Hip pain can sometimes cause lower back pain, and vice versa. Your hips can cause back pain because they sit near your spine therefore, the pain may be felt in your back.
Lower back and hip pain can be caused by injury during sports activities, conditions such as arthritis, strain, or poor posture.
Your hip and lower back share causes since they perform similar roles, such as lifting, twisting, and movement. Overuse can lead to pain in the two areas.
How Lower Back and Hips Work Together
Your lower back, your pelvis, and your hip joints are closely interconnected through shared muscles, joints and ligaments. This facilitates your body movement and stability.
The lower back is part of the spinal column, made up of the lumbar spine. The lumbar spine consists of five vertebrae known as L1 to L5 that provide body weight support, surround and protect your spinal cord, and allow for a wide range of body motions. These vertebrae are large, thick and more block-like bones.
The pelvis bone is a basin-shaped bony structure inside your hips, buttocks and pubic region. It holds up your truck and connects it to your legs below.
Your hip joint is a connection point between your legs and your torso. It is made up of your thigh bone and your hip bone. It’s a ball-and-socket joint that supports your body weight and allows you to move your upper leg.
Your lower back and the hips are closely connected through a network of muscles, nerves, and joints. They are closely linked in terms of anatomy and function.
Joints:
Your sacroiliac joints connect the lower back to the pelvis, acting as a bridge between the spine and the hip bones. This plays a crucial role in the transfer of forces and allows movement.
Muscles:
There are many muscles which connect the lower back and the hip. These muscles include the Psoas, gluteus muscles, and muscles of the lower back, which include the quadratus lumborum. These muscles work together to stabilise your spine, move your legs and support your trunk.
Nerves:
Many nerves transmit signals which connect the spine and the hips, causing sensation and movement. One of them is the sciatic nerve, which is a major nerve that runs from your lower back through the buttocks and down your legs.
Your lower back and the hip share a nerve pathway. The nerves that innervate your lower back and your hips originate from the same region of the spine. For example, your sciatic nerve runs from the lower back through the hips and down each of your legs.
Common Causes of Lower Back and Hip Pain.
Your daily activities can be the main reason you experience lower back and hip pain.
Poor posture can cause hip and lower back pain. Did you know that the way you walk influences how low back or hip pain is? Below are some of the walking styles that may trigger pain in your hips or back.
- Slouching while walking.
- Unnatural swaying of the hips.
- Looking down while walking.
- Wearing uncomfortable shoes, such as high heels. Your feet should hit the ground heel first before the ball of your foot.
- Uncomfortable shoes for flat feet.
Obesity can cause lower back and hip pain. The lower back supports your weight, and being overweight can put too much pressure, causing pain.
Muscle strain.
While working out, you may overstretch your ligaments, and this can put them at risk of tearing. Overstretching and tearing of muscles and tendons causes muscle strain.
If you have a muscle sprain, you feel pain in your back and dull pain in your hips.
Muscle strain can be treated through physical therapy. A physical therapist trains you on how to stretch properly to avoid overstretching and tearing.
Herniated disk.
Herniated discs occur when the jelly-like centre known as the nucleus pushes out through the annulus. A herniated disk is sometimes referred to as a ruptured or slipped disk. Ruptured disks mostly occur in the lower back and can lead to pain injury or weakness in the leg.
The main causes of a herniated disk are disk degeneration and lifting heavy items with the thigh muscles instead of the leg muscles.
A ruptured disk can be treated through physical therapy to support the spine and strengthen trunk muscles.
Arthritis.
Arthritis is the inflammation of the joints. Arthritis occurs when your cartilage breaks, causing your bones to rub against each other, leading to inflammation of the joints.
Pinched nerves.
Pinched nerves are conditions that occur when too much pressure is applied to a nerve by surrounding muscles, tissues, or bones. Too much pressure leads to weakness, numbness, pain, and improper nerve functioning.
A pinched nerve feels like a shooting pain and discomfort in your back, spine or hip.
Pinched nerves can also be caused by old scars from a previous injury, stress,obesity, arthritis or repetitive movements.
Pinched nerves can be treated through rest, physical therapy to strengthen your muscles and anti-inflammatory treatments to relieve pain.
Sacroiliac (SI) Joint Dysfunction.
The SI joint functions as a shock absorber between the upper body, legs, and pelvis. The sacroiliac joint connects the hip bone to the sacrum.
SI joint pain feels like a sharp, stabbing pain from the hips, pelvis, to the lower back. The apin can also be felt in your thighs.
The sacroiliac joint function of sacroiliitis is the inflammation of the SI joints. It can be caused by Osteoarthritis, Gout, injury or abnormal walking patterns.
SI joint dysfunction can be treated through surgery if the pain is severe, with pain relievers and injections for mild pain.
Hip- Specific Issues.
Pain in the hip signifies an underlying injury, condition or structural problem. You may feel pain in the hip, outside the hip or the butt area. Below are some of the causes of hip pain:
Bursitis.
Bursae are fluid-filled sacs that connect muscles to the bones and prevent tissues from rubbing against each other. Bursts occur when repeated stress overworks the hip joint.
Trochanteric bursitis affects women mostly. When you walk, jump, or cycle, the IT band may become tight due to overuse, rub against the trochanteric bursa, and irritate your hips. You know you have trochanteric bursitis if you experience pain outside your hip. The pain may be sharp and get worse when you move downstairs.
Muscle strain.
Repeated running activities can strain the muscles, tendons and ligaments that support the hips. When the tissues get inflamed due to overuse, you may feel pain in your hips, and it may affect your movement.
Sciatica.
When the sciatica nerve that runs from your hip to your buttock gets injured, it causes hip pain.
Hip fractures.
Hip fractures can be caused by old age, repetitive activities or an injury. Your bones may become weak as you age, therefore putting you at risk of breaking a bone when you get an injury. You know you have hip fractures if you have pain in your hip, thighs, groin and back. Hip fracture may be dangerous if you have: Bed sores, blood clots, UTI or low weight.
Hip Osteoarthritis.
Hip osteoarthritis develops as you age. Osteoarthrosis of the hip feels like a sharp stabbing pain or dull ache, and sometimes your hip may be stiff. You can feel pain in various locations such as: groin, thigh, buttocks and knee.
You can also be diagnosed with osteoarthritis if you have experienced an injury, swelling of the joint or hemochromatosis( a condition that affects the cartilage).
Is Your Pain Coming from Your Hips or Back?
You need to understand the difference between lower back and hip pain to get the right treatment. You know that pain is coming from your hips if it starts from the hip area and groin area and moves down the knee. If your pain starts from your buttocks and moves down to your leg, it’s likely to be a spine problem.
How to Diagnose Root Cause
It may be difficult for doctors to identify the source of pain since your lower back and hip share similar symptoms. However, differential diagnosis helps in ruling out conditions having similar symptoms as well as injuries.
Differentiating diagnosis helps your doctor differentiate issues causing lower back and hip pain. Below is an overview of differential diagnosis:
- Your doctor asks you questions related to your problem. Example: symptoms, lifestyle habits, family health history, medications you have used before and medical history(medical conditions).
- The second is a physical exam. Physical examination identifies signs related to your symptoms, such as swelling, abnormalities, etc. Physical examination also involves testing your reflexes, sensation, and strength.
- Third is a list of possible diagnoses from the physical examination results.
- Last is the ordering of tests to identify the root cause: The test may be: blood tests, MRI, X-rays and other imaging tests.
Prevention Tips for Combined Hip and Back Pain.
Below are some of the ways to prevent hip and back pain:
Strengthen core and hip muscles.
Rest helps your muscles relax and relieve stress, but to help with pain, you need to strengthen your core and hip muscles.
Regular strengthening of core and hip muscles helps relieve inflammation and muscle tension. Below are some of the stretches for hip and core strength:
Piriformis stretch.
- Lie on your back and straighten your legs.
- Lift the leg with the hip problem and bend your knee. With your opposite hand pull the knee to your opposite shoulder, to stretch your butt and hip.
- Hold the stretch for 30 seconds.
- Repeat the stretch 4 times for each leg.
Hip flexor stretch.
- Kneel on your affected leg and bend the other leg with the foot flat on the floor.
- With your back straight, gently push your hips forward to stretch the upper thigh of your back leg and foot.
- Hold the stretch for 30 seconds.
- Repeat 4 times on each leg.
Gluteal stretch.
If you have a glute replacement, avoid doing hip stretches. Below are step-by-step instructions on how to do a gluteal stretch.
- Lie on your back and bend your knees.
- Place the ankle of the affected hip on the other leg.
- Put one hand on the knee and, using the other hand, pull the leg towards the opposite shoulder.
Child’s pose stretches.
- Kneel and sit on your knees.
- With your buttocks on your knees, lean forward and rest your head on the floor.
- Straighten your arms forward with your palms facing up.
- Inhale and exhale deeply for at least 3 to 5 minutes.
Avoid prolonged sitting (hip flexor tightness).
Hip flexor tightness occurs when your hips and legs are in the same position for a long period. Sitting for long hours makes your hip flexors short and tight.
A good ergonomic work setup can prevent hip flexor tightness. To prevent back pain, sit with your feet and pelvis well aligned, and spine straight. To prevent hip pain, ensure your hips are higher than your knees when seated. Use a lumbar pad to support your back, and your feet are a bit raised for comfort.
Walking loosens your muscles. Walking and stretches help stretch the hip areas that are too tight. Examples of this stretch include: Standing hamstring stretch, seated hamstring stretch, seated hip flexor stretch and standing hip flexor stretch.
Taking walks keeps your iliopsoas muscles moving and prevents them from freezing and shortening. Shortening of the iliopsoas muscles causes muscle knots and cramps in and out of your hips, in your glute area and lower back.
Use proper lifting techniques (protect spine and hips).
Have you lifted something heavy before and encountered back pain afterwards? Improper lifting techniques compress your spinal discs and stress your lower back. How should you lift to avoid straining your lower back?
- Test your load by pushing it to know how heavy it is.
- Stand with your feet apart. Your shoulders should be squarely over your feet. At this position, you are ready to engage your core when you lift your load.
- Push your chest forward to straighten your back and bend your knees to lift your load.
- Keep your shoulders in line with your hips to avoid twisting.
- To change direction, lead with your hips and not your shoulders.
- Hold your load close to the centre of gravity to prevent an injury.
- Bend your knees to grab a load and lift with your leg muscles while your back is straight.
When to see a Doctor
Severe pain that exceeds two weeks, inability to walk and difficulty emptying your bowel can be a danger sign; ensure to seek medical help as soon as possible.
Conclusion
Hip and back pain are interconnected seeking medical help earlier may help address the issue before getting to chronic pain. Symptoms and causes may be similar, but your healthcare provider will be able to determine the origin of your pain. Changing lifestyle habits can be a good step; however, your doctor can diagnose the root cause and provide the best treatment plan.
Can a herniated disk cause hip pain?
Yes, a herniated disk can cause hip pain. Herniation affects nerves that travel from the lower back to the hips. The pain feels like a shooting pain in front of the back of your hips.
Herniated disks also cause sciatica, whereby the herniated disk puts pressure on the sciatic nerve, causing pain and numbness in your buttocks and hips.
Herniated hip makes it difficult to bend, sit or lift objects, however, treatments such as physical therapy, medication, changes in lifestyle habits, and surgery are good treatments.
Physical exercises such as stretches and strengthening exercises strengthen your muscles, relieve tight muscles and reduce pressure on the affected discs.
In cases where you have severe pain, muscle relaxants and painkillers such as Ibuprofen can help relieve pain and inflammation.
Avoiding strenuous activities that stress your hip muscles, such as lifting heavy items and repetitive running, is one of the lifestyle habits you can adopt to relieve herniated hip pain.
Chronic pain may require surgery, but always seek a doctor’s advice to know the best surgical option for you. Some of the surgery options include: Spinal fusion, discectomy and artificial disc replacement.
How do I know if my pain is from arthritis or a muscle strain?
Muscle strain pain is felt when you move, while arthritis pain is felt when you are at rest.
Arthritis takes longer to heal compared to muscle strain. Arthritis involves inflammation of joints, while the main symptom of muscle strain is muscle spasms.
|
Type of injury |
Muscle strain |
Arthritis |
|
Causes |
Muscle pain can be caused by injury, overuse, infection or fibromyalgia. |
Arthritis can be caused by bone cancer, gout, rheumatoid arthritis and osteoarthritis. |
|
Treatment |
Muscle strain can be treated through rest, massage, and applying ice to the area of treatment. |
Arthritis can be treated through physical therapy and surgery. |
What’s the difference between sciatica and hip bursitis?
Sciatica occurs due to irritation of the sciatic nerve that runs from the lower back to the feet, while hip bursitis occurs when the bursa around the hip gets irritated and inflamed.
Sciatica pain is felt anywhere around the sciatica nerve, while hip bursitis pain is felt in the groin area.
Sciatic pain occurs on one side of the body, while bursitis can occur in one hip or two hips.
Sciatica can affect anyone, but hip bursitis mostly affects women, middle-aged to elderly people. Hip bursitis rarely affects young people, especially men.
