Have you heard of the “low-back-butt complex”? Perhaps not by that exact name, but it's a term I've coined for a prevalent issue in my practice. Essentially, individuals experiencing low back pain often also suffer from hip pain, and vice versa. Distinguishing between the two can be challenging, as they are often interconnected. Let me elaborate...
It's a feedback loop of pain referral that appears to be quite common. Pain originating from the hip can transmit signals upward to the lower back and across to the other side. Simultaneously, pain in the lower back can radiate downward, typically on the same side. This pain referral pattern fosters guarding and dysfunction throughout the entire region.
For example, pain originating in the right hip can not only refer to the right side of the lower torso but also across the spine and diagonally to the small of the back and the left lower back. The left lower back can then refer pain downward to the left hip. The left hip can, in turn, refer pain back up to the small of the back and over to the right. The right side then refers pain down to the right hip, completing the cycle.
At this juncture, it becomes challenging to determine which part of the body was dysfunctional first and how the dysfunction began. Was it the right hip? The right side of the lower back? Or perhaps the left side? Maybe the left hip?
Tracing pain patterns is a significant aspect of my approach to bodywork. Initially, my inclination is to reduce the intensity of the pain while noting the specific pain pattern. Over the following weeks of treatment, I endeavor to piece together information such as daily activities, postures, and habitual body positions. So, each time I encounter the low-back-butt complex, I approach it with curiosity – it's a familiar pattern. Yet, it presents with its own distinct characteristics, and each client’s unique journey to get to that state.
An important point to remember is that the issue that was loud enough to prompt the client to seek help usually didn’t develop overnight. It's rarely the recent activity, like an awkward sleeping position, road trip, or something that happened while gardening, that caused the underlying problem. Typically, the action leading to back pain was merely “the straw that broke the camel’s back.” Long-standing patterns set the stage for that event to finally “push them over the edge.”
In our following discussion, we will explore the relationships between posture, gait, and other factors that may contribute to the low-back-butt complex. Stay tuned!
