A hernia occurs when an organ or fatty tissue pushes through a weak spot in the surrounding muscle or connective tissue. While often recognized by a visible bulge, commonly in the abdomen or groin, hernias do not always present with such obvious signs. It is possible for a hernia to manifest with discomfort in seemingly unrelated areas, including the back and hips.
How Hernias Can Cause Back and Hip Pain
Hernias can lead to pain in the back and hips through several physiological mechanisms, often involving nearby nerves. When tissue protrudes, it can directly press on surrounding neural structures, such as the femoral nerve or obturator nerve, which supply sensation and motor function to the thigh and hip region. This impingement can cause pain that radiates along the nerve’s pathway.
Pain from a hernia can also be perceived in distant areas like the back or hip due to referred pain. This occurs because different body parts share common nerve pathways leading to the spinal cord. For example, irritation of nerves in the groin area by an inguinal hernia might be interpreted by the brain as pain originating in the lower back or hip because these regions’ nerves converge at similar spinal segments.
The presence of a hernia can also alter how the body moves and distributes weight, leading to compensatory muscle strain. To avoid discomfort at the hernia site, individuals might unconsciously adjust their posture or gait, placing undue stress on muscles in the lower back, pelvis, or hips. Over time, this tension and altered biomechanics can result in muscle fatigue, spasms, and pain in these areas.
Specific Hernias That May Cause Pain
Several types of hernias are commonly associated with pain radiating to the back or hips due to their anatomical locations. An inguinal hernia, the most frequent type, occurs when tissue protrudes through a weak spot in the abdominal wall near the groin. This protrusion can compress nerves like the ilioinguinal or genitofemoral nerves, leading to pain that can extend into the inner thigh, hip, or even the lower back.
A femoral hernia, less common but more serious, involves tissue pushing through the femoral canal, located just below the inguinal ligament. Its proximity to the femoral nerve and major blood vessels means it can directly impinge on these structures, causing pain that radiates down the front of the thigh and into the hip region. This type of hernia is more prevalent in women.
Sports hernia, also known as athletic pubalgia, involves a tear or weakening of the soft tissues in the lower abdominal or groin area, though it is not a true hernia with a visible bulge. This condition causes severe groin pain, which often radiates to the hip, inner thigh, or lower abdomen, particularly during activities involving twisting or sudden movements. While not a traditional hernia, its symptoms closely mimic those that can cause referred back and hip pain.
Recognizing Other Hernia Symptoms
Since back and hip pain can stem from numerous causes, identifying other accompanying symptoms can help suggest a hernia as the underlying issue. The most classic indicator of a hernia is a noticeable bulge or swelling, often in the groin or abdominal area, which may become more prominent with coughing, straining, or standing. This lump might disappear when lying down.
Individuals may also experience localized pain directly at the site of the hernia, which worsens with activities that increase abdominal pressure, such as lifting heavy objects or prolonged standing. A burning sensation, heaviness, or pressure in the affected area are also common. For certain types of hernias, particularly those involving the intestine, digestive issues like nausea or constipation might occur.
When to Consult a Doctor
It is advisable to consult a doctor if you experience persistent back or hip pain, especially when accompanied by other symptoms suggestive of a hernia. If you notice a new bulge or swelling in your groin or abdomen, or if existing pain intensifies with physical activity or straining, medical evaluation is warranted.
Immediate medical attention is necessary if you experience sudden, severe pain in the hernia area, accompanied by nausea, vomiting, fever, or an inability to pass gas or stool. A bulge that becomes tender, discolored, or cannot be pushed back in could indicate a medical emergency, such as an incarcerated or strangulated hernia.