Potential Causes Of Pain Radiating From Hip To Knee

Most hip pain is caused from overworking the muscles either by repetitive stress or overdoing exercises. The pain is caused by inflammation of the soft tissues and tendons of the hip. Usually this pain is relieved in a few days. Prolonged hip pain can be the cause of a specific condition. When the hip joint is injured, pain can be felt in the groin all the way down to the knee. Sometimes knee pain is the only sign that the hip is injured this is called referred pain.

A slipped lumbar disc in your lower back can also cause pain that is felt in your hip. With a lumbar disc injury, your knee and leg may also feel weak. Spinal stenosis is the narrowing of your spinal cord and nerves, which can cause isolated hip pain felt along with a numb feeling in the knees and legs. A sprain in your lower back, or a lumbosacral sprain, is an injury to the ligaments in your lower back. Pain from this injury accumulates to one side of the spine around the hip, making it difficult to bend or twist.

All these hip pain causes can be treated with conservative, therapeutic treatments.

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Lower Back Pain Causes

Most low back pain is due to a disruption in the way the spine, muscles, discs, and nerves fit together and move. Some mechanical causes of low back pain include:

Congenital

• Skeletal Irregularities: scoliosis , lordosis , kyphosis , etc.
• Spina Bifida: the incomplete development of the spinal cord or its protective covering.

Injuries

• Traumatic Injury: sports accidents, car accidents, or falls.

Degenerative Problems

• Intervertebral Disc Degeneration: spinal discs wear down from aging, causing them to lose their natural cushion.
• Spondylosis: general spinal degeneration from aging. This issue affects the joints, discs, and bones of the spine.
• Arthritis and Other Inflammatory Diseases:osteoarthritis, rheumatoid arthritis, spondylitis, etc.

Nerve and Spinal Cord Problems:

Non-spine Pain Sources:

• Kidney Stones: sharp lower back pain, usually on one side.
• Endometriosis: the buildup of uterine tissue outside the uterus.
• Fibromyalgia: a chronic pain syndrome causing muscle pain and fatigue.
• Tumors: tumors can press on or destroy the spinal cord and nerves.
• Pregnancy: lower back pain usually begins in later stages of pregnancy, and is resolved after birth.

When The Spine Is The Likely Culprit

Most lower spine problems are caused by a herniated disk that presses on nerves in the spinal column. This produces the pain known as sciatica, which can be felt in the hip. You may have a herniated disk if pain:

• Is limited to your back, buttocks or hip.
• Shoots down your leg.
• Worsens with sitting or bending.
• Improves when standing or walking.

If you have night sweats, ahistory of cancer, or pain that is not relieved by lying down ,see your doctor the problem may be more serious.

Some people develop whatDr. DeMicco calls a double whammy problems in both the hip and lower back.Its not surprising, since both osteoarthritis and spinal changes are morecommon with each passing decade, he explains.

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Pain In Hip Down To Knee

Hip pain that radiates down to the knee can be very uncomfortable. Your knee and hip joints are the largest joints in your body they support your bodys weight and they work together to give you the mobility that is sometimes taken for granted.

The hip is a ball-and-socket joint that helps you move your legs with a wide variety of motions that you use throughout the day, like going up and down stairs. It has a wide range of motion and is very stable if the knee joint works properly. The joint, which sits atop the femur, is called the femoral head, and the socket created by the hollow of your pelvis is called the acetabulum. Surrounding the joint is the fibrous capsule sleeve that holds the bones together.

The knee is an incredibly complex joint that goes through a tremendous range of motion. It has many muscles that cross the knee joint to help control its movement while walking, running, squatting, or going up and down stairs. All of this movement occurs while supporting your body weight. The internal components of the knee include several strong ligament structures that prevent excessive shearing motions. Likewise, we have several strong muscles that cross the outside of the knee joint including the quadriceps, hamstrings, and gastrocnemius muscles.

What Treatments Are Available

Nonsurgical treatments: Physical therapy, chiropractic manipulation, and stretching exercises help many patients. Some patients may require oral anti-inflammatory medications or topical patches, creams, salves or mechanical bracing.

Joint injections: Steroids can reduce the swelling and inflammation of the nerves. Joint injections are a minimally invasive procedure that involves an injection of a corticosteroid and an analgesic-numbing agent into the painful joint . While the results tend to be temporary, if the injections are helpful they can be repeated up to three times a year.

Nerve ablations: Injections into joints or nerves are sometimes called âblocks.â Successful SI joint injections may indicate that you could benefit from radiofrequency ablation ââ¬â a procedure that uses an electrical current to destroy the nerve fibers carrying pain signals in the joint.

Surgery: If nonsurgical treatments and joint injections do not provide pain relief, your physician may recommend minimally invasive SI joint fusion surgery. Through a small incision, the surgeon places titanium implants and bone graft material to stabilize the joint and promote bone growth. The surgery takes about an hour. The patient may go home the same day or following day. For several weeks after surgery, the patient cannot bear full weight on the operated side and must use crutches for support.

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What Are The Symptoms

The signs and symptoms of SI pain start in the lower back and buttock, and may radiate to the lower hip, groin or upper thigh. While the pain is usually one sided, it can occur on both sides. Patients may also experience numbness or tingling in the leg or a feeling of weakness in the leg.

Symptoms may worsen with sitting, standing, sleeping, walking or climbing stairs. Often the SI joint is painful sitting or sleeping on the affected side. Some people have difficulty riding in a car or standing, sitting or walking too long. Pain can be worse with transitional movements , standing on one leg or climbing stairs.

Many People Come In With A Tilted Pelvis However For Many Of These Patients That Is Not What Is Causing Their Pain

In this brief video Danielle R. Steilen-Matias, MMS, PA-C. Caring Medical Florida explains.

The summary transcript:

• What is interesting about the diagnosis of the tilted pelvis is that we see a lot of patients without that diagnosis and they in fact do have a tilted pelvis. So the question is, is the tilted pelvis the cause of their hip and back pain or not?

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The Varieties Of Lower Back And Hip Pain

When X-rays and MRIs come back negative, a physician without adequate training in the musculoskeletal system may not know what to prescribe other than physical therapy exercises.

The problem with this strategy is that PT can aggravate certain conditions. I’ll go into this in more detail with each of the conditions listed below.

The most frequent regions of pain I hear reports about include

Often lower back and hip pain can present as a kind of moving target. Sometimes the pain is centered squarely on the outside of the hip joint near the hip bone.

Other times the pain can wrap around to the gluteal muscles. At times an individual might experience pain in more than one area.

The reason for this medley of possibilities is that muscular compensation is often at the heart of lower back and hip pain.

Further, muscular compensation is a continual process in which muscles are constantly adjusting, trying to figure out how to make do with the circumstances they’re presented with such as postural distortion.

Organs Located Near Or Above The Right Hip

Knowing what organs are located near your right hip bone can sometimes help to diagnose the cause of pain above your hip. The lower right abdomen is also referred to as the right lower quadrant .

Dr. Jacquline Payne on Patient.info explains that your RLQ is the right side your abdomen between your belly button and waistline. Organs that are in your lower right abdomen near or above your right hip include:1

• A large part of your colon. Inflammation or infection of your digestive system can cause RLQ pain that can feel as if you have a sore right hip. A buildup of gas or stool can also cause severe lower abdominal cramping pain.
• Appendix. Sharp squeezing pains above your right hip are often caused by appendicitis if the small organ becomes inflamed and infected.
• The right kidney. Your right kidney is located in your middle back. However, a kidney infection or kidney stones can cause intense pain to spread through your lower right abdomen.
• The right fallopian tube and right ovary. Issues connected to a womans reproductive system often just affect one or the other side of the pelvic area. This can also cause lower back pain in women or cramping abdominal pain.

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Summary And Contact Us Can We Help You

The hip joint joins the leg to the pelvis. Unfortunately for most people, both legs are not exactly the same. They may look the same, but from a biomechanical standpoint, they are not the same. One leg may be rotated either in or out, or one leg may be shorter than the other. The shorter leg is especially common if one leg was broken during childhood. Because the hip joint connects the leg to the pelvis, the hip joint will sustain the brunt of any biomechanical abnormality that may occur. If one leg is shorter than the other, the hip joints will be stressed because the leg-length discrepancy causes an abnormal gait. The gait cycle is most efficient when the iliac crests are level. Unequal leg lengths cause the pelvis to move abnormally. This is evidenced by the waddling gait of someone with a hip problem. This waddling gait helps remove pressure on the painful hip.

We hope you found this article informative and it helped answer many of the questions you may have surrounding your leg length discrepancy, pelvic tilt, pelvic incidence-lumbar lordosis mismatch, and walking difficulties challenges. If you would like to get more information specific to your challenges please email us: Get help and information from our Caring Medical staff

References

This article was updated September 3, 2022

What Are We Seeing In This Image A Lot Of Tilt

In this image, we see an x-ray of a patient. The x-ray is of Dr. Ross Hausers pelvic tilt. Dr. Hauser suffered from the sudden and acute onset of lower back pain on his left side. He also displayed symptoms of sciatica. The x-ray revealed on his left side a decrease in the distance from the ischial tuberosity to the top of the iliac crest. This means that there would be an increase in tilt between the left and right sides. This is displayed in the increase in distance from the sacroiliac joint to the midline compared to the right side. For Dr. Hauser, Prolotherapy treatments to his left iliolumbar, sacroiliac, and sacrotuberous ligaments resolved his pain and pelvic distortions.

With leg-length discrepancy, either hip joint can cause pain, and usually both hip joints hurt to some degree. To propel the leg forward, the hip joint must be raised which strains the gluteus medius muscle and connective tendons and the posterior hip ligaments. Leg-length problems are also associated with recurrent lower back problems because they cause the pelvis to be asymmetric.

Whether it is a low back problem, pubis problem, pelvic floor, or hip problem, leg length discrepancy can cause significant and disabling problems down the road.

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Mononeuropathies Of The Leg

Mononeuropathies can affect nerves in the legs, arms, or other parts of the body. Mononeuropathy means a single nerve or nerve group has been damaged, for example, by a lesion that has developed along a nerve or group of nerves. Carpal tunnel syndrome is a good example of a mononeuropathy, in this case, affecting the wrist area. With mononeuropathy symptoms may be sudden or may develop slowly . Some of the more common mononeuropathies are

• femoral neuropathy
• sciatic nerve dysfunction
• peroneal neuropathy .
• tibial neuropathy .

Symptoms of the neuropathies above would include burning sensation in leg areas where these nerves are housed as well as lack of coordination of these leg muscles. Other symptoms include muscle wasting, pain, and twitching, cramps, and spasms in these nerves. Treatment focuses on isolating the underlying cause of the nerve disorder and addressing it using medications such as injected glucocorticoids and/or physical

Sciatica Or Other Back Pain

Up to 85% of Americans experience some type of back pain during their lives. But this doesn’t always involve the sciatic nerve. In many cases, back pain is the result of overextending or straining the muscles in the lower back. What most often sets sciatica apart is the way the pain radiates down the leg and into the foot. It may feel like a bad leg cramp that lasts for days.

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Kidney Disease Kidney Failure Advanced Kidney Infection

Kidney pain, kidney stones, kidney failure, and advanced kidney infections can cause radiating lower back pain, especially pain that affects the lowest ribs in the back and higher buttock area. Kidney issues can also cause pain in the groin area and difficulty urinating. Groin pain in women, especially pregnant women, is a special concern and the patient should be taken to the ER immediately. If you think a kidney issue is causing your back pain, get to an ERâbecause once a kidney issue is advanced enough to cause back pain, it is usually quite serious.

What Causes Lower Right Back Pain What Is Lower Right Back Pain A Symptom Of

Causes of lower right back pain can be divided into two categories: mechanical problems and underlying conditions. Mechanical problems have to do with the bones and tissues in your back your ligaments, spine, tendons and muscles. Underlying conditions are disorders of your organs. Pain from conditions that affect your organs can radiate to your back.

Mechanical problems:

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Herniated Disk In The Lower Back

A herniated, ruptured, or “slipped” disc means that a vertebral disc one of the soft pads of tissue that sit between each of the vertebral bones has becomes squeezed out of shape. Its cushioning material has been forced against, and possibly through, the ring of fibrous tissue that normally contains it. This causes pain, numbness, and weakness in the legs.

The normal aging process causes the discs lose moisture and become thinner, making them more vulnerable to “slipping.”

Most susceptible are men from ages 30 to 50. Smoking, obesity, lack of exercise, and improper lifting are also risk factors.

Symptoms include pain, weakness, numbness, and tingling in the back, leg, and foot.

Diagnosis is made through patient history, neurological examination, and MRI scan.

Treatment begins with rest, nonsteroidal anti-inflammatory drugs, physical therapy, and sometimes epidural steroid injections into the back to ease pain and inflammation.

Surgery to remove the herniated part of the disc the part that was squeezed out of place can also be helpful.

Rarity: Common

Top Symptoms: lower back pain, moderate back pain, back pain that shoots down the leg, back pain that gets worse when sitting, leg weakness

Urgency: Primary care doctor

Early And Correct Diagnosis Is Key

When seeing a physician for hip or lower back pain, imaging such as x-rays and MRIs are usually conducted at the sight of the symptoms. Yet, these studies can sometimes show abnormalities that are not actually the root cause of the pain. Let me share a quick example.

A fifty-year-old gentleman had severe pain in the outside of his hip. He saw a physician and had an x-ray of the hip area performed. It was determined that he had mild arthritis in the hip, but the arthritis should not have caused the extensive symptoms he was enduring.

So, he started physical therapy for a period of time and saw no improvement. He then received a cortisone shot in the hip, and that didnt work either. His treatment plan moved on to a stem cell injection with platelet rich plasma in the hip, which also offered no improvement to his symptoms.

This mans symptoms started in April and proceeded to get worse and worse to the point that he was in a wheelchair when he came to the OrthoVirginia office in August. I looked over his symptoms and decided to have a MRI performed on his lower back, even though he had absolutely zero pain coming from his lumbar spine.

It turned out that the L3 and L4 nerves in his back were being compressed, and the symptoms were appearing in his hip. A minimally invasive surgery was performed, and his pain was gone immediately.

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