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Hip pain from lower back problems
When hip pain is really coming from the back, how to tell, and how physical therapy treats both
Hip pain from lower back problems is common because nerves and muscles from the lower spine reach the buttock, hip and thigh. Pain from an irritated joint or nerve in the back can be felt mostly in the hip, while the true hip joint usually hurts in the groin. The hip itself, the sacroiliac joint, tendons and bursae can also cause pain, and more than one area can be involved after a fall. An exam that checks both the back and the hip helps find the source, and physical therapy often treats both together.
In the video, a patient fell on her hip and hurt her back. She was in so much pain that she could not drive. She first came to physical therapy for her hip, but her therapist found that the hip pain was also coming from her back, so they treated both. Between hands-on work and exercise, she has much less pain and is back to her activities. At Precision Care Medical & Sports Performance, our physical therapists in Brooklyn and Staten Island look at the whole chain from the low back to the hip.
How the lower back can cause hip pain
- Referred pain: the lower spinal joints and discs can send a deep ache into the buttock and outer hip; see facet joint pain
- Nerve irritation: a pinched nerve root can cause pain, tingling or numbness that travels into the hip and down the leg
- Muscle guarding: after a fall, the back, buttock and hip muscles tighten together and can each add to the pain
- Sacroiliac (SI) joint: the joint between the spine and pelvis can hurt in the buttock and hip area
Hip or back? Clues that point each way
Pain in the groin, trouble putting on socks and pain when the hip is rotated can point to the hip joint itself. Pain above the belt line, pain that travels below the knee, tingling, or pain that changes with bending and sitting can point to the back. Outer hip pain when lying on that side can come from the tendons or a bursa. These are only clues, not a diagnosis: an exam is needed, and a physician orders X-rays or an MRI when the exam suggests they will change the plan. See hip pain treatment and lower back pain treatment.
How physical therapy treats hip pain from lower back problems
Treatment targets whatever the exam finds, often in both areas:
- Manual therapy to loosen tight back and hip muscles, as in the video
- Strength work with resistance bands for the hips, buttocks and core; see core exercises for back pain
- Mobility for the lower spine and hip
- Balance training after a fall; see balance exercises
- A home program to keep the gains going; see home exercise program
For more on therapy for the spine, see physical therapy for back pain.
When to see a doctor first
After a fall, get checked promptly if you cannot put weight on the leg, the leg looks shortened or turned out, or pain is severe, since a fracture needs to be ruled out. New leg weakness, numbness in the groin or loss of bladder or bowel control needs emergency care.
Related care at Precision Care Medical & Sports Performance
Physical therapy for hip and back pain near you
Looking for physical therapy for hip pain near me? Precision Care Medical & Sports Performance offers physical therapy at our Brooklyn office on Shell Rd, close to Brighton Beach, Homecrest and Gerritsen Beach, and at our Staten Island office on Richmond Rd, serving Midland Beach, Oakwood and Richmondtown.
If you are not sure whether the pain is coming from your hip or your back, our pain physicians, Ashley Marcus, MD in Brooklyn, Jake Stephen, DO on Staten Island and Yuri Gordin, MD in Manhattan can examine you first, including at the Precision Care Spine & Pain Center in Midtown Manhattan, convenient to the Upper West Side and Washington Heights. Physical therapy is not offered at the Manhattan office. Request an appointment or call the office closest to you.
Questions patients ask
Can lower back problems cause hip pain?
Yes. Joints, discs and nerves in the lower back can send pain to the buttock, hip and thigh. An exam that checks both areas helps find the source.
How do I know if my hip pain is from my back?
Pain above the belt line, pain that travels below the knee, tingling, or pain that changes with bending and sitting can point to the back. These are clues only; an exam is needed.
Where is pain from the hip joint usually felt?
Pain from the hip joint itself is often felt in the groin or front of the hip. Outer hip pain can come from tendons or a bursa, and buttock pain from the back or SI joint.
Can physical therapy help hip and back pain at the same time?
Yes. Your therapist can treat both areas in the same visits with hands-on work, strengthening, mobility and balance training.
Do I need an X-ray or MRI?
Not always. A physician orders imaging when the exam suggests it will change the plan, or after a fall to rule out a fracture.
Where can I get physical therapy for hip pain near me?
Precision Care Medical & Sports Performance offers physical therapy at two offices:
- Brooklyn2781 Shell Rd, Suite 101, Brooklyn, NY 11223(718) 648-1234 · Get directions
- Staten Island1630 Richmond Rd, Suite 101, Staten Island, NY 10304(718) 339-7100 · Get directions
Physical therapy is offered in Brooklyn and Staten Island only.
Educational only, not medical advice. These videos and this article explain common problems and treatments in general terms. They are not a diagnosis or a treatment plan for you. Results vary from person to person. See a qualified clinician about your own symptoms, and call 911 or go to an emergency room for an emergency.
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