When Your Hip Is Not Your Hip!
Let’s clear up a major misconception many people have about their lower back, butt and hips.
I will start by saying that I don’t particularly like the term “butt”. We sometimes think of someone as being a “pain in the butt”, so it doesn’t have a nice sound to it. But ever since I heard Forrest Gump tell President Johnson that he was wounded in the “but-tocks”, I can’t say it out loud to a patient and keep a straight face.
Your butt is made up of the pelvic bone, often referred to as the hip bone. In the photo, the hands are placed on the hips (pelvic bones).
Three muscles with very imaginative names, the gluteus maximus, gluteus medius and gluteus minimus overlay the back side of the pelvic bone. Those muscles are collectivley called the buttocks, or butt for short.
Your hip joint is in the groin area, in the front of the pelvis. The hip joint is where the ball on the end of the thigh bone ( the femur ), fits into the socket (the acetabulum) on the pelvic bone.
Many problems in the lower back cause pain in the butt. If you look at a diagram of lower back nerve anatomy, you will see that many of the nerves from the lower back go into the butt. If you have a pain in the butt, it’s very likely from your lower back, not your hip joints.
A problem with your hip joint will show up as pain in the groin (right where the ball and socket joint is located), and the pain will often radiate down the front of your thigh to your knee. Sometimes the pain in the knee has the patient convinced they need a knee replacement! Not so, as the pain is referred to your knee through some amazing neurology that occurs in your brain.
Not all pain in the groin means you need a hip replacement. The hip flexor muscles from the lower back can cause pain in this area. Soft tissue problems around the outside of the hip joint called femoral-acetabular impingement can also cause groin pain.
To keep your hips healthy, see this previous post on a great hip mobility exercise here.
So, there’s really no ifs, ands or buts about it, pain in your butt is mainly from your lower back and you don’t need a hip replacement.
An obvious choice for this blog’s video!!