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Home > June Newsletter > Article
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Patients with low back pain should also have their hip joint examined as a potential source of pain.
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| Dr Bruce Mitchell in his presentation at the American College of Sports Medicine - ACSM 53 rd Annual Meeting in Denver Colorado last week highlighted that findings from a study previously completed at the University of Melbourne's Centre for Health, Exercise and Sports Medicine (CHESM), shows that there is a high representation of low back pain in patients with pathology in their hip joint.
The study’s aim was to determine the common sites of area of pain for patients undergoing hip arthroscopic surgery. Clinical presentation of non arthritic hip pathology can be difficult, as recent studies with smaller subject numbers have demonstrated that pain experienced by the patient may be located in the buttock, groin, thigh, lumbar spine, lateral hip, lateral knee, hamstring and abdomen.1,2 However, increasingly, hip joint pathology is more readily recognized as the source of pain due to heightened clinician awareness, especially in the area of sports medicine;1,2,3,4.
The study, based on 81 subjects, required patients who were about to under go hip arthroscopic surgery to complete a self administered questionnaire using a 10 point VAS for 9 areas of the body that had been previously determined as being relevant for hip pathology. The subjects were asked to rate their average pain for each site for the previous week.
 The study results showed that the most common site of pain for patients with hip joint pathology is deep inside the hip. The second most common site of pain is in the groin, then low back pain and pain on the lateral aspect of the hip equal third. Other sites of pain included buttock, upper leg, knee, lower leg and stomach. The average number of sites of pain in these patients was 6.4.
Results:
Area of pain
(81 subjects) |
% subjects who scored one or more
|
% subjects who scored five or more |
Mean VAS score
(all scores included) |
Mean VAS score
(including scores  1 only) |
Low Back |
84.27 |
41.57 |
3.96 |
4.742 |
Buttock |
76.40 |
30.34 |
3.10 |
4.05 |
Outside Hip |
81.61 |
44.83 |
3.96 |
4.80 |
Deep Inside Hip |
91.95 |
57.47 |
5.28 |
5.71 |
Groin |
83.15 |
50.56 |
4.49 |
5.43 |
Upper Leg |
69.32 |
36.36 |
3.09 |
4.49 |
Knee |
45.45 |
23.86 |
2.01 |
4.47 |
Lower Leg |
39.33 |
16.85 |
1.60 |
4.18 |
Stomach |
41.38 |
17.24 |
1.97 |
4.73 |
Table 1: Area of Pain |
Conclusion:
The general conclusion drawn is that hip problems will most commonly present with pain deep inside the groin, low back and buttock. Patients with low back pain should also have their hip joint examined as a potential source of pain. Hip patients may also have pain in the lateral aspect of the hip, the buttock, upper leg, knee, lower leg and stomach.
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Study:
The Area of Pain of Patients Undergoing Hip Arthroscopic Surgery
Authors:
Bruce Mitchell, FACSM, Emma Colson, Peter Brukner, FACSM, Kay Crossley, Emma Carrington, Michelle Fehlberg. CHESM, University of Melbourne, Melbourne, Australia.
References:
1: Mitchell B, McCrory P, Brukner P, O'Donnell J, Colson E, Howells R.
Hip joint pathology: clinical presentation and correlation between magnetic resonance arthrography, ultrasound, and arthroscopic findings in 25 consecutive cases.
Clin J Sport Med. 2003 May;13(3):152-6.
2: Mitchell B, Colson E, Chandramohan T.
Lumbopelvic mechanics.
Br J Sports Med. 2003 Jun;37(3):279-80.
3. DeAngelis NA, Busconi BD.
Hip arthroscopy in the pediatric population.
Clin Orthop Relat Res. 2003 Jan;(406):60-3.
4. DeAngelis NA, Busconi BD.
Assessment and differential diagnosis of the painful hip.
Clin Orthop Relat Res. 2003 Jan;(406):11-8.
June 2006
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