During my experience, a 40-year-old middle-aged male patient came to my office with persistent low back pain. He described worsening lower back pain for several months, initially suspected to be caused by prolonged sitting and poor lifestyle habits. However, after detailed inquiries and a series of examinations, I found that the problem was not just in the lower back. In fact, the patient's hip muscles were significantly tense and weakened, a condition known in medicine as a "hidden pain point" that is often overlooked, but is an important cause of low back pain.
Low back pain may be a non-lumbar cause
Buttock muscle problems
Muscle tension and weakening: Tension or weakening of the gluteus medius may lead to abnormal pelvic position, which in turn increases the burden on the lumbar spine and triggers low back pain. Sciatica: Tight hip muscles such as the piriformis muscle can compress the sciatic nerve, causing pain to radiate to the lower back and lower extremities. Weakening of abdominal muscles and instability of core muscles: Weakening of abdominal muscles leads to a decrease in core support, which cannot effectively support and protect the spine and increase the burden on the lower back. Unbalanced legs with unequal leg lengths: Inconsistent leg lengths can lead to pelvic tilt, which can adversely affect the lower back in the long term. Foot problems: Structural problems such as flat feet can change the walking posture and indirectly cause low back pain. Visceral disease Kidney disease: such as kidney stones or kidney infection, pain may radiate to the lower back. Digestive problems: Gastrointestinal disorders can also cause lower back pain. Psychological factors stress and anxiety: Long-term psychological stress and anxiety can cause muscle tension in the body, including the lower back and peripheral muscles, causing or aggravating low back pain.
Understanding these potential non-lumbar causes can help us diagnose and treat low back pain more holistically, preventing misdiagnosis and missed diagnoses, and thus providing patients with more effective treatment options. In the following sections, we will explore the specific effects of these factors and their prevention and treatment strategies. Common Neglected Causes: Hip ProblemsHip ArthritisHip arthritis, including osteoarthritis or rheumatoid arthritis, indirectly burdens the lower back by changing the way you walk and your posture. Ischemia of the femoral headThe lack of blood supply to the femoral head can lead to joint pain, and the patient may unconsciously change his or her walking posture to relieve the pain, which may cause muscle tension in the lower back in the long run. Hip dysplasia, such as developmental hip dysplasia (DDH), is congenital or developmental and can lead to pelvic imbalance, which in turn can lead to low back pain. Strain and overuseThe muscles and tendons around the hip joint can be strained by repeated or overuse, such as hip strain, which is common in runners and ball players, and can affect the lower back through muscle tension.
Soft tissue injuries of the hip
Injuries such as tendonitis or bursitis around the hip joint can also cause pain and indirectly lead to lower back pain through postural changes. Prevention and management in daily life recommends exercising to strengthen the core muscles: perform regular core stability exercises, such as Pilates and yoga, to strengthen the abdominal and back muscles. Hip strengthening: Includes hip extension and strengthening exercises, such as hip bridges and lateral leg raises, that help improve the strength and flexibility of the hip muscles. Improve lifestyle habits to avoid staying in the same position for long periods of time: change standing or sitting positions regularly and stand up every 30 minutes. Pay attention to sitting and standing postures: Keep your spine neutral and avoid bending over or twisting your body for long periods of time. Use an ergonomic chair with the appropriate tools: Choose a chair that supports the lumbar body, especially for people who need to sit for long periods of time. Wear appropriate footwear: Wear well-supported shoes, especially when standing or walking for long periods of time. Regular assessment and treatment
Regular check-ups: Have regular health assessments of the hip and spine, especially if there is a history of low back pain or hip pain. Seek physical therapy: If you have hip or low back pain, consider physical therapy to improve symptoms and function. Mental health management stress reduction methods: Adopt effective stress management techniques, such as meditation, deep breathing, or listening to music, to help reduce physical tension caused by stress. By implementing these strategies, you can not only reduce low back pain caused by hip problems, but also improve your overall health and enhance your quality of life. In the next section, we will discuss how to address low back pain caused by the hip joint through specific treatments.