Saturday, May 21, 2011

Hip Pain: Does it mean I have a problem with my hip?

The answer is, of course, not necessarily. Pain can arise from many tissues: muscles, tendons, ligaments, joint capsules, bones, nerves, etc. While certainly all of these components collectively comprise the hip (and can cause a great number of conditions that lead to hip pain), hip pain does not necessarily arise from the hip itself. Referred pain patterns are not uncommon and should be considered when diagnosing hip pain. This becomes a very important distinction when working with golfers. Hip pain can develop as a result of so many different problems. It matters where the pain is located (front, back, side, combination, etc.) and what type of pain is being described (sharp, shooting, dull, achy, burning, etc.). The golf swing can cause the pain or it may not. Is the pain arising from the hip or from somewhere else that causes the hip to hurt? As a golfer, it is important to be evaluated by a doctor who is familiar with the golf swing and the biomechanics involved in the movement.

Recently, I saw a patient (an avid golfer) in the office who was experiencing hip pain that had been getting worse. The patient had received a full work-up on the hip from another provider and had undergone therapy for pain. Despite extensive efforts, the pain was becoming worse. When the patient presented in my office, I did the most obvious thing to do: I examined the painful hip. But after the evaluation, it was evident to me that the hip was not the generator of the pain. So I looked at the next most likely cause of hip pain (outside of the hip itself) and uncovered the culprit. It originated in the lumbar spine; L4/5 to be exact, and our findings were confirmed by MRI.

The important take-away here is that referred pain can be tricky to diagnose. If you are experiencing pain that has not been managed to your satisfaction, it can be worth your time and effort to seek out a second opinion. And when looking for a second opinion, look for a doctor that is knowledgeable about the golf swing. It can make all the difference in receiving the proper diagnosis and treatment plan.

All the best,

Nathan Williams, DC, MS, TPI-CGFI