title: Deconstructing Chronic Low Back Pain in the Older Adult-Step by Step Evidence and Expert-Based Recommendations for Evaluation and Treatment. Part VIII: Lateral Hip and Thigh Pain.
abstract: OBJECTIVE
  This article presents an evidence-based algorithm to assist primary care providers with the diagnosis and management of lateral hip and thigh pain in older adults. It is part of a series that focuses on coexisting pain patterns and contributors to chronic low back pain (CLBP) in the aging population. The objective of the series is to encourage clinicians to take a holistic approach when evaluating and treating CLBP in older adults.
  
  
  METHODS
  A content expert panel and a primary care panel collaboratively used the modified Delphi approach to iteratively develop an evidence-based diagnostic and treatment algorithm. The panelists included physiatrists, geriatricians, internists, and physical therapists who treat both civilians and Veterans, and the algorithm was developed so that all required resources are available within the Veterans Health Administration system. An illustrative patient case was chosen from one of the author's clinical practices to demonstrate the reasoning behind principles presented in the algorithm.
  
  
  RESULTS
  An algorithm was developed which logically outlines evidence-based diagnostic and therapeutic recommendations for lateral hip and thigh pain in older adults. A case is presented which highlights the potential complexities of identifying the true pain generator and the importance of implementing proper treatment.
  
  
  CONCLUSIONS
  Lateral hip and thigh pain in older adults can contribute to and coexist with CLBP. Distinguishing the true cause(s) of pain from potentially a myriad of asymptomatic degenerative changes can be challenging, but a systematic approach can assist in identifying and treating some of the most common causes.
authors.affiliation: *Department of Physical Medicine and Rehabilitation, Rehabilitation Institute of Chicago/McGaw Medical Center of Northwestern University, Chicago, Illinois.
authors.forename: Monica
authors.initials: M
authors.lastname: Rho
authors.affiliation: Department of Neurology, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Camacho-Soto
authors.affiliation: *Department of Physical Medicine and Rehabilitation, Rehabilitation Institute of Chicago/McGaw Medical Center of Northwestern University, Chicago, Illinois.
authors.forename: Abby
authors.initials: A
authors.lastname: Cheng
authors.affiliation: Extended Care & Rehab, VA Central Iowa Health Care Systems, Des Moines, Iowa.|Des Moines University, Des Moines, Iowa.
authors.forename: Mark
authors.initials: M
authors.lastname: Havran
authors.affiliation: Geriatric Research Education and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania.|Division of General Internal Medicine, Center for Research on Health Care, University of Pittsburgh, Pittsburgh, Pennsylvania.|Clinical and Translational Sciences Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
authors.forename: Natalia E
authors.initials: NE
authors.lastname: Morone
authors.affiliation: **Division of Geriatric Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
authors.forename: Eric
authors.initials: E
authors.lastname: Rodriguez
authors.affiliation: VITAS Healthcare, Miami, Florida.
authors.forename: Joseph
authors.initials: J
authors.lastname: Shega
authors.affiliation: Geriatric Research Education and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania.|Clinical and Translational Sciences Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.|**Division of Geriatric Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.|Department of Psychiatry.|Department of Anesthesiology, Pittsburgh, Pennsylvania, USA.
authors.forename: Debra K
authors.initials: DK
authors.lastname: Weiner
keywords: Chronic Low Back Pain; Diagnostic Algorithm; Elderly; Greater Trochanteric Pain Syndrome; Hip Osteoarthritis; Iliotibial Band Pain; Lateral Hip Pain; Lumbar Radiculitis; Lumbar Radiculopathy; Lumbar Spinal Stenosis; Meralgia Paresthetica; Thigh Pain