Have you suffered with hip pain for too long?
Have you received exercises for your hip strength and it has made no difference to your pain?
Have you ever considered it could be coming from your back?
Hip pain is often referred from the back, meaning the problem starts in the spine but the pain is felt in the hip region. This happens because nerves, joints, and muscles in the lower back share pathways with structures around the hip.
Here’s how that referral occurs:
Shared nerve supply (lumbar spine → hip)
- The lumbar spine gives rise to nerves that travel to the hip, buttock, groin, and thigh.
- Irritation or compression of these nerves (from a disc bulge, herniation, spinal stenosis, or arthritis) can cause pain to be felt in the hip even though the hip joint itself is normal.
- Common examples:
- L2–L3 irritation → pain in the groin or front of the hip
- L4–L5 irritation → pain in the outer hip or buttock
- Sciatic nerve involvement → pain radiating through the buttock and down the leg
Facet joint referral
- The facet joints in the lower lumbar spine can become inflamed or arthritic.
- Pain from these joints often refers to the buttock, lateral hip, and upper thigh.
- This pain is typically dull, aching, and worsens with spinal extension or twisting.
Muscle and myofascial referral
- Tight or irritated paraspinal muscles, quadratus lumborum, or gluteal muscles can refer pain into the hip region.
- Trigger points in these muscles may cause deep, aching hip pain that mimics joint pathology.
- Poor posture, prolonged sitting, or altered gait can contribute.
Altered biomechanics
- Low back dysfunction can change the way the pelvis and hips move.
- Abnormal loading of the hip muscles and tendons can cause secondary pain around the hip even when the original problem is spinal.
Distinguishing features of referred back pain
Hip pain referred from the back often:
- Occurs with or after low back pain
- Changes with spinal movement rather than hip movement
- May be associated with numbness, tingling, or weakness
- Is less likely to cause true hip joint stiffness or reduced hip range of motion
Clinical importance
Because hip and lumbar spine conditions overlap, both areas must be assessed. Treating the hip alone may not resolve symptoms if the primary source is the spine.
Does this sound familiar?
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