Lower back and hip pain, physical therapy: Focus Physiotherapy✓

Pain that occurs simultaneously in the lower back and hips represents a complex biomechanical issue, as these two regions are functionally connected and work together in movement and trunk stability. The lower back, pelvis, and hips form a unified system, so restricted movement or overload in one region often leads to additional strain and symptoms in the other. In many patients, pain in one region gradually affects movement patterns and may contribute to the development of secondary pain in nearby structures.

The anatomy of this area includes the five lumbar vertebrae, the sacrum, the pelvis, and the hip joint, as well as strong muscles that stabilize and move these structures, such as the gluteal muscles and the iliopsoas. Important nerve structures also pass through this region, including the sciatic nerve, so pain may originate from the spine, the hip, or the soft tissues that connect them. Symptoms may occur due to muscle imbalance, overload, inflammatory processes, reduced mobility, or degenerative changes. Understanding the relationship between hip mobility and lumbar spine stability is important for properly identifying the cause of the symptoms. Timely physiotherapy assessment and properly directed treatment can help reduce pain, improve function, and prevent the development of chronic complaints.

• Lumbar disc herniation
• Sciatica
• Hip osteoarthritis
• Sacroiliac dysfunction

The causes of combined back and hip pain are most commonly associated with mechanical overload, muscle imbalance, and degenerative changes. Factors such as weakness of the gluteal muscles, tightness of the hip flexor muscles, and poor sitting posture may contribute to the development of symptoms. Although the pain is felt in two different regions, the cause is often related to a single process that disrupts the balance of the entire pelvis and lumbopelvic region.

The main causes of lower back and hip pain include:

• Lumbar disc herniation (L4-S1), when pressure on the nerves causes back pain that may radiate toward the hip region.
• Coxarthrosis (hip osteoarthritis), degenerative wear of the hip joint cartilage that may also lead to secondary back pain due to an altered walking pattern.
• Sacroiliac dysfunction, a problem in the connection between the spine and pelvic bones that often manifests as pain in the lower back and hip area.
• Piriformis syndrome, when a muscle in the gluteal region places pressure on the sciatic nerve, causing pain in the hip and lower back.
• Trochanteric bursitis, inflammation of the bursa on the outer side of the hip that often occurs in people with long-term back pain.

Accurately determining whether the pain primarily originates from the spine or the hip joint is important for creating an individualized treatment plan. Each of the listed causes requires an appropriate rehabilitation approach in order to achieve longer-term relief and improved functionality.

Treatment of lower back and hip pain at Focus Fizikal is aimed at reducing pain, relieving overloaded structures, and restoring better muscle balance through the use of modern therapeutic methods. The therapeutic approach combines procedures for relaxing tense tissues with manual techniques for mobilizing the spine, pelvis, and hip. Successful rehabilitation includes not only pain relief, but also strengthening the muscles that contribute to pelvic stability and proper movement patterns.

A modern rehabilitation approach includes the following phases:

• A detailed functional assessment of walking mechanics, leg length, and range of motion in the lumbar spine and hip.
• The application of physical therapy procedures such as TECAR therapy, high-power laser therapy, and magnetotherapy, in accordance with the patient’s condition and indications.
• Manual therapy and pelvic mobilization aimed at improving the mobility of the sacroiliac joints and the function of the hip joint.
• Kinesiotherapy with an emphasis on specific exercises for strengthening the gluteal muscles, deep core stabilizers, and stretching the hip flexors.
• Education on protective sleeping positions, proper sitting ergonomics, and additional therapeutic techniques based on professional assessment.

Consistent implementation of the recommended exercise program is important for maintaining the achieved results and preventing the recurrence of symptoms. This comprehensive approach contributes to better body stability and a safer return to daily and physical activities.