A Pain in the Butt

Sciatica can be a pain in the butt,

but not all pain in the back of the hip or thigh is sciatica.

Pain in the back of the hip and thigh can be one of many different diagnoses. Some more common issues that can be the cause are sciatica, hamstring strains, and tendinopathies. This article will discuss some of the different presentations of diagnoses that could be related to pain in the posterior hip or thigh.

Sciatica can be experienced with pain, numbness, or tingling down the back of the thigh and into the leg and foot. Pain usually ranges from mild to moderate intensities. Sciatica results from compression of the sciatic nerve of the nerve roots that come together to form the sciatic nerve.  People are often able to walk and jog without any limitations. Individuals often do not have any decrease in their strength and may have a small decrease in their flexibility when compared to their non-involved side.

Hamstring strains often occur very quickly when performing high-speed activities like sprinting or lifting a very heavy object.  After a hamstring strain, bruising can be present and accumulate around the site of injury. The pain is usually intense immediately after injury and has a slow decrease as the injury heals. A significant decrease in strength, difficulty with walking and being unable to run are common clinical signs.

Tendinopathy refers to a breakdown of the part that connects the muscle to the bone.  These gradually develop over time and start with dull aches and low pain levels.  There is not usually a loss of motion but there may be a loss of strength when dealing with tendinopathy. There is usually some tenderness with palpation over the involved tendon. Symptoms may be non-existent early in the day but as the day progresses the symptoms slowly increase with more activity.

These are three common injuries that are associated with pain in the back of the hip or thigh. This is not a comprehensive list and you should reach out to your physical therapist to help you make the correct diagnosis. This will help speed up your recovery and get you back to doing things that matter to you most sooner.

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