What’s the Difference Between Psoriatic Arthritis and Rheumatoid Arthritis?

From healthcentral.com

While both these conditions involve your joints, some key points of distinction can help you tell them apart

Psoriatic arthritis (PsA) and rheumatoid arthritis (RA) are both chronic inflammatory diseases that impact the joints. Telling the conditions apart can be challenging, but there are differences between the two that a trained eye can detect, says Laura Coates, Ph.D., an associate professor and researcher of psoriatic arthritis at the University of Oxford in England. Psoriatic arthritis is characterized by joint inflammation and often includes skin psoriasis. Meanwhile, rheumatoid arthritis is characterized by joint inflammation that affects multiple joints, often in a symmetrical fashion (i.e., both knees or both wrists). 

How else are they similar and different? Let’s take a closer look at the ways these conditions overlap and what makes them unique.

Psoriatic Arthritis or Rheumatoid Arthritis?

The presence of psoriasis, an inflammatory skin condition, is often a clue that points to psoriatic arthritis rather than RA. Psoriasis occurs before the development of psoriatic arthritis in about 85% of patients.

There is also a gender gap between the two conditions: Psoriatic arthritis affects men and women equally, while more women than men develop rheumatoid arthritis, according to the Arthritis Foundation. Other key differences to look for include symmetry of symptoms: RA affects the hands, knees or ankles, and usually the same joint on both sides of the body (both hands as an example). RA is more common than PsA, affecting approximately one million people in the U.S., while psoriatic arthritis impacts roughly half that.

Meanwhile, although PsA symptoms differ between patients, peripheral joints are often involved, such as the fingers and toes. Back involvement is commonly associated with psoriatic arthritis (up to 70% of the time), and nail issues are often present. Dactylitiis, the swelling of a finger or toe, would also point to psoriatic arthritis. And unlike the symmetry of RA, PsA typically attacks joints on one or the other side of the body.

Key differences between rheumatoid arthritis and psoriatic arthritis include:

Rheumatoid Arthritis (common with RA but not PsA):

• Symmetrical joint involvement

• Cervical spine involvement (neck)

• Interstitial lung disease

• Rheumatoid Factor Positive

• IL-6 driven (inflammatory pathway)

• HLA-DRB1 alleles (genetic link)

Psoriatic Arthritis (common with PsA but not RA):

• Psoriasis

• Distal joint involvement

• Asymmetrical joint involvement

• Axial spine involvement

• Enthesitis

• Dactylitis

• Nail involvement

• IL-17A-driven (inflammatory pathway)

• IL-12/23-driven (inflammatory pathway)

• HLA-B27 alleles (genetic link)

Causes

How or why someone develops rheumatoid arthritis or psoriatic arthritis is not completely understood, but there are a few strong ideas. A combination of genetics and the environment is believed to play a role in both diseases. According to research in the journal Rheumatic and Musculoskeletal Diseases, one theory of how rheumatoid arthritis comes to fruition is the development of lung inflammation first, typically prior to joint symptoms, with the accompanying production of antibodies to citrullinated protein antigens. The gut and associated microbes are suspected of initiating psoriatic arthritis, according to the same source.

Family history, smoking or a viral infection may also play a role in the pathogenesis of both conditions. No matter the initial causes, both diseases trigger high amounts of inflammatory proteins (called cytokines) that are associated with joint pain and damage.

Comparison of Symptoms

In addition to the specific joints involved and symmetrical versus asymmetrical symptoms, there are other ways your doctor may be able to tell PsA for RA. According to Coates, tell-tale signs your doctor may look for include:

Psoriatic arthritis indicators:

• RF and anti-CCP seronegative blood tests

• Inflammatory markers often normal

• Absence of rheumatoid nodules

• Asymmetric oligoarticular manifestations

• Predilection for the distal interphalangeal joints

• Radiologic damage

• Spinal issues (in about 50% of cases)

• Skin manifestations (psoriasis)

Rheumatoid arthritis indicators:

• RF and anti-CCP seropositive blood tests

• Inflammatory markers usually raised

• Rheumatoid nodules present over bony prominences

• Symmetrical polyarticular manifestations

• Typically affects the metacarpophalangeal and proximal interphalangeal joints

• Radiologic changes

• Spine is largely unaffected

• Skin manifestations are atypical

Diagnosing Rheumatoid Arthritis and Psoriatic Arthritis

To determine if you have either condition, your provider will usually begin with a physical exam. If multiple joints are inflamed and are predominantly symmetric, this may indicate rheumatoid arthritis. Joint involvement is often, but not always asymmetric in psoriatic arthritis (the right elbow and left knee may be painful).

Your provider will also be on the lookout for which joints are impacted: RA typically affects the shoulder, elbow, wrist, hip, knee, ankle and foot joints. In psoriatic arthritis, the joints of the hands and feet, large joints of the lower extremities, the axial spine and sacroiliac joints are commonly affected. If you have back pain, where the back hurts may also be an important clue. Back pain is usually not present in rheumatoid arthritis other than cervical spine pain (pain in the neck region).

There may be other clues to differentiate the two conditions that are important in the diagnosis process. Dactylitis, inflammation of the entire finger or toe, can be common with psoriatic arthritis. Dactylitis impacts psoriatic arthritis patients up to 50% of the time, compared with approximately 5% of patients with rheumatoid arthritis.

The presence of nail disease may also help your provider make a diagnosis. Up to 80% of people with psoriatic arthritis have some sort of nail changes. Nails may have pitting, discoloration, thickening, or the nail may be pulling away from the nail bed, as examples.

Blood tests may also help your doctor with a diagnosis. Approximately 80% of people with rheumatoid arthritis test positive for rheumatoid factor (RF) and about 60% to 70% have antibodies to cyclic citrullinated peptides (CCP), according to the Cleveland Clinic. RF and CCP are absent in most individuals with psoriatic arthritis.

Different types of imaging tests may also be required. For example, x-rays may be used to look for changes to the bones, such as new bone formation related to psoriatic arthritis. Magnetic resonance imaging (MRI) or an ultrasound test may help your doctor look at soft tissue issues, such as enthesitis that may also be related to psoriatic arthritis or tenosynovitis (inflammation around the tendon) which may indicate rheumatoid arthritis.

To aid in your diagnosis, your doctor will also collect information about your family’s medical history. If a parent or sibling has psoriatic arthritis, that greatly increases your chance of developing psoriatic arthritis, with a recurrence rate between 30% to 55%, according to the Journal of Rheumatology. On the other hand, while there is a family risk associated with rheumatoid arthritis, genes only slightly increase the risk. Environmental factors are likely to play a stronger role, according to the American College of Rheumatology.

Even with an experienced provider, differentiating between the two conditions isn’t easy 100% of the time, says Coates. “Typical rheumatoid arthritis and typical PsA are quite different, but sometimes there are ‘gray’ cases in the middle that confuse us and can be tricky to separate,” she says.

Treating Rheumatoid Arthritis vs. Psoriatic Arthritis

Reducing inflammation and treating “upstream” symptoms of the diseases is the name of the game when deciding on treatment options for both rheumatoid arthritis and psoriatic arthritis, according to the journal Rheumatic and Musculoskeletal Diseases. Steroids or methotrexate are examples of medications that will reduce inflammation related to both conditions.

However, medications that target more downstream symptoms and that are more disease-specific are not effective for both conditions, says Joel Gelfand, M.D., a board-certified dermatologist and director of the Psoriasis and Phototherapy Treatment Centre at Penn Medicine in Philadelphia, PA. “Several medications are effective for psoriatic arthritis but not RA, biologics targeting IL-23 or IL-17 being some examples,” Dr. Gelfand explains. Similarly, a biologic targeting the IL-6 inflammatory pathway would be prescribed for rheumatoid arthritis and not psoriatic arthritis.

Interestingly, some of the medications approved for both conditions may be processed differently in the body based on the condition. For example, Dr. Gelfand and colleagues investigated the risk of liver disease in patients with psoriasis, psoriatic arthritis, and rheumatoid arthritis receiving methotrexate. They found that individuals with psoriatic disease were more susceptible to liver disease and methotrexate hepatotoxicity than were rheumatoid arthritis patients.

“There is the concept of the psoriatic liver, where the inflammation in psoriasis seems to promote fatty liver changes which could be aggravated by methotrexate,” Dr. Gelfand explains. “A variety of blood tests and imaging techniques are now available to detect liver fibrosis (scarring) before clinically significant liver damage occurs, so methotrexate can be used safely in most patients with psoriatic disease.”

Having Both?

Fortunately, the odds are great that you won’t get both conditions. According to Coates, “It’s hard to ever say ‘never’ in medicine but this is pretty much a no.” Sometimes, it just takes time to sort things out, she says. “I saw one patient who was originally diagnosed with PsA and psoriasis and had psoriatic arthritis-type pattern disease but then after a few years he developed new rheumatoid antibodies (that were definitely negative before) and his arthritis changed.”

Takeaways

Both rheumatoid arthritis and psoriatic arthritis are similar and overlapping because both are inflammatory conditions that impact joints. There are important differences between the two diseases, and it is important to get to an experienced healthcare provider such as a rheumatologist who is familiar with the subtleties of each. Early detection and treatment for both is mission critical. The quicker a correct diagnosis is made, the sooner treatment can begin and remission achieved.

https://www.healthcentral.com/condition/psoriatic-arthritis/psoriatic-arthritis-vs-rheumatoid-arthritis

Arthritis Treatment: How Active Lifestyle Helps To Ease Joint Pain And Inflammation

From india.com

Physical exercise is crucial for achieving optimal physical and mental health to manage arthritis. Additional advantages to treating joint pain and discomfort may also come from exercise

Arthritis is a painful condition which affects one or more joints. It leads to joint pain and stiffness, which hamper day to day activities of the patient. When left untreated, arthritis can reduce one’s range of motion and even make it difficult to sit up straight. Arthritis can make it difficult to do everyday tasks like walking or even just picking things up, regardless of the reason. Symptoms of this bone-related condition usually worsen with age.

How Exercise Eases Arthritis Pain And Discomfort?

Your joints, such as those in your fingers, hips, and knees, hurt from arthritis, which also makes it challenging to move them. If you have arthritis, these joints may become swollen, stiff, and painful. A number of factors, such as age or when your body’s defence system starts fighting your own joints, can cause it. Regular exercise helps prevent bone loss, keep the muscles around weak joints healthy, and perhaps reduce joint discomfort and swelling. Working out also relieves pain and stiffness by replenishing the lubricant in the joint cartilage.

5 Exercise Tips For Arthritis Patients

1. Warm-Up Exercise: Start your exercise session with a light warm-up. Your risk of injury is reduced by warming up your muscles and joints in preparation for the next workout. In this sense, gentle stretches and range-of-motion exercises are very helpful.
2. Low-Impact Workout: Exercises that have little impact and are easy on the joints should be prioritized. Walking, stationary cycling, swimming, and water aerobics are all excellent forms of exercise. These activities benefit your heart while placing little strain on your joints.
3. Stay Hydrated: To keep your joints lubricated and lower your risk of cramping, it is crucial to stay hydrated. Water is important to consume before, during, and after exercise.
4. Consistency: Stability and steadiness are essential to reap the benefits of exercise for managing arthritis over the long run. To gain from exercise’s potential for improving your life with arthritis, aim for consistent, ongoing activity.
5. Rest: Rest is important so that your joints can heal and recover as a result. Overtraining can exacerbate the effects of arthritis and cause more severe problems.

Managing symptoms and, maintaining an active lifestyle are the two most crucial things to do after receiving a diagnosis of arthritis. If a person experiences joint pain along with redness, swelling, soreness, or warmth close to the joint, they should see a doctor.

https://www.india.com/health/arthritis-treatment-how-active-lifestyle-helps-to-ease-joint-pain-and-inflammation-5-tips-6411104/ 

‘A new door opens’: Keith Richards says arthritis has changed how he plays guitar

From theguardian.com

Rolling Stones guitarist says he is in no rush to stop touring as band releases first studio album in 18 years

He owns more than 1,000, though he plays only a few on stage. But as Keith Richards’ love affair with the guitar remains undimmed, his fingers are not quite what they used to be.

The Rolling Stones guitarist struggles with arthritis, which has affected the way he plays. “Funnily enough, I’ve no doubt it has, but I don’t have any pain: it’s a sort of benign version,” he told BBC Radio 4’s Today programme. “I think if I’ve slowed down a little bit it’s probably due more to age.

“And also, I found that interesting, when I’m like, ‘I can’t quite do that any more,’ the guitar will show me there’s another way of doing this. Some finger will go one space different and there’s a whole new door just opened here.”

Richards (right) performing on stage with Mick Jagger at the London Stadium in 2018. Photograph: Simone Joyner/Getty Images

Richards, 79, was speaking as the band releases Hackney Diamonds, its first studio album of original material in 18 years. The decision to return to the studio, he said, came when Mick Jagger suggested it at the end of the band’s 60th anniversary tour last year. “And for the first time it hit me in the right spot,” says Richards. “Because I’ve always wanted to record the band as soon after they get off of the road as possible, because then the band is lubricated.”

Track titles such as Angry and Live by the Sword suggest it’s an antagonist album – and the album’s title is London slang for the beads of shattered glass on the street after a smash-and-grab. “Mick writes the lyrics,” Richards said.

“But he’s got some angst in him and I said, ‘Well, let’s use it because the singer has to want to sing the material’.

“Mick, given a song that he’s not really interested in, can really make it bad. And that’s maybe one of the reasons it took 18 years, because Mick’s waves of enthusiasm come and go.”

They tried to keep the album as “simple as possible”, he said. “And we actually cut this record to be a vinyl record, with a cover, and a plastic thing that you pull out and put on the turntable.”

Of vinyl, he said: “It’s by far the best sound if you really want to listen to a record. I mean, digital is toy town. You use synthesisers. Now we have AI, which is even more superficial, artificial.”

Guest artists on the album include Lady Gaga and Stevie Wonder. “Which is the thing that only happens when you record in LA, ha ha: guess who’s dropped by!”

“Lady Gaga is a piece of work,” added Richards. “I love working with her because she has a great attitude towards things and a great voice, and I always wanted to see her play off against Mick.”

The plan, he said, was to take it on the road next year “while everybody is still standing”.

Asked if the Rolling Stones would ever stop touring, Richards laughed. “My answer is I’m not Nostradamus. Of course it’s going to end some time, but everybody is in good fettle. There’s no particular rush.

“We’re having great fun doing this. And this is what we do.”

https://www.theguardian.com/music/2023/oct/10/keith-richards-rolling-stones-arthritis-has-changed-how-he-plays-guitar 

Stiff Low-Back and Aching Hip Pain: What's Causing It?

From verywellhealth.com

Sudden pain could be the result of a minor injury, such as a strain 

Low-back and hip pain typically affects one side of the body. However, it is possible to have pain on both sides depending on the underlying cause or if you experience pain that radiates or is widespread. 

Low-back pain is one of the most common reasons for healthcare provider visits and time missed from work. It often occurs with hip pain, but back pain can sometimes be mistaken for hip pain. This is because the hip joint is located near the lumbar spine (low back). A hip injury might also mimic back pain.  

Hip and back pain might also occur with the following:

• Referred back pain
• Groin pain on the same side
• Stiffness and tenderness 
• Pain with movement and walking 
• Leg pain on the affected side

Boy_Anupong / Getty Images

Referred back pain is pain from a source in the low back that is felt in the upper thigh, buttock, and groin. Referred back pain typically does not occur below the knee and might occur with specific causes, including kidney stones and gallstones.

Right-sided pain might be linked to specific causes, such as kidney and gallbladder problems. However, it's possible to experience pain on either side (depending on which kidney is affected) or pain that radiates throughout the back and into the abdomen.

One-sided back and hip pain can occur on the left or right side and is linked to multiple causes, including muscle strains, a pinched nerve, arthritis, herniated discs, and sacroiliac (SI) joint problems. Some low-back and hip pain causes might be specific to people assigned female at birth, such as pregnancy and gynaecological problems.

Fortunately, hip and back pain and their underlying causes are manageable and treatable. Surgery is rarely needed to manage pain and other symptoms. 

This article will cover the causes of one-sided low-back and hip pain, pain management, emergency care, and tips on living with chronic back and hip pain.  

What Causes One-Sided Low-Back and Hip Pain? 

The most common causes of hip and back pain are injuries, arthritis, and disc problems. You might also experience it as a result of an underlying health condition. Many causes of one-sided back pain might also affect both sides of the body.

Overuse Injury 

Back and hip strains can be caused by overuse, in which repetitive movements damage muscles over time. Stressful, repetitive motions can cause the low-back muscles to become stiff and sore. They might also lead to overstretched muscles and small tears in affected muscle areas.

Sports like baseball, tennis, and golf can contribute to strain because they involve sudden, forceful movements.

A chronic strain of the low back can cause significant pain over time. You might also have severe pain in a muscle area that is already inflamed and experiences extra stress. 

Vertebral Fracture

A vertebral spine fracture occurs when one or more vertebrae (bones of the spine) are compressed or cracked. Vertebral fractures are common in older adults, people with osteoporosis (a bone-thinning disease), or after a severe traumatic injury (i.e., an automobile accident or fall).

Symptoms of a vertebral fracture include a sudden popping sound in the low back and back pain that radiates in the hip, buttocks, and legs. 

Arthritis

Arthritis is a common cause of one-sided back and hip pain, although some types may affect the entire lower back and both hips. Back pain associated with arthritis is considered chronic. Arthritis can cause radiating back pain that comes and goes, back stiffness, hip pain, and reduced mobility. 

Axial spondyloarthritis (axSpA) is a type of inflammatory arthritis that primarily affects the spine and causes severe low-back and hip pain. Additional symptoms include fatigue, joint pain, heel pain, and eye inflammation. 

Additional arthritis types that might lead to low-back and hip pain are: 

• Psoriatic arthritis (PsA): Psoriatic arthritis is a type of inflammatory arthritis that attacks the joints and skin. In about 20% of people with the condition, PsA involves the spine and can lead to the fusing of one or more vertebrae.
• Osteoarthritis (OA): OA is the most common type of arthritis. When it affects the spine, it can lead to loss of cartilage in the facet joints where the vertebrae meet, leading to pain and the formation of bone spurs that might press on nearby nerves and cause further pain.
• Reactive arthritis: This type of arthritis occurs after a genital, urinary, or gastrointestinal system infection. It can cause inflammation of the joints, including the sacroiliac joint, leading to low-back and hip pain. You have two SI joints where the lower spine and pelvis connect.
• Enteropathic arthritis: This arthritis type sometimes occurs with inflammatory bowel disease and commonly affects the SI joint, causing low-back and hip pain on one or both sides of the body.
• Spinal stenosis: Caused by a bony overgrowth of the vertebrae and thickening of ligaments, spinal stenosis (narrowing of the spinal canal) may cause low-back pain, hip pain, pain and numbness of the legs, and bladder and bowel problems. It may result from changes related to OA and other arthritis types. 

Disc Injury

A disc injury, such as a tear or herniation, can cause low-back and hip pain. A small tear in the disc's outer part can occur due to aging. If this occurs, you may experience severe pain lasting for weeks or months. 

You might develop a herniated disc from lifting, bending, or twisting. A herniated disc occurs when the gel-like centre of the disc (nucleus) pushes against the outer part. The nucleus may press through if the disc is significantly worn out or experiences trauma.

If the disc bulges or protrudes (bulging disc), it may pressure the spinal nerves, causing pain. This pressure may cause low-back pain extending into the hip, the buttock, and the leg. 

Degenerative Disc Disease 

The intervertebral discs between adjoining vertebrae in the vertebral column can wear away and shrink. When this happens, they can collapse and lead to facet joint pain. The facets are located between each vertebra at the back part of the spine. When the discs and the facets rub against each other, you will experience pain. 

Pain from degenerative disc disease affects the low-back and hips on one side or both. It may radiate into the buttocks and hips and worsen with lifting, bending, and twisting. It might improve with activity, including walking and running.

Piriformis Syndrome

Piriformis syndrome is an injury caused by compression of the sciatic nerve. the piriformis muscle sits deep in the buttock. When it spasms, it may compress and irritate the sciatic nerve, causing radiating symptoms down the leg. The nerve can become compressed from an injury, muscle spasms, or inflammation. 

This condition can cause one-sided pain in the low back, hip, buttock, and back of the leg. It can also cause sciatic nerve pain (sciatica), including sharp, shooting leg pain. 

Sciatica pain results from irritation of the sciatic nerve—the largest nerve in the body, which starts in the low back and goes down into the foot. You have two sciatic nerves, one on each side of the body.

Sciatica can occur with various low-back pain conditions. It does not cause back pain but can be a symptom of an underlying back pain cause.

A Pinched Nerve 

A pinched nerve in the back might cause low-back and hip pain. This type of pain is often severe and accompanied by numbness.

If you have a pinched nerve, pain may come on suddenly and progress. Pain might radiate into the legs. You might experience weakness of the lower extremities. 

A pinched nerve might occur for various reasons. Causes include peripheral neuropathy, disc herniations, or arthritic spine changes.

Sacroiliac Joint Dysfunction

Sacroiliac joint dysfunction can cause low-back and hip pain. Low-back pain related to SI dysfunction can be dull and achy and is typically felt on one side. It may spread into the hips, buttocks, and groin. 

Sacroiliitis (inflammation of the SI joints) might also lead to low-back pain and hip pain. It commonly occurs in people with inflammatory arthritis, including ankylosing spondylitis and rheumatoid arthritis. It often affects one side of the body but can sometimes affect both.

Infection 

An infection can occur anywhere in the spinal column, including intervertebral disc space, the spinal canal, and nearby tissues. A spinal infection can also occur after a spinal trauma or surgery to the spine. 

Symptoms that might occur with a spinal infection include severe back pain, fever, chills, muscle pain and spasms, weakness and numbness in the arms and legs, and bladder or bowel incontinence. 

Poor Posture 

Poor posture and slouching can lead to low-back and hip pain on one or both sides. You may experience pain while sitting, but pain might also occur when standing and walking, especially after sitting for an extended period. 

Kidney Pain

You can feel pain in the area of your back where your kidneys are located. Kidney pain can affect one side of the back or both.

But having pain in both of the areas of your back closest to your kidneys does not mean you have a problem with one or both kidneys. This is because there are many muscles, bones, and organs around and near your kidneys and, without diagnostic testing, it is hard to pinpoint a cause.

See a Healthcare Provider

If you have constant back pain that is limited to the area where your kidneys are located, or you think you might have a kidney problem, contact your healthcare provider right away.

Pelvic Floor Dysfunction 

The pelvic floor is the group of muscles in the pelvic region that support the organs of the pelvis (bladder, rectum, uterus, etc.). The pelvic floor muscles control urination, bowel movements, and sexual intercourse. 

Pelvic floor dysfunction is the inability to control pelvic floor muscles, leading to urinary incontinence and inability to complete bowel movements. It may also cause low-back, hip, and pelvic pain on one or both sides of the body.

Gynaecologic Conditions 

Back and hip pain can affect anyone. But people assigned female at birth will experience back pain more often than those assigned male at birth. Researchers have long suspected that body structure and hormone differences are to blame. 

Various gynaecologic conditions can cause low-back and hip pain. Such conditions only affect people assigned female at birth. Pain might occur on one or both sides of the body.

Gynaecologic conditions that can lead to back pain that affects one side or both include:

• Premenstrual syndrome (PMS): A group of mental and physical changes that occur days or a week before a monthly menstrual cycle
• Endometriosis: A condition with growths of tissue like the lining of the uterus (endometrium) in the abdomen and pelvic area resulting in painful and heavy periods and fertility issues
• Dysmenorrhea: Painful periods
• Premenstrual dysmorphic disorder (PMDD): A more severe form of PMS
• Adenomyosis: Painful and heavy periods as a result of endometrial tissue growth 
• Polycystic ovary syndrome (PCOS): A hormonal disorder that causes numerous small cysts to form on the ovaries, can cause low-back and sacral pain (at the bottom of the lumbar spine)
  
• Ectopic pregnancy (or other pregnancy-related complications): A pregnancy complication where the embryo attaches outside the uterus
• Pregnancy: Common occurrence that may be due to hormone increases, additional weight, centre of gravity changes, posture changes, and stress on the body.
  

Is Low-Back and Hip Pain Ever a Sign of Cancer?

It is rare, but low-back and hip pain might be related to some cancer types. For example, back pain might be an early sign of prostate cancer, or it may occur with spinal cancer. But if back and hip pain occur in people with cancer, they will present with other symptoms, including severe fatigue, fever, and weight loss. 

Different Ways to Manage Low-Back and Hip Pain

Depending on the cause of your low-back and hip pain, your healthcare provider might prescribe treatments to manage symptoms. 

Your treatment options might include:

• Physical therapy to reduce stiffness and keep you mobile 
• Prescription pain relievers to relieve pain and bring down inflammation 
• Oral and injection corticosteroids to ease inflammation and pain
• Muscle relaxers to help with muscle pain and spasms 
• Hormonal birth control to treat gynaecological back pain causes 
• Antidepressants to help relieve chronic back and hip pain and the symptoms of PMS or PMDD
• Surgery in rare instances, which may include surgery to repair discs and other vertebrae problems, or to remove endometrial-like tissue in people with endometriosis 
  

Follow Your Treatment Plan

Pain relief and improvement can take time and commitment. Therefore, it is important to be patient and follow your treatment plan.

Let your healthcare provider know if treatments are not helping or causing severe side effects. You should also notify them about back pain that continues up to six weeks after treatment or that interrupts your sleep for at least three nights over one week. They can change your treatment plan or order testing to determine additional causes of hip and back pain.

Emergency Low-Back, Hip, and Pelvic Symptoms 

If you experience pain that comes on suddenly and worsens quickly, you might have a serious condition that requires emergency medical attention. 

Low-back, hip, and pelvic symptoms that require emergency care include:

• Pain going down one leg below the knee
• Back or hip pain after a fall or injury
  
• Back or hip pain accompanied by a fever
• A sharp, shooting pain rather than a dull ache
• Sudden leg weakness 
• Bladder or bowel incontinence 
• Saddle anaesthesia (a loss of feeling in the buttocks, groin area, and insides of the thighs) 

If you are experiencing leg weakness, saddle anaesthesia, and incontinence, this could be a sign of a  severe condition called cauda equina syndrome(CES). CES is caused by nerve compression. It is a medical emergency that requires immediate nerve decompression surgery to reduce permanent damage. 

Tips for Living With Chronic Low-Back and Hip Pain

Chronic low-back and hip pain can affect more than just the body. It can stop you from doing the things you enjoy and lead to feelings of depression. Fortunately, there are measures you can take to manage pain and help yourself feel better emotionally and physically. 

Tips for managing chronic low-back and hip pain include: 

• Stay active: Exercise is vital to any chronic back pain treatment plan. It is one of the first therapies your healthcare provider will recommend. A physical therapist can tailor a plan designed for your unique health situation and suggest ways to make exercise a part of your daily routine. 
• Improve posture: Be aware of your posture and take steps to improve it. Pay attention to your posture while sitting, standing, and walking, learn to properly lift heavy items, and avoid sitting for long periods. 
• Address sleep problems: Adults need seven to nine hours of sleep at night. Ways to improve your sleep quality include making sure your bed is comfortable, keeping smartphones and other devices out of the bedroom, and keeping your bedroom dark and at an ideal temperature. Talk to a healthcare provider if you still have difficulties with sleep, even after addressing sleep hygiene. 
• Manage stress: If you are dealing with significant stress, you may find it harder to manage back and hip pain. Consider different ways to relax, such as mindfulness, meditation, deep breathing, and yoga. Smartphone apps can be helpful guides to relaxation and meditation techniques. 
• Use pain-relief creams: You can find various over-the-counter (OTC) pain-relieving creams and ointments at your local pharmacy and online. Many of these have cooling and numbing effects for pain relief. Some newer creams contain cannabidiol (CBD). Research on CBD ointments and creams has shown they are effective in managing back pain following spinal surgery.
• Consider alternative therapies: Acupuncture, massage, laser therapy, and electrical nerve stimulation can be extremely helpful for managing chronic back and hip pain. Ask your healthcare provider which alternative therapies might help you.
• Make changes to your diet: If you eat foods considered inflammatory, you might experience more back and hip pain. This includes trans fats, refined sugars, and processed foods. Talk to your healthcare provider to see if diet changes might improve your hip and back pain. Keeping a healthy weight might also improve back and hip pain because it reduces spinal pressure. 
  

Summary 

Low-back and hip pain are common problems. Back and hip pain occurs because the back muscles and spine support much of the body's weight with walking, standing, sitting, and other activities.

Common causes of back and hip pain include injuries, arthritis, poor posture, or repetitive stress on the lower back. Some causes of low-back and hip pain are specific to people assigned female at birth, including pregnancy, PMS, endometriosis, and dysmenorrhea.

Back pain is considered chronic if it lasts three or more months. Chronic back pain can cause additional symptoms, including hip, leg, and buttock pain. Back and hip pain typically affect one side of the body, but it is possible to have pain that radiates throughout the entire lower back and affects both hips.

You can manage low-back and hip pain with lifestyle medications and self-care. Your healthcare provider can prescribe additional therapies to help you manage underlying causes and treat severe pain. Surgery is rarely needed to treat back and hip pain.

Contact a healthcare provider if back and hip pain does not improve or worsen. You should seek emergency care for back and hip pain that presents with leg weakness, saddle anaesthesia, and incontinence. These are signs of cauda equina syndrome, which is a medical emergency.

https://www.verywellhealth.com/lower-back-hip-pain-7974013