Lower back pain and ham string pain

Hi,

To give you a brief history, I am 40 years old man who likes to keep relatively fit. I am a hockey player (but not at the moment), I like to run a couple of times a week and I also like to ride my bike at the moment that is three times a week 10.5 miles to work and then back again.

My problem is I am having a pain in my lower back to the left of my spine around the top of my pelvis (best guess not good at biology) this feels like a sharp specific pain at the same time as I get this pain I also get the feeling of a ham string pull half way down my left thigh which feels like an actual lump is being pulled. I am also suffering from a pain in my right hip which will not go away an when I exercise a lot feels painful to touch so I can not lay on that side.

So far I have been seen by four physio's two provided by the NHS and two private physio's and I have not had any success all of them have agreed that I do not have arthritis in my hip but have not been able to sort out the problem. The last physio who is a sports physio of a very high standing has recommended I see an Osteopath but I cannot afford to do this at the moment.

I am now unable to play hockey because of the pain and I also suffer when I am cycling or running so it is impacting on my life.

Can anyone offer any advice on how to get past this?

Thanks,

alamb200

Hi alamb200,

Its hard to say what the cause of the pain is without being able to physically assess you...

Are the pain in the back and the tightness in the hamstrings always present together or are they ever independen of each other?
What kind of treatments/exercises/advice have you been given so far and would you say that any of them have helped or made the symptoms worse?

Also has anyone assessed the mobility of your Sacro-illiac joints or the positioning of you pelvis? It would seem to me that the area of pain and the high level of activity would make this the first area which I would clear

Yes, I'm curious as to the treatment approaches, as well. And what did help and what did not. Have you had any MRI or xrays done on the back and hip? The pain in the leg...is it a numb, tingling, radiating, burning problem at all? Or just the tightness? Did you have an issue where you felt it may have torn with any of your activities?

Treatment is different for disc issue vs myofascial issue. If you're having myofascial issues, seeing a massage therapist who does good trigger point therapy can make all the difference in the world. Then learning how to self-release with a foam roller and ball can keep you on your feet and able to exercises. Getting any muscle imbalances sorted out can make a huge difference as well. I'd be curious to check out any trigger point issues in your quadratus lumborum (QL), glutes (med and min particularly), piriformis, hamstrings, and hip flexors for good measure. This area can be overlooked in physiotherapy, though usually disc diagnosis and treatment is not.

The xray and MRI would help to determine if you have other issues going on with the spine as well, from narrowing to deterioration, to disk bulge, to fracture, to ruling out cancer.

Hi,

First of all thanks for taking the time to reply.

As for exercises I have had several different ones assigned one was to lay on my stomach and raise myself up using my arms but keeping my pelvis on the floor, I also had like a hula hoop movement prescribed and various hamstring stretches. There was also one where I had to sit on a chair and put my foot on the opposite knee then pull the raised knee up.

One of the physio's who was trying sports massages did mention the Sacro-illiac joints but could not do anything with them hence his suggestion of the Osteopath.

To answer the question of whether they pains happen at the same time, the hamstring pain is more common than the back pain but after I have had the hamstring pain the back hurts within a short time.

The other thing I forgot to mention in my initial introduction is the fact that I have had a operation on my knee for ligament damage and I also have had insoles prescribed by a podiatrist to resolve pronation.

Thanks,

alamb200

It seems like there is certainly an element of muscle imbalance going on with the relationship of the hamstrings and the lower back. If that were so the hamstrings stretches were along the right line but they would need to be combined with core stability exercises. It can be fairly common to have variances in kinetic control and muscle imbalances following surgeries on the knee.

I would also agree with violablue's other common problems and I feel that the symptoms seem more of a myofascial origin. Saying that I wouldn't rule out other sources as a proper assessment isn't really possible on here


Good luck
Chris

What would you suggest my next course of action should be? Do I go for an Osteopath?

Thanks,

alamb200