YANMD, but what do I ask my doctor about this hip/back pain? (In my 20s)

October 21, 2015 12:04 PM

YANMD, but until I can see a doctor, I'm looking for guidance on what questions to ask. Student, mid-20s, male, non-smoker, somewhat overweight (not obese) but relatively healthy otherwise. I don't remember injuring my back or hip recently. Recently, after sitting or standing in place for long periods of time, I develop terrible radiating, bilateral pain in my lower back, right above my buttocks. It feels like I got home from two weeks of skiing! I have to stretch and walk around, and it gets better with exercise. What exercises should I do, and what questions should I ask my doctor?

Yes, I do need to exercise more, though I do quite a bit of walking. However, as a student, I have to sit for long periods of time, and the last thing I need is not being able to study comfortably!

posted by Seeking Direction to Health & Fitness (10 answers total)

You should ask your doctor for a referral to an orthopedist and/or a physical therapist, who can both hep you figure out this out. Depending on your health plan, you may be able to do this on the phone today, without having to go in to see your GP.
posted by brainmouse at 12:10 PM on October 21, 2015

The area you're describing sounds to me like your sacroiliac joints (SI joints). Look into stretches and therapies for that area, see if it makes sense. When I had terrible SI joint pain, I found Pilates exercises extremely helpful.
posted by KathrynT at 12:21 PM on October 21, 2015

You can try some piriformis stretches, which you can do laying on the couch or floor or wherever you feel like laying down. (altho i don't recommend the yoga pigeon pose to anyone with hip pain.)
posted by poffin boffin at 12:25 PM on October 21, 2015

This may not help your lower back pain, but for random shoulder/arm pain, I find running and Pilates both useful.
posted by the_blizz at 12:25 PM on October 21, 2015

I had a similar problem when I was about 50 lb. overweight (male, 44 at the time): radiating pain in my lower back that was alleviated by standing and walking. My physician diagnosed arthritis and said I would need to learn to live with it, but after some prodding he referred me to a physical therapist. The PT asked some questions and prescribed some core strengthening exercises. After a couple of weeks I was a new man. Between PT and losing weight, I have not had a recurrence.
posted by brianogilvie at 12:28 PM on October 21, 2015

Yoga, and PT.

Very often, lower back pain is referred pain from groin muscle tightness. When you sit, your groin and inner quads are contracted while your glutes are stretched. Sit on the ground in a V and lean forward to stretch out the groin muscles, along with your hamstrings.
posted by Dashy at 12:38 PM on October 21, 2015

I had similar pain in college and grad school, and occasionally now as a desk-bound working stiff. (I've always been obese but now I am 50 pounds lighter and fit, though not fast.)

Things that helped:
- Going to a sports medicine doctor to confirm exercise was indeed the thing to do.
- Taking the extra junk out of my backpack and lugging around as little weight as possible. Not an exercise, but helpful.
- Yoga/pilates, especially any poses/exercises that require engaging the pelvic floor and, um, lower part of your core muscles. Not sure of the technical term.
- Gentle engagement of these muscles, whether sitting, standing, or walking. I have a habit of arching my back and disengaging completely, which causes aching back with shooting pains if I take a wrong step. Slightly tucking my pelvis helps a lot.
- Varying my exercise. I just biked last winter (no walking/running/yoga), and was creaky and crabby by February.
- For relaxing a tight lower back, I lay on my back, pull my knees up toward my chest, and rock gently back and forth. It looks funny but feels like a very soft massage.
posted by esoterrica at 12:58 PM on October 21, 2015

Sounds like sciatica pain to me. You can go to an ortho and physical therapy - if it is sciatica ortho will do nothing and send you to the PT. The exercises I use and that take care of it completely can be found on the web. There are 4 basic ones:
-stand behind a chair and arch your back while holding the back of the chair.
-Lay on our back with knees bent and alternately lift your knee to your chest
-Lay on our back with knees bent, tighten your gluts and then make a bridge with your butt in the air ( lift your butt up off the floor with feet on the floor, knees bent.
-on all fours do the yoga cow/cat pose- arch your back then drop it down as you lift your head and tail end.

There are others but these 4 have relieved me of pain every time I pinch that nerve. If sciatica basically you have pinched the nerve in your back and these exercises help to unpinch it.

Good luck.
posted by shaarog at 1:06 PM on October 21, 2015

The resting squat helps me when I get that sitting/standing for too long feeling. If you aren't able to get comfortable squatting flat-footed, progressions typically involve holding on to something in front of you or putting stuff under your heels.

(I wish people wouldn't do this, but a lot of the decent material on the subject calls it the "third-world squat", so maybe try searching that)
posted by hollyholly at 1:30 PM on October 21, 2015

IAAD, but not your doctor. If the pain is worse with prolonged sitting/standing, and especially if you wake up feeling stiff and it takes more than a few minutes to loosen up, the one thing I'd want to rule out before doing any exercise or physical therapy is spondyloarthritis. Why don't you see your friendly neighbourhood physician and tell him/her what's going on? A face-to-face encounter with a physical examination is, I think, going to be the most helpful, rather than seeking advice on the Internet.
posted by greatgefilte at 5:43 AM on October 22, 2015