Left Lower Back and Hip Pain: Causes and Solutions

Q: Left Lower Back and Hip Pain: Causes and Solutions

Hello Ms. <br>KOKO： You mentioned that after doing squats with an empty barbell, you felt some discomfort in your lower back. <br>Upon returning home and resting, you found that even walking caused pain. <br>After a night of rest, you felt slightly better, but the next day, even

Left lumbar and hip pain?

Hello doctor, I have been experiencing lower back pain for the past ten years due to sitting for long periods during exams and suddenly lifting heavy objects.
Since then, my back occasionally hurts, and I need to stretch it.
Typically, it takes about a month to recover, and I can go several months without pain.
However, in April of this year, after sitting cross-legged on the floor using a tatami bed as a desk for two hours, I stood up and found my back in severe pain, especially after sitting for long periods at work.
The pain radiates from my lower back to my hip.
I have consulted several traditional Chinese medicine and Western medicine practitioners.
Some rehabilitation doctors said it was due to tight fascia, while others mentioned slight anterior pelvic tilt.
After two months of treatment, I finally found some relief.
A few weeks ago, I went to exercise and felt some discomfort in my lower back while doing squats with just the barbell.
When I returned home and rested, I found that even walking caused pain.
After a night of rest, I felt slightly better, but the next day, even sneezing caused pain, and I couldn't bend down on my left side.
I am currently continuing with stretching exercises, but I really can't figure out the cause.
I would like to ask what I should do to improve my condition.

KOKO, 20~29 year old female. Ask Date: 2022/08/31

Dr. Jiang Junyi reply Neurology

Hello Ms.
KOKO: You mentioned that after doing squats with an empty barbell, you felt some discomfort in your lower back.
Upon returning home and resting, you found that even walking caused pain.
After a night of rest, you felt slightly better, but the next day, even sneezing caused pain.
Your symptoms may suggest a lumbar disc herniation, which could be compressing a nerve root.
This condition occurs due to a decrease in the elasticity and cushioning ability of the intervertebral disc's nucleus pulposus, causing it to protrude through fissures in the annulus fibrosus, or even to extrude beyond the fibrous layer.
The spine is subjected to repetitive stress, particularly from abnormal pressures such as bending to lift objects or prolonged bending and twisting during work, which can lead to disc herniation.
Disc herniation can also result from acute injuries, such as sudden twisting, bending to lift heavy objects, or excessive force from incidents like falling from a ladder or landing directly on the spine.
For nerve repair, it is recommended to supplement with B vitamins.
Most patients are advised to undergo at least six weeks of non-surgical treatment.
Physical therapy can help strengthen the back muscles and improve spinal flexibility and stability.
Rest or limited activity followed by a gradual return to activity can alleviate symptoms.
If pain persists for more than six months without improvement, surgery may be considered.
Thank you for your inquiry, and I encourage further discussion.
I recommend consulting with a rehabilitation specialist or a neurosurgeon for evaluation and treatment.
Wishing you good health and peace.
Dr.
Jiang Junyi, Department of Neurology, Taoyuan Hospital.

Reply Date: 2022/08/31

More Info

Understanding left lower back and hip pain can be quite complex, especially given your history of intermittent pain over the past decade. Your symptoms suggest a multifactorial issue that may involve muscular, skeletal, and possibly neurological components.

From your description, it seems that your pain began after prolonged sitting and lifting heavy objects, which is a common trigger for lower back pain. This can lead to muscle strain, ligament sprains, or even more serious conditions like herniated discs. The fact that your pain radiates from the lower back to the hip area indicates that there may be involvement of the lumbar spine or the sacroiliac joint, which connects the lower spine to the pelvis.

The mention of tight fascia and slight pelvic tilt by various healthcare providers suggests that your pain may also be related to muscular imbalances or postural issues. Tightness in the fascia can restrict movement and lead to pain, while pelvic tilt can affect the alignment of your spine and hips, potentially exacerbating your symptoms.

Your recent experience with squatting and subsequent pain could indicate that your core muscles and stabilizers are not adequately supporting your spine during physical activity. This is particularly important when performing exercises like squats, where proper form and core engagement are crucial to prevent injury.

Given that you have already consulted various healthcare professionals, including traditional Chinese medicine practitioners and rehabilitation specialists, it may be beneficial to consider a comprehensive approach to your treatment. Here are some recommendations:
1. Physical Therapy: Engaging in a structured physical therapy program can help strengthen your core and back muscles, improve flexibility, and address any postural issues. A physical therapist can provide tailored exercises that focus on your specific needs.

2. Core Strengthening: Focus on exercises that strengthen your core muscles, such as planks, bridges, and pelvic tilts. A strong core provides better support for your spine and can help alleviate pain.

3. Stretching and Flexibility: Continue with your stretching routine, but ensure that you are targeting not only the lower back but also the hip flexors, hamstrings, and glutes. Tightness in these areas can contribute to lower back pain.

4. Ergonomics: Evaluate your workspace and sitting posture. Ensure that your chair provides adequate lumbar support and that your workstation is set up to promote good posture. Taking regular breaks to stand and stretch can also help.

5. Pain Management: If your pain persists, consider discussing pain management options with your healthcare provider. This may include non-steroidal anti-inflammatory drugs (NSAIDs) or other medications to help manage your symptoms.

6. Alternative Therapies: Some patients find relief through acupuncture, chiropractic care, or massage therapy. These modalities can help alleviate muscle tension and improve circulation.

7. Gradual Return to Activity: When returning to physical activities, especially weightlifting or squatting, start with lighter weights and focus on form. Gradually increase the intensity as your strength and confidence improve.

8. Consultation with a Specialist: If your pain continues despite conservative measures, consider seeking a consultation with an orthopedic specialist or a spine specialist. They may recommend imaging studies, such as an MRI, to rule out any structural issues like herniated discs or spinal stenosis.

In conclusion, managing left lower back and hip pain often requires a multifaceted approach that includes physical therapy, strengthening exercises, ergonomic adjustments, and possibly medical interventions. It’s important to listen to your body and avoid activities that exacerbate your pain. With the right treatment plan, you can work towards alleviating your symptoms and improving your quality of life.

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