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Accurately differentiate between pain of hip vs. lumbar origin

 

pain of hip vs. lumbar origin

 

The diagnostic process for any condition really boils down to making our best guess. Incorrect guesses result in wasted time and money. Successful clinicians make better guesses more often. With more experience, we become better guessers.

Accurately differentiating between pain of hip vs. lumbar origin can pose a significant clinical challenge. The following video blog describes one simple concept to help you make this distinction.

Your patient’s presentation and history will direct your exam to one or more regions of the body. Using clinical prediction rules, orthopedic tests, and repetitive motion testing yields a more specific diagnosis. For example, if a patient presents with a burning sensation in the groin crease with a positive C sign, you will likely want to lead your evaluation with hip orthopedic tests. However, low back pain and hip can often mimic each other. Groin pain, while often an indicator of hip pathology, can also arise from a variety of lumbosacral conditions including an upper lumbar disc lesion.

A study by Kido (1) provides information on upper lumbar disc pathology that will help direct your assessment and management of groin pain. The study found that one major factor in distinguishing hip from back complaints is the reproduction of symptoms with hip movement through flexion and extension, i.e. Straight Leg Raise and Femoral Nerve Tension tests.

Check out this new video where Dr. Steele outlines the process of differentiating between hip and back pain.

Applying research into your daily clinical practice is a very efficient way to become a better guesser. ChiroUp helps you quickly access the current chiropractic best practice management of more than 90 conditions. We are proud to be your partner in our common pursuit of clinical excellence!

Reference

  1. Kido T, et al. Clinical Diagnosis of Upper Lumbar Disc Herniation: Pain and/or numbness distribution are more useful for appropriate level diagnosis. J Orthop Sci. 2016.

About the Author

Dr. Brandon Steele

Dr. Brandon Steele

DC, DACO

Dr. Steele began his career at The Central Institute for Human Performance. Dr. Steele has trained with experts including Pavel Kolar, Stuart McGill, Brett Winchester, and Clayton Skaggs. He has been certified in Motion Palpation, DNS, ART, and McKenzie Therapy. Dr. Steele lectures extensively on clinical excellence and evidence-based musculoskeletal management. He currently practices in Swansea, IL and serves on the executive board of the ICS.

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