Back Pain Vs. Hip Pain

Q: you have had plenty of back pain over the years. Today I leaned forward to shave and WHAM. My back went out -- SEVERE pain and I am in bed with my laptop for company. What a damn way to start of 2009! But, could this be hip pain? How can you tell. This is very far down, just above the right buttock. If I put my right hand on my right hip and bend to the right it isn't to bad. Can someone descible the location of right hip pain?

A: The area you are describing sounds like sacral (sacroiliac). It would be approximately mid buttock. Having said that, it would be easy to confuse hip and back pain, but given the onset of your symptoms, I think (in my non-medical opinion) that it is more likely your back. Hip pain can occur along the side of the hip if the trocanter area is involved or in the case of bursitis. There may also be pain along the front of the hip. With arthritis in the hip the pain is more commonly described as being in the groin area. A description of pain in the groin is usually what doctors look for in making a determination about whether or not there is arthritis damage in the hip. I have had several doctors tell it is both. So I am not much help. When I get the mid pain in the buttocks, they feel around for the hip joint and tell me it is the hips. other times I have had them tell me it is the lower back because I have DDD in the lower back. So really not sure which is which but i feel for you and hope it heals quickly for you. I had to stay in bed one month one year because I through out my back and that is where it was. It was the worse I ever threw out my back at all. I had a back brace on, and my one son would have to come up behind me and hold my back with the back brace on, so I could get up from a laying position to get up and out of bed so I could go to bathroom. I couldn't move at all without his help to get out of bed. Once out of bed the back brace was enough to keep me up and moving. Ice if you can handle ice. Then after a few days, heat. Watch your movements, your back is now in a weaken condition. If you have to cough or sneeze back up to a wall so you don't pull the back out more. Do not try to bend forward right now - your back is telling you something. Start with ice. 5 minutes on, 5 minutes off. Try not to spend all the time in bed - take gentle walks for a few steps. Then when lying down try to have something under your knees. If you think you can handle it gently (as in probably 3 times), put your legs in a bent position, feet on the bed. Then gently again keep your hips in the same spot, pelvic tilt and then slowly keeping knees together go to the right gently and slowly only until just before the pain area. Then to the left - stop just before pain. If 3 times doesn't hurt then keep it at that, lower and relax. Try a couple more times then stop, ice and heat. If you aren't taking too much of anything else and tylenol or aspirin doesn't bother you try taking robaxacet or robaxin Muscle relaxants, such as methocarbamol (example: Robaxin), are helpful in treating pain that is accompanied by muscle spasms. Muscle relaxants reduce spasm and tension in muscles by slowing down signals from the brain which cause muscles to contract. These drugs are very effective when taken in combination with a pain reliever such as ibuprofen (example: Robax Platinum), acetaminophen (example: Robaxacet), or ASA (example: Robaxisal). Do check with your pharmacist though. You are probably right in saying they are a cascading series of events Mel. My suspicion is that you are dealing with weak muscles or inbalanced muscles from the problem with your knee. Core exercises, physio will probably help to get the body back into condition. Just go slow, keep moving and you should be back to work by Monday. In the meantime don't bend forward. You are aggravating that area obviously. Ice, ice, and more ice. Then heat, heat and more heat. Move slowly and try not to twist or pick up anything on the floor. When you can next week get to a physiotherapist (can you see one on Saturday - that might get you through to Monday). It is frustrating and painful. Been there too many times. The idea is to build up your core strength when all this is over. And do it under supervision. Stop the cascade. Will be looking forward to hearing that things are a little better by Sunday.

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