Proximal Hamstring Tendinopathy Presenting as Hip and Lower Back Pain

A woman in her early sixties presented with moderate lower back pain, right groin pain, and right hip pain beginning several years prior. After a brief spontaneous resolution, she experienced severe exacerbation seven years later and was treated with anti-inflammatory medication, physical therapy, sacroiliac joint injection, and hip arthrogram without improvement. Symptoms spontaneously resolved approximately one year later. Eight months before presentation, symptoms reappeared with higher intensity. Another sacroiliac injection and hip radiograph were negative. Lumbar magnetic resonance imaging (MRI) revealed disc herniations. The patient worked part-time and was very active but had difficulty with activities of daily living. Initial chiropractic treatment improved lower back pain but not hip pain. Right hip MRI revealed proximal hamstring tendinopathy with partial tear. Treatment addressing the hamstring resulted in complete resolution. This case emphasises independent MRI review and ordering advanced imaging when initial treatment fails.