Hips Don't Lie

Is It Your Hip or Your Low Back? Understanding the Connection Between Hip Pain and Low Back Pain

When you experience pain in your lower back, it is easy to assume that the problem is coming directly from your spine. But what if your low back isn’t actually the primary source of your discomfort?

Hip problems can sometimes cause pain that is felt in the low back, buttocks, or even the groin and thigh. Because the hips, pelvis, and lumbar spine work closely together, discomfort in one area can influence how the surrounding joints and muscles move and feel.

Understanding the connection between your hip and low back can be an important first step toward identifying the underlying source of your pain.

How Are the Hips and Low Back Connected?

Your hip joints and lumbar spine are designed to work together to help you walk, bend, rotate, stand, and perform everyday activities.

The hip is a ball-and-socket joint that connects your thigh bone to your pelvis. Your lumbar spine sits directly above the pelvis and provides stability while allowing your trunk to move.

Because these structures are mechanically connected, limited hip mobility or irritation around the hip can change the way your pelvis and lower back move. In some cases, the low back may compensate for reduced movement elsewhere.

For example, if your hip does not move comfortably during walking or bending, your body may alter its movement pattern to accomplish the same task. Over time, this can contribute to increased stress on the muscles and joints around the pelvis and lower back.

What Does Hip-Related Pain Feel Like?

Hip-related pain does not always feel like what people expect “hip pain” to feel like.

Depending on the underlying cause, discomfort may be felt in:

The front of the hip or groin
The outside of the hip
The buttocks
The upper thigh
The low back
The area around the pelvis

Some people may notice pain with walking, climbing stairs, getting in and out of a car, standing from a chair, or sleeping on the affected side.

Others may primarily notice stiffness or reduced mobility rather than sharp pain.

How Can Hip Pain Feel Like Low Back Pain?

The hip and low back share many of the same surrounding muscles and movement patterns. When the hip is stiff, painful, or not moving efficiently, the pelvis and lumbar spine may compensate.

This can create a situation where the discomfort you feel in your low back may not necessarily mean that the low back is the original source of the problem.

For example, someone may experience low back discomfort after prolonged sitting. While the lumbar spine may certainly be involved, the hip joints and surrounding muscles can also contribute to how the pelvis is positioned and how the person moves when standing up or walking.

This is why simply treating the location where you feel pain may not always address the factors contributing to it.

Hip Pain vs. Low Back Pain: What Should You Look For?

Although symptoms can overlap, certain patterns may provide clues about where your discomfort is coming from.

Hip-related symptoms may include:

Groin or front-of-hip pain
Pain with hip rotation
Difficulty getting in or out of a car
Pain with stairs or prolonged walking
Discomfort lying on one side
Reduced hip range of motion

Low-back-related symptoms may include:

Pain centered around the lumbar spine
Pain aggravated by bending, lifting, or prolonged standing
Stiffness after sitting or sleeping
Pain that travels into the buttocks or leg

However, these patterns are not definitive. Hip, low-back, and nerve-related conditions can have overlapping symptoms, which is why a thorough evaluation is important.

Your Buttocks Can Be Part of the Puzzle, Too

The buttocks sit at the intersection of several important structures, including the hip joint, pelvis, lumbar spine, and numerous muscles and tendons.

Pain in this area can therefore have many potential sources.

For example, the gluteal muscles play an important role in stabilizing the pelvis and controlling movement of the hip. If the hip or surrounding structures are not functioning optimally, the muscles around the pelvis may have to work differently to maintain stability.

This doesn’t necessarily mean that a “weak muscle” is the cause of someone’s pain. Rather, it highlights why looking at the entire hip-pelvis-low-back system can be more useful than focusing on a single body part.

Why an Evaluation Matters

When hip and low back symptoms overlap, determining the source of the pain requires more than simply asking, “Where does it hurt?”

A comprehensive evaluation may include looking at:

Hip and lumbar range of motion
Strength and movement patterns
Walking mechanics
Joint mobility
Muscle function
Posture and pelvic movement
Neurological symptoms
Activities that reproduce or relieve your symptoms

The goal is to develop a clearer picture of what structures may be contributing to your symptoms and whether additional medical evaluation or imaging is appropriate.

When Should You Seek Medical Attention?

Most musculoskeletal pain is not an emergency, but certain symptoms warrant prompt medical evaluation.

Seek medical attention if your back or hip pain is accompanied by symptoms such as significant weakness, progressive numbness, loss of bladder or bowel control, numbness around the groin or inner thighs, fever, unexplained weight loss, or severe pain following significant trauma.

If pain is persistent, worsening, or interfering with your ability to walk, sleep, work, or participate in your normal activities, it is also a good idea to have it evaluated.

The Bottom Line

Your hip and low back don’t work independently.

Because the hip, pelvis, and lumbar spine are closely connected, pain felt in one area can sometimes be influenced by dysfunction or irritation in another. That is why identifying the source of your symptoms is often more helpful than simply treating the location where you feel pain.

If you’ve been dealing with persistent “low back pain” that doesn’t seem to improve—or if your pain is accompanied by hip stiffness, groin discomfort, or changes in how you walk—it may be worth having both your hips and lumbar spine evaluated.

A thorough assessment by your Chiropractor can help determine what may be contributing to your symptoms and guide an appropriate treatment plan.