Is it my hip or is it my back, Doc?
We get this type of question all the time. In the world of musculo-skeletal medicine you cannot speak of the low back without talking about the hip, and vice versa. These two structures are intimately intertwined and work together in all facets of locomotion.
Often, patients will come to us after having an invasive mid level procedure such as an epidural steroid injection into the hip or back with little to no relief. We also have patients who have MRIs with positive findings for hip pain, but realize after extensive therapy and medical intervention their pain is emanating from their back.
The Relationship of The Low Back and Hip in Pain Generation
The point is as a manual medicine practitioner you have to look at the big picture. The dynamics of the lumbo-pelvic spine are such that several muscles, tendons, ligaments, nerves, and bone structures work to perform movement patterns.
An injury/infarction to one portion of this structure can have implications on structure either above or below the injury. How the body moves and reacts to the asymmetry will help you understand where the problem is emanating from and ultimately facilitate the healing process.
As an Active Release Technique Certified Chiropractor in Manhattan, we have been trained to observe movement patterns and look for malfunctions. An example of some of the hip structures we examine and palpate with an injury can include:
- Psoas
- Illiacus
- Quadratus lumborum
- Lumbar paraspinal
- Multifidi
- Rotatore
- Gluteus Maximus
- Gluteus Medius
- Gluteal Minimus
- Piriformis
- Gemelli
- Sacro-tuberous ligament
- Dorsal Sacral Ligament
- Hamstring
Having years of experience observing, palpating, and treating these structures gives the patient the best chance that they will be accurately diagnosed and ultimately treated for their injury.
Here at The Center For Spine Care and Mobility we have integrated multiple soft tissue specialists who each focus on a specific part of the patients rehabilitation. The Chiropractor for example will lengthen tight stuck tissue, and focus on alignment while the physical therapist will strengthen weak, facilitated tissue.
The patient might also benefit from soft tissue massage, acupuncture, or trigger point therapy as an additional service. Having the ability to combine modalities in one space at the same time gives our patients the best chance to heal in the shortest amount of time. The end goal being a correction of postural asymmetry and a return to activities of daily living pain free. If this is something you are suffering from feel free to contact us for an evaluation.
