stenosis, and many other structural sources in the Lumbar Spine. The quick answer is to follow these spine tips to keep your lower back healthy. If the lower back and hip pain persists, or it feels like there is a pinched nerve in the hip or leg, it is advised that you see a medical professional to determine the best course of treatment specific to your diagnosis and condition.
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