When it comes to causes of lower back and hip pain, each case or patient is unique. However, various health conditions or injuries can affect the nerves in the lower back and hip region. When a person experiences lower back and hip pain, the cause may be overuse of muscles, an injury, or symptoms of a medical condition.
Lower back pain is the most common cause of activity limitation and people not going to work, which imposes a substantial economic burden on families and individuals. According to the Health Policy Institute, lower back and hip pain healthcare and indirect costs are over $12 billion annually.¹
In this article, we will be looking at what can cause lower back and hip pain.
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Low back pain is the second most common cause of disability. According to the Centers for Disease Control and Prevention, it is also the leading type of pain patients report. Almost 65 million American adults reported experiencing back pain recently, with 16 million (8%) suffering from chronic back pain.²
Low back pain is more common in adults than children and adolescents, but the figure is rising as young people spend more time on their screens.³
Lower back pain is common in people aged 18 or older and peaks at 80 to 89.
Lower back pain is more common among females than men. Females had a lower back prevalence of 8.01% in 2017, whereas males had 6.94% in the same year.⁴
Fortunately, 95% of individuals affected by low back pain in America recover within a few months.⁵
Several risk factors come into play when it comes to low back pain. Some risks include obesity, occupational posture, depressive moods, body height, and age.
Constant lower back and hip pain could indicate a problem with the sciatic nerve, which runs from the lower back down to the back of each leg. When the nerve is under pressure, it causes pain from the lower back spreading to the hips and buttocks. However, there are other causes of lower back and hip pain, which include:
Sprains and strains
This is the most common cause of lower back and hip pains. In medical terms, having a sprain means having a torn or overstretched ligament, while a strain means having a torn or overstretched muscle or tendon.
When you have a sprain or strain, you experience discomfort when performing some activity and only subsides when you rest.
There are many causes of sprains and strains, such as lifting heavy objects, sports injuries, twisting the body in awkward positions, or trauma from falling.
Tight hip flexors
Hip flexors are tendons or muscles that start from the hips up to the knees. The hip flexor works to coordinate motion in the hips and legs. If they get tight and stiff, especially if you remain seated for extended periods, it is common to experience some form of lower back and hip pain.
A herniated disk means that a cushioning disk found between the vertebrae gets out of position. When this happens, the disk places additional pressure on nerves close to them, resulting in a burning or tingling pain from the lower back to your hips.
Sacroiliac joint dysfunction
The sacroiliac joint usually connects the lower parts of your spine to the pelvic bone, and if the joint’s movement becomes flawed, you will experience pain in your lower back and hips.
Symptoms of a sacroiliac joint dysfunction make getting a comfortable resting position challenging.
Arthritis is a common disease that leads to the swelling and tenderness of one or several joints. The pain comes from the breakdown of the protective and cushioning cartilage of the spine, which leads to increased pressure of nerves and makes the spinal bones rub one another. Osteoarthritis is the leading cause of lower back and hip pain.
This is another form of arthritis that, like osteoarthritis, specifically affects the spine and is a leading cause of chronic lower back and hip pain. Ankylosing spondylitis causes inflammation of the spinal joints, and its symptoms include muscle/ tendon stiffening and pain and are usually acute during morning hours.
Paget's disease leads to bone softening that affects the hips, pelvis, arms, and lower back. The condition is rare, and according to the American College of Rheumatology, 1% of Americans are estimated to have the condition.⁶ If you are diagnosed with it, you have a high risk of experiencing bone fractures and pain.
It can be challenging to pinpoint what is causing lower back and hip pain when sitting or standing. If you are unsure why you have lower back and hip pain when standing or sitting, groin pain is a great indication.
Due to the proximity of the groin area to the hips, your groin pain could be an extension of hip pain. On some occasions, the pain flows down to the knees. If hip pain goes untreated, it can lead to osteoarthritis on the hip joint, which then causes pain in the buttocks and knees.
Feeling pain above your waistline that flows downwards usually indicates a lower back problem, and just like hip joints, the pain can spread to other parts of your body, including the groin, knees, and legs.
You can effectively treat the condition when you know what causes low back and hip pain. There are different levels of lower back pain. There is acute back pain which is more common and only lasts for a few days or weeks. Then there’s the subacute low back pain which can last for four weeks to 12 weeks. The most severe is chronic back pain, which lasts for more than 12 weeks.
However, most people don't visit a hospital when experiencing low back pain because it typically resolves itself after a few days.
The main goal of treatment for subacute pain is to prevent it from reaching the chronic level. Fortunately, all three lower back pain levels require the same type of treatment, and a combination of different approaches works even better.
Here are some treatment approaches available for lower back and hip pain:
Cognitive behavioral therapy (CBT) helps people looking for alternative treatment for their lower back and hip problems. These therapies are often conducted by a physical therapist, psychologist, or clinician.
The treatment starts with understanding your condition then you progress to learning how to develop a positive way of thinking. Finally, you will set your goals and work to achieve all of them.
Part of lower back and hip pain treatment involves taking care of yourself, and this includes understanding your pain levels and actively changing your routine without restricting movement completely. However, it is essential to stay active by performing light stretches to reduce the pain over time.
Applying heat to the lower back and trying relaxation exercises can also help reduce pain. Self-care may also mean watching how you work your back and how much strain you put on it. For example, you can seek help if you need to lift heavy objects that may aggravate your lower back and hip pain.
If you are experiencing a high level of pain, it would be best to seek short-term relief before progressing to other long-term forms of treatment. You could try any of the following:
The technique involves moving the joint on the spine beyond the normal range of motion.
Acupuncture involves piercing the lower back and hip with very fine needles.
A short-term solution that helps people relax and get momentary relief from lower back and hip pain.
You can purchase over-the-counter medication to help relieve your pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) work better than acetaminophen. Always consult with your physician before buying any over-the-counter pain medication.
Movement-based therapy is recommended for people experiencing lower back and hip pain for more than four to six weeks.
Additionally, people who feel that their lower back pain treatment is not affected should consider movement-based therapy. A physical therapist supervises aerobics, stretching, extension and flexion exercises, general overall fitness, strengthening, or a combination of exercises.
Not many people suffering from lower back and hip pain reach the level that requires surgery. It usually involves an issue with the nerves at the base of the spinal cord, which is very rare.
People with persistent radiculopathy should consider surgery, especially if other non-surgical treatments are ineffective.
Depending on the severity of your lower back and hip condition, your health care provider could recommend surgery if you have bladder and bowel issues, increasing neurologic problems, and lack of improvement.
Most people who experience lower back pain don't need medical attention since the pain often improves in a few days. However, if the issue persists, you should get evaluated by a primary care provider.
A healthcare professional may conduct a physical exam and sometimes need more information (like scans) to assess the situation further and suggest appropriate treatments. It would be wise to visit a healthcare professional if:
You are 70 years or older and are experiencing new lower back pain
You are experiencing persistent pain that continues through the night, even when lying down
You have problems with your bowels, bladder, or sexual organ
You are experiencing weakness in one or both legs
You have lower back pain that is accompanied by weight loss or fever
If you are older than 50 years and had an accident or fell resulting in low back pain
Lower back and hip pain are usually recurring conditions, so staying active will reduce your chances of experiencing another episode. There is no specific exercise to prevent low back and hip pain, pick an exercise you enjoy and work with it. Additionally, lift heavy objects using the correct form and take regular breaks if you sit or stand for long periods.
Lower back and hip pain is a condition that affects almost everyone. While the condition mostly heals itself, it's advisable to visit a healthcare professional to perform a body exam if you are concerned or unsure of the underlying cause.
Delaying a visit to a healthcare provider can result in chronic lower back pain, poor sleep, loss of mobility, spinal injury, and muscle fatigue. These factors can impact your quality of life and your loved ones.
Finally, a healthcare professional is a great source of information on managing your lower back and hip pain.
Chronic back pain | Georgetown University
Acute low back pain | Centers for Disease Control and Prevention
Low back pain | World Health Organization
40 Back pain statistics (to send a shiver down your spine) | The Good Body
Paget's disease | National Organization for Rare Disorders