Do you have hip pain or pain in your thigh that just won’t go away? (Now if you do have hip degeneration and have been told you need a hip replacement, then you probably have more going on than this article pertains to)
Ever thought that there may not be anything wrong at all with your hip? It may in fact be ‘referred pain.’
What is referred pain? It is pain in an area of your body that can often be some distance away from the actual stressed tissue.
One good example is sometimes hip pain can be diagnosed as hip bursitis: inflammation of the bursa (fluid-filled sac near a joint) at the part of the hip called the greater trochanter. When this bursa becomes irritated or inflamed, it causes pain in the hip. Yes, hip pain truly can be coming from your hip, but when you have tried to get rid of it with traditional therapies or injections and it still is there, then the source may be coming from somewhere else…and it may be nerve root referred pain.
Check out this map of the dermatomes of the body that depicts where nerve roots refer to:
The following excerpt is from ‘Taming Pain: Lessons from the Trenches.”- Second Edition 2013 by Cheryl F. Wardlaw, PT MMSc, CFMT :
“A nerve root is the part of the nerve that comes off of the spinal cord and goes out the hole between two vertebrae.
Each nerve root has some fibers mixed in from the nerve root above and below, so it’s not EXACT. Each nerve root, when stressed, can cause pain in a predictable path. It will cause weakness in predictable muscles. Let’s take the L4 nerve root for example. Let’s say you have pain on the side of your hip and in the front of your thigh. The muscles that pick up your big toe (L4) and straighten your knee (L3& L4) are weak. I would sure need to look at what could be irritating the L4 nerve root!
Could it just be hip bursitis? Doubtful. Hip bursitis doesn’t make your big toe weak. Could it be 5 things: hip bursitis, a pulled muscle in your thigh, some knee arthritis, a bunion on your big toe and low magnesium? Well, it could be, but I would still have to rule out the L4.
Things that stress a nerve root:
If we decide that a nerve root is squawking, and we know which nerve root, the question still remains, what is irritating the nerve root? So here goes:
The Facet joint: the joints in your spine are called facet joints
The Nerve Root: comes out of the hole in front of the facet joints. Changes at the facet joint can decrease the size of the space and put pressure on the nerve. Inflammation will be the result.
The Disc: The spacer between the vertebrae is the disc. If the disc shrinks down (degeneration) the bones will get closer together. The size of the opening will decrease and the nerve will be compressed and will inflame. If the disc bulges back, the same thing happens.
The Spinal Canal: The space that the spinal cord runs through is called the canal. Across time, bone can build up inside the canal and make less room for the nerve root. This condition is known as spinal stenosis. The nerve will be compressed and will inflame.
Now that we know where it is, ( Let’s stick with L4 as our suspect), what might be causing it ( let’s choose a locked facet) and that the nerve root is inflamed, our job is as simple as a game of CLUE : Colonel Mustard, in the library, with the candlestick! Referred pain patterns help me figure out where I should be working!
If your therapist or doctor are only treating your symptoms, and not searching very actively for where the pain is coming from, then you will be hurting a very long time.”
-See how maybe your hip pain isn’t really coming from the hip itself, but rather may be coming from your back? Contact me today to see how I can help solve your pain puzzle and get rid of the nerve culprit!