Low Back & Hip Pain? Is it Nerve, Muscle, or Joint? How to Tell.

Bob & Brad2 minutes read

Bob and Brad, popular physical therapists, emphasize the importance of distinguishing between nerve, joint, and muscle-related back and hip pain, with facet joints, sacral iliac joint, hip joint, and spinal nerves being potential sources of pain with different symptoms and diagnostic tests to identify each issue. They provide specific techniques to diagnose and differentiate between nerve issues, joint pain, and muscle tenderness, outlining treatment options such as rubbing the muscle, using tools like Thera Cane, and applying heat and ice for relief.

Insights

  • Identifying the source of back and hip pain involves distinguishing between nerve, joint, and muscle-related issues, with facet joints, sacral iliac joint, hip joint, and spinal nerves all potentially contributing to pain, necessitating a comprehensive diagnostic approach.
  • Differentiating nerve pain from joint and muscle issues is crucial, as symptoms like tingling and numbness can indicate a pinched nerve, requiring specific tests like the straight leg raise and slump test for diagnosis, while joint pain, especially from facet joints and the sacral iliac joint, may present with localized pain and unique referral patterns down the leg, necessitating targeted assessments for accurate identification and treatment differentiation.

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Recent questions

  • What are common sources of back and hip pain?

    Back and hip pain can stem from facet joints in the spine, sacral iliac joint, hip joint, muscles, ligaments, and spinal nerves.

  • How can nerve pain be identified?

    Nerve pain symptoms like tingling, numbness, and strange sensations can indicate a pinched nerve, often caused by a disc or piriformis muscle irritating the nerve.

  • What tests can help diagnose nerve issues?

    Tests like the straight leg raise and slump test can aid in diagnosing nerve problems, helping to pinpoint the source of pain and discomfort.

  • How can joint pain, specifically facet joints, be identified?

    Joint pain, particularly from facet joints, can be identified through specific movements that cause localized pain, helping to differentiate it from other sources of pain.

  • How can muscle tenderness be assessed?

    To assess muscle tenderness, lay down in a prone position and press on the muscle belly, feeling for tenderness or warmth, distinguishing muscle issues from nerve problems, with various treatment options available for relief.

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Summary

00:00

Identifying Back and Hip Pain Sources

  • Bob and Brad are well-known physical therapists on the internet.
  • They discuss the importance of determining whether back and hip pain is nerve, joint, or muscle-related.
  • Facet joints in the spine, with 10 in the low back alone, can cause pain due to wear and tear like arthritis.
  • The sacral iliac joint and hip joint are other sources of pain, along with muscles and ligaments in the area.
  • Spinal nerves can also cause pain and irritation, making diagnosis complex.
  • Nerve pain symptoms like tingling, numbness, and strange sensations can indicate a pinched nerve.
  • Pinched nerves can be caused by a disc or piriformis muscle irritating the nerve.
  • Tests like the straight leg raise and slump test can help diagnose nerve issues.
  • Joint pain, particularly facet joints, can be identified through specific movements that cause localized pain.
  • The sacral iliac joint can cause pain that does not refer past the knee and may be linked to leg length discrepancies.

09:42

Identifying SI pain and muscle tenderness techniques.

  • Pinpoint testing for SI involves identifying specific pain in the back that can refer down the leg, usually caused by disc or SI issues rather than muscle strains, which are more localized and don't refer pain down the leg.
  • To assess muscle tenderness, lay down in a prone position and press on the muscle belly, not the spine, feeling for tenderness or warmth, distinguishing muscle issues from nerve problems, with treatment options including rubbing across the muscle, using tools like Thera Cane, and applying heat and ice for relief.
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