Navigating Hip and Low Back Pain With Differential Diagnosis

Hip pain and lower back pain affect a significant portion of the population. Both can impact quality of life, making the activities of daily living more difficult. For athletes, chronic hip or lower back pain can make it challenging or even impossible to continue playing sports.

Fortunately, many conditions that result in hip or lower back pain can be treated with orthobiologics. Before treatment, however, it is crucial to pinpoint the root of the issue.

Diagnosing the cause of hip or lower back pain can be challenging because various conditions and injuries can cause it. Differential diagnosis helps doctors more accurately pinpoint the underlying condition causing hip or lower back pain.

In this article, we detail the differential diagnosis of back pain vs. hip pain and provide an overview of orthobiologic therapies used to treat both.

Understanding Low Back Pain

Low back pain (LBP) is a widespread problem affecting millions. According to the World Health Organization (WHO), LBP is the leading cause of disability globally.

LBP can feel sharp or dull. It can occur only in your lower back or radiate down your buttocks and spine. Additionally, LBP can worsen in certain positions, such as sitting down or bending over, and it may come with additional symptoms like stiffness and muscle spasms.

While most cases of LBP are not severe and resolve on their own without treatment, others require medical attention. Severe or chronic LBP can make movement difficult, which limits a person's ability to perform daily activities or work, reducing quality of life.

LBP is typically categorized into two types: Specific and non-specific.

A disease, injury or structural condition of the spine cause specific LBP. It can also result from pain radiating from another part of the body.

Meanwhile, non-specific LBP is the more common of the two. Doctors call it non-specific LBP when the cause of the pain cannot be identified.

Specific LBP may be caused by conditions such as:

• Injuries to the muscles, tendons or ligaments (sprains and strains)
• Spinal fractures
• Arthritis
• Spondylolisthesis
• Herniated disk and degenerative disk disease
• Spinal stenosis

Not all causes of LBP are musculoskeletal in nature. For example, kidney stones, spine tumors and some cancers can cause back pain.

Understanding Hip Pain

Contrary to common misconception, it's not just older adults who can experience hip pain. Anyone of any age can feel pain, stiffness and limited mobility in and around the hip joint.

Hip pain can be mild and temporary, with no particular cause. In other cases, hip pain can be severe or chronic, signaling a more serious underlying issue that requires medical treatment.

Common causes of hip pain include:

• Ankylosing spondylitis
• Osteoarthritis
• Rheumatoid arthritis
• Bursitis
• Trauma to the hip joint from sports injuries or accidents
• Repetitive strain/overuse injuries
• Hip labral tears
• Fractures
• Iliotibial band syndrome
• Dislocation
• Hip flexor strains

How Doctors Diagnose Low Back Pain and Hip Pain

Hip pain and low back pain often share similar symptoms. Both can cause discomfort in the hip region, and the pain might radiate to the lower back or vice versa. This overlap makes it difficult for patients and doctors alike to identify the source of the problem.

For instance, injury to the sacroiliac (SI) joints in the lower back can cause pain in the hip, buttocks and legs. Meanwhile, a tilted pelvis due to hip arthritis can result in spine misalignment, which in turn can cause lower back pain.

Conditions affecting the hip joint or lower back can have symptoms that mimic each other, and pain in these areas could actually be "referred" pain originating from another part of the body, adding to the diagnostic complexity.

To accurately diagnose the cause of hip and lower back pain, doctors use a method called differential diagnosis. This approach involves systematically ruling out other conditions that share your symptoms until they can be sure which disease or injury is causing your hip or lower back pain. Differential diagnosis also enables doctors to fully distinguish between hip and lower back issues.

They systematically consider various factors, like the location of the pain, its nature, and what makes it better or worse. Imaging tests such as X-rays and MRIs may be employed to get a closer look at the bones, joints and soft tissues. These help rule out issues like arthritis, fractures, or herniated discs that could be causing the pain.

An Overview of the Differential Diagnosis Process

The process begins with your doctor asking you a series of questions about the following:

• Your symptoms
• Any medications and supplements you could be taking
• Your medical history, including any health conditions you currently have
• Your family's health history
• Your lifestyle, diet and habits

Next, your doctor will perform a physical exam. They will look for swelling, redness, warmth and abnormalities in your range of motion. Also, they may test your reflexes, sensation and strength. This is done to help identify physical signs that may be associated with your symptoms.

The third step is to compose a list of possible diagnoses: Conditions you may have based on your symptoms and the results of your physical exam.

At the final step, your doctor will order tests to narrow the possible diagnoses. These tests may include:

• Blood tests
• Urinalysis
• MRI, X-ray and other imaging tests
• A biopsy
• A mental health screening

Through differential diagnosis, doctors can accurately diagnose the source of pain. This approach ensures that the treatment plan is tailored to the actual problem, improving patients' chances of finding lasting relief from hip pain, low back pain or a combination of both.

Orthobiologics: Innovative Treatments for Hip Pain and Low Back Pain

Orthobiologic therapies use biological materials, such as platelet-rich plasma, bone marrow and adipose or fat tissue. These fall under the umbrella of regenerative medicine, as they leverage the body's natural ability to heal itself.

Examples of orthobiologic therapies include:

• Cell Therapy
• Platelet-Rich Plasma (PRP) Injections

Orthobiologic therapies utilize cells or platelets from a patient's body or donor to help heal injuries or address damage from degenerative conditions.

Orthobiologics can be used to treat conditions such as:

• Osteoarthritis of the hip
• Hip labral tears
• Hip degeneration
• Avascular necrosis of the femoral head
• Iliotibial band syndrome
• Degenerative Disc Disease
• Lumbar arthritis
• Disc herniation
• Sciatica

These treatments are an excellent option for patients with hip pain or lower back pain caused by a musculoskeletal condition, particularly those who cannot or do not want to undergo surgery.

Get a Tailored Treatment Plan for Hip or Low Back Pain

Differential diagnosis helps healthcare providers identify the root cause of low back pain or hip pain, while orthobiologic therapies offer a minimally invasive alternative to conventional surgical treatments.

Chicago Cell Therapy & Regenerative Medicine provides specialized care to patients with conditions that affect the musculoskeletal system, including the hips and lower back. Our team of medical professionals are highly trained and well-versed in differential diagnosis as well as innovative treatment approaches like orthobiologics. We aim to help our patients manage the effects of their hip or back condition while avoiding the risks and complications of more invasive surgical options.

Reach out to us to schedule a consultation today. Please complete our online appointment form or call (630) 920-2323 for questions.