The answer to whether hip pain can cause lower back pain is a definitive yes. The two regions are interconnected parts of a complex system, the lumbopelvic region, where dysfunction in one area frequently leads to pain in the other. This overlapping discomfort is so common that doctors refer to the phenomenon as “hip-spine syndrome.” Pain signals from both the hip and the lower back are processed in close proximity within the nervous system, which can make it difficult for the brain to pinpoint the exact source of the problem. This shared anatomy means that a problem starting in the hip often creates a cascade of effects that ultimately stresses the lumbar spine.
The Shared Anatomical Neighborhood
The connection between the hip and lower back is established by a dense network of joints, muscles, and nerves that span the pelvis. The Sacroiliac (SI) joints act as a bridge, linking the sacrum—the triangular bone at the base of the spine—to the ilium, which forms the hip bones. When the mechanics of the hip joint are compromised, the SI joint is one of the first to feel the secondary strain.
Large muscle groups, like the psoas and the gluteal muscles, also span both regions. The iliopsoas muscle complex connects the lower spine and pelvis to the femur, meaning tightness or weakness in this group can directly influence the posture and stability of the lumbar vertebrae. The sciatic nerve, which originates in the lower back, travels near the hip joint, making it susceptible to irritation from hip-related issues. This proximity means that pain originating in the hip can easily “refer” into the lower back, mimicking a spine problem.
Biomechanical Compensation and Altered Movement
When a hip becomes painful, stiff, or loses its normal range of motion, the body unconsciously begins to change how it moves to avoid discomfort. This is known as biomechanical compensation, which shifts the burden of movement away from the compromised hip joint and onto the more mobile lumbar spine. This adaptation is the primary mechanism by which hip problems create secondary back pain.
A common example occurs during walking or standing, where a stiff hip can limit the natural rotation and flexion required for a smooth gait. To compensate, the body may overuse or twist the lower spine, leading to excessive lumbar extension or rotation. This altered movement pattern places abnormal, sustained stress on the structures of the lower back, including the ligaments, intervertebral discs, and facet joints. Over time, this chronic loading can lead to secondary back conditions like facet joint arthritis or muscle spasms.
Specific Hip Conditions Linked to Lower Back Pain
Several hip pathologies are well-known for creating this pain cascade, demonstrating a clear link between hip health and spinal stress.
Hip Osteoarthritis (OA)
Hip Osteoarthritis (OA) involves the degeneration of cartilage in the ball-and-socket joint, which significantly reduces the hip’s available range of motion. This stiffness forces the lumbar spine to move more dramatically during daily activities, such as bending or rising from a chair. This leads to the development of secondary back pain in up to 49% of patients with advanced hip OA.
Greater Trochanteric Pain Syndrome (GTPS)
Trochanteric Bursitis is often referred to as Greater Trochanteric Pain Syndrome (GTPS), involving irritation of the tendons and bursae on the outer hip. The pain associated with GTPS frequently causes a protective, asymmetric change in walking, known as an antalgic gait, or a change in muscle activation that stresses the back. This altered gait and muscle guarding can overload the lumbar structures, resulting in back discomfort that is a direct consequence of the hip pain.
Femoroacetabular Impingement (FAI)
Femoroacetabular Impingement (FAI) is a condition where extra bone growth on the hip socket or ball causes premature contact during movement, limiting mobility. This deep hip restriction forces the spine to compensate, often leading to chronic postural changes and increased strain on the lumbopelvic structures. Recognizing these hip conditions as the source of back pain is important because treating the spine alone will not resolve the underlying hip dysfunction.
When to Seek Professional Diagnosis
Because the symptoms of hip and lower back pain overlap significantly, professional evaluation is necessary to identify the primary source of the problem. A physical examination by a doctor or physical therapist involves specific movement tests to determine whether pain is provoked by hip motion or spinal movement. Pain felt deep in the groin, for example, is more typical of a hip joint issue, while pain that radiates down the back of the leg may indicate a spinal nerve issue.
Imaging, such as X-rays or MRI, is often used to visualize the joints and soft tissues, though these images sometimes show abnormalities that are not the actual source of the pain. In ambiguous cases, a diagnostic injection of local anesthetic administered directly into the hip joint can temporarily numb the area. If the back pain immediately resolves after the hip injection, it provides strong evidence that the hip was the originating issue. Seek immediate medical attention if you experience sudden, severe pain, a loss of bowel or bladder control, or pain that radiates down both legs, as these can be signs of a serious spinal issue.