What should I do next if my back hurts when I bend forward?
I am a 26 years old female. Today, I suddenly realised that my left lower back/hip hurts when I bend forward and then back straight at a certain angle. However, there is no pain past the angle. May I know what happened, what's the cause and what can I do to alleviate it?
Dear Zai Zai
Thank you for your question - it’s certainly a common problem that we see in clinic!
It sounds from what you have said that there is a potential overlap of pain generators - it could be your back and equally it could be your hip!
Often, it can be difficult to differentiate one from the other without an assessment of your symptoms (how did it come on, where does the pain localise to, is there any spreading of the pain and what makes it worse) together with a thorough clinical examination (of your back and hips).
Pain around this area could come from:
1. The hip joint
2. Muscles around the hip
3. Your sacro-iliac joints
4. Your lower back muscles
5. Your lower back joints/dics
6. Nerves or the spine
Sometimes, you might be sent for an MRI scan, depending on findings. This looks at anatomical reasons for your pain, it doesn’t really consider the functional aspects and is not normally a first line unless you have red flag symptoms.
Because back pain is so common, we set up the back pain clinic to specifically look at this problem, considering posture, your occupation, activities etc.
People to consider seeing include:
1. Physiotherapists - ideally someone who specialises in back problems
2. TCM practitioner - especially one who sees back pain and is proficient in acupuncture. In our clinic we have someone who I work closely with and who sees many of my back pain patients.
3. Sports/MSK physicians - sometimes there are specialist back pain clinics or that they run
4. Orthopaedic surgeons - often most sports/Msk physicians or physiotherapists will know of surgeons and perhaps will refer you. particularly if they assess you and feel a surgical input is needed.
As you can see, there are many choices but perhaps seeing what is available to you locally is important. Often, regularity of treatment is key!
Most back pains don’t require surgery or imaging so being assessed and feeling confident with this is important.
Good luck with your symptoms!
Dear Zi Ai,
Thank you for your question, and thanks to Dr Dinesh for the very useful tips on back pain. There are potentially many causes of your lower back and/or hip pain.
It is important to differentiate the origin of the pain, and a thorough physical examination and history of the symptoms would be important.
Radiological imaging such as an MRI would be also useful in identifying the cause of the pain, and then we can start you on proper treatment. Many a times, medication and physiotherapy would suffice in alleviating the symptoms. Proper back care is important as well.
If the pain is persistent, it would be useful for you to consult a doctor, and then we can help toward working out the cause of the pain.
Hope this is useful.
Dr Sean Ng