Hip Pain Treatment in Royal Palm Beach, FL
Hip pain is frequently mislocated. The SI joint, the lumbar spine, and the hip itself can all produce pain in the same region. Knowing which one matters.
Hip pain treatment in Royal Palm Beach, FL at Cobblestone Spine and Joint Institute requires careful clinical differentiation between three structures that produce overlapping symptom patterns: the hip joint itself, the sacroiliac joint, and the lumbar spine. Pain felt in the hip region can originate from any of these sources. It can also be referred from a lumbar disc herniation at L2 or L3, which refers directly to the groin and anterior hip. Getting the diagnosis right before starting treatment is the difference between getting better and going in circles.
Dr. Dean Mammales uses specific provocation testing, including Patrick's FABER test, Gaenslen's test, and hip quadrant testing, to differentiate between these sources before any treatment begins.
Common Sources of Hip Pain
The SI joint is a primary weight-bearing joint between the sacrum and the ilium. Dysfunction here produces pain in the posterior hip and buttock that is often mistaken for lumbar disc pain.
Degeneration of the hip joint cartilage produces groin pain, restricted internal rotation, and a characteristic pattern of stiffness in the morning and after sitting.
The piriformis muscle sits directly over the sciatic nerve in the buttock. When tight or in spasm, it compresses the nerve and produces buttock and leg pain that mimics disc herniation.
Femoroacetabular impingement involves abnormal contact between the ball and socket of the hip. Produces groin pain during hip flexion and is common in younger athletic patients.
Inflammation of the bursa on the outer hip. Produces lateral hip pain that is worse lying on that side. Responds well to MLS laser therapy.
L2 and L3 nerve roots refer pain to the groin and anterior thigh. A patient who thinks they have a hip problem may actually have a lumbar disc issue.
The Sacroiliac Joint: Most Often Missed
The SI joint is the most commonly missed diagnosis in patients presenting with hip and lower back pain. Research suggests that SI joint dysfunction is responsible for approximately 15 to 25 percent of lower back pain cases, yet it is rarely specifically tested for in primary care. The pain pattern is posterior hip and buttock pain, sometimes with radiation into the posterior thigh, that worsens with one-legged standing, climbing stairs, and rolling over in bed.
We treat SI joint dysfunction frequently and effectively with targeted sacroiliac manipulation and hip strengthening protocols. Many patients who have had months or years of lumbar-focused treatment with incomplete resolution have an SI joint component that was never addressed. Once it is, the improvement is often rapid.
Hip Pain in the Equestrian Community
Wellington and Loxahatchee have large equestrian populations and riders develop hip pain in specific patterns. Years of sustained hip adductor contraction in the saddle compresses the medial hip structures. Asymmetrical posting creates differential loading on the SI joints, producing unilateral SI joint dysfunction that is often described as hip pain on the more heavily loaded side. We have treated many Wellington and Loxahatchee riders for this pattern and understand the biomechanics of riding-related hip dysfunction well.
MLS Laser for Hip Pain
For hip bursitis, tendinopathy, and inflammatory hip conditions, MLS laser therapy produces significant pain reduction and accelerates tissue healing. Combined with the mechanical corrections described above, it shortens the treatment timeline meaningfully for most inflammatory hip presentations.
Call (561) 753-2225 or book your evaluation here. Bring any hip imaging you have from the past two years.
Hip Pain Needs the Right Diagnosis.
We differentiate between the SI joint, lumbar spine, and hip joint at your first visit. Same-week appointments available.