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Debunking Lower Back & Hip Pain Myths: Insights from a Physiotherapist.




If you've ever experienced that nagging ache in your lower back or felt those sharp twinges in your hips, you're not alone. Lower back and hip pain affect millions of people worldwide, and with such prevalence, it's no surprise that myths and misconceptions about their causes and treatments abound. As a physiotherapist, I've encountered my fair share of these myths, and today, I'm here to bust some of the most common ones with evidence-backed insights.



Myth #1: Rest is the best treatment.


Let's start with a classic misconception. When lower back or hip pain strikes, many people's first instinct is to rest and avoid any movement that might exacerbate the discomfort. However, research suggests otherwise. While short-term rest may provide temporary relief, prolonged inactivity can actually worsen the pain and lead to muscle weakness and stiffness. Studies suggest that targeted exercise treatment can help reduce pain significantly [1].



Myth #2: Pain equals damage.


It's easy to fall into the trap of believing that experiencing pain in your lower back or hips means there's significant damage or injury present. However, pain is often a complex phenomenon influenced by various factors, including psychological and social elements, rather than solely indicative of tissue damage. Studies have shown that structural abnormalities in the spine, such as disc degeneration or herniation, are prevalent in people without any symptoms of lower back pain. This suggests that pain may not always correlate with structural damage [2].



Myth #3: Core strength alone can prevent lower back pain.


Building a strong core is undoubtedly beneficial for overall spinal health, but solely focusing on core exercises may not be the panacea for lower back pain. While core strength is important, other factors such as posture, flexibility, and movement patterns also play crucial roles in preventing and managing lower back and hip pain. Evidence suggests that also targeting hip strength among other areas can provide relief of symptoms of lower back pain [3].



Myth #4: Surgery is the only solution for chronic pain for individuals dealing with chronic lower back or hip pain.


The idea of surgery might seem like the only way out. However, surgery should typically be considered as a last resort after conservative treatments, such as physiotherapy, medication, and lifestyle modifications, have been exhausted. Research published in The New England Journal of Medicine found that for patients with lumbar spinal stenosis, a common cause of lower back and leg pain, surgical decompression provided similar outcomes to non-surgical treatments at two-year follow-up [4].



Myth #5: Hip pain always originates from the hip joint.


While hip joint problems can indeed cause hip pain, it's essential to recognise that hip pain can stem from various sources, including muscles, tendons, ligaments, and even the lower back. Therefore, assuming that all hip pain originates from the hip joint alone may lead to misdiagnosis and ineffective treatment. A study published in the Journal of Orthopaedic & Sports Physical Therapy found that hip pain can frequently arise from extra-articular sources, such as the lumbar spine or pelvic structures, highlighting the importance of a comprehensive assessment to identify the underlying cause accurately [5].



Myth #6: Stretching is always beneficial for hip pain.


While stretching can be beneficial for relieving tightness and improving flexibility in some cases, it's not always the best approach for managing hip pain, especially if the pain is caused by muscle weakness or instability. In such instances, targeted strengthening exercises may be more effective in addressing the underlying issues [6].



Conclusion


When it comes to lower back and hip pain, separating fact from fiction is crucial for effective management and treatment. By debunking these myths and embracing evidence-based practices, individuals can empower themselves to take control of their pain and work towards a healthier, pain-free life.


Remember, if you're experiencing persistent lower back or hip pain, consulting a qualified physiotherapist or healthcare professional is always the best course of action. Don't let myths dictate your journey to recovery - trust in science and evidence instead!


Our Barnet, Cockfosters & Enfield Physio's have tons of experience in dealing with all types of hip and lower back pain. Have confidence that our specialist Physiotherapists will closely assess, diagnose & treat you in the correct & evidence-based way for all injuries. You can book an appointment here.



Blog By: Emre Oz (Musculoskeletal Physiotherapist at Crouch Physio).



References:


1. Rainville, J., Hartigan, C., Martinez, E., Limke, J., Jouve, C. and Finno, M., 2004. Exercise as a treatment for chronic low back pain. The Spine Journal, 4(1), pp.106-115.


2. Brinjikji W, et al. (2015). 'Systematic literature review of imaging features of spinal degeneration in asymptomatic populations.' American Journal of Neuroradiology. DOI: 10.3174/ajnr.A4173.


3. de Jesus, F.L.A., Fukuda, T.Y., Souza, C., Guimarães, J., Aquino, L., Carvalho, G., Powers, C. and Gomes-Neto, M., 2020. Addition of specific hip strengthening exercises to conventional rehabilitation therapy for low back pain: a systematic review and meta-analysis. Clinical rehabilitation, 34(11), pp.1368-1377.


4. Weinstein JN, et al. (2008). 'Surgical versus Nonoperative Treatment for Lumbar Spinal Stenosis.' The New England Journal of Medicine. DOI: 10.1056/NEJMoa0707136.


5. Redmond, J.M., Gupta, A., Nasser, R. and Domb, B.G., 2015. The hip-spine connection: understanding its importance in the treatment of hip pathology. Orthopedics, 38(1), pp.49-55.


6. Santamaría, G., Rodríguez, I., Rodríguez-Pérez, V., Cobreros-Mielgo, R., Lantarón-Caeiro, E., Seco-Casares, M. and Fernández-Lázaro, D., 2023. Effect of hip muscle strengthening exercises on pain and disability in patients with non-specific low back pain—a systematic review. Sports, 11(9), p.167.

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