A health condition in which pain occurs in the hips, lower back, buttocks, and groin is called Psoas syndrome. Usually, it is difficult to tell what is causing pain because there are multiple muscles in the areas listed above. If the pain does not go away within 2-3 weeks, you should visit a doctor, especially if it occurs when you move or use your hips.
In other words, this condition causes painful irritation in one of the psoas muscles. Sometimes, this disorder is called iliopsoas syndrome. In general, the psoas muscles begin from the lower back to the top of the hips on either side of the spine.
In general, psoas syndrome occurs rarely, and some people never get diagnosed because the symptoms usually disappear without treatment. Moreover, some healthcare professionals think this syndrome is frequently misdiagnosed or underdiagnosed because there are multiple disorders or injuries that cause pain in those areas of the body.
Symptoms
While the primary symptom of this syndrome is pain, it may also cause stiffness or tightness in the lower back. Usually, pain occurs in the following parts of the body. Examples include:
- Lower back pain, especially in the lumbosacral region (this is the border between the bottom of the spine and buttocks)
- Butt pain
- Groin pain
- Hip pain
- Pelvic pain
The pain caused by this syndrome can worsen in some positions or during physical activity. Sometimes, the pain may spread down the legs or get worse when you try to stand up straight.
Causes and Risk Factors
This condition usually occurs due to overuse of the hips or sports injuries (the most common cause of Psoas syndrome). Some people may also develop this syndrome without an obvious cause. In such cases, the condition is called idiopathic psoas syndrome. In rare cases, certain infections or types of cancer may spread to the psoas muscles and cause pain.
While this condition can affect anyone, some people are more likely to develop it. Check below some factors that could elevate your risk of psoas syndrome:
- Hockey
- Track and field sports (especially high jump and hurdles)
- Running
- Dance
Moreover, children and teens who play sports may have an increased risk because their bodies are changing and developing quickly. As a result, their muscles are more prone to injuries and irritation. Sometimes, people may develop psoas syndrome as an adverse reaction after a hip surgery (such as hip replacement).
What Are The Potential Complications of Psoas Syndrome?
While this syndrome rarely causes complications, some people can experience the following ones, especially if they do not get treatment. Examples include:
- Persistent pain
- Reduced mobility
- Pelvic and spinal misalignment
- Psoas abscess
- Nerve compression
- Venous thromboembolism (VTE)
This article does not contain all possible complications of psoas syndrome. In any case, you can consult with your doctor about ways to reduce the risk of developing the previous complications.
How to Prevent Psoas Syndrome?
Doctors usually recommend warming up and stretching before exercise or physical activity to reduce the risk or even prevent all types of muscle injuries. It helps improve overall flexibility and protect the muscles. Sometimes, physical therapists may change your posture when you are sitting, exercising, or doing other activities to reduce the irritation of the psoas muscles.
Furthermore, you should not increase your activity level suddenly. Usually, it is advised to increase your training intensity slowly over time. If your psoas muscles are affected, you should avoid heavy lifting, running, or hills until they heal.
Diagnosis
Usually, doctors begin the diagnosis of psoas syndrome with a physical examination to check for irregularities linked to the disease. They may also ask some questions about your lifestyle habits and symptoms. During this procedure, doctors will examine the hips, legs, and spine. Furthermore, diagnosing this condition is often a differential diagnosis, which means doctors will exclude other disorders that cause similar symptoms. Check below some musculoskeletal problems that may cause similar symptoms:
- Adductor muscle strains
- Hip labral tears
- Hip growth plate fractures (this occurs mostly in children and teens)
- Hernias
- Trochanteric bursitis
However, there are some health conditions that may also cause symptoms similar to psoas syndrome. These include:
- Kidney stones
- Prostatitis
- Arthritis
- Some types of cancer or muscle infections (in rare cases)
During differential diagnosis, physicians may also perform some imaging tests to get images of the spine, hips, and other parts of the body. For example:
- Spine or hip X-rays (this test is often used to check for arthritis)
- Ultrasound
- MRI (magnetic resonance imaging) scans
Sometimes, your doctor may perform a blood test to check for infections.
Treatment
In most cases, doctors prescribe different treatments for people with this syndrome because they depend on the exact cause. Check below for the most common treatments:
- Physical therapy
- Rest of stopping the activity that caused psoas syndrome
- OMT (osteopathic manipulative treatment)
- Cortisone shots
Core Stabilization
In some cases, physical therapists may recommend a core stabilization program. It includes specific exercises that help strengthen the core muscles and improve movement between the core, spine, and pelvic area.
Frequently Asked Questions
What are psoas stretches?
These include specific exercise or posture changes that target the psoas muscles. In some cases, they are called psoas releases. During this procedure, therapists will teach you exercises that you can do at home to improve the effectiveness of the treatment.
Does psoas syndrome go away?
Most people regain a full range of motion with treatment and exercises. After recovery, you can resume the previous activity level of physical activities. For more details, discuss it with your doctor.
How long does it take to recover from psoas syndrome?
In most cases, people recover within 1-2 months, but pain becomes milder after starting the treatment (such as physical therapy or OMT). It is very important to consult with your doctor about the time when you can resume the training or intense physical activities. If you have additional questions, ask your healthcare provider.
