Lower Back and Hip Pain

Before talking about lower back and hip pain it is probably worth establishing where exactly you think your hip is.  I often have patients pointing to various bits of their body and describing it as their hip. The three most common paces are shown in the image below.

However, when I'm talking about hips I mean the hip joint, this is under the crease where your leg joins your trunk. It is not at all uncommon for someone to have lower back and hip pain. There are two common causes of this. 

lower back and hip pain

Hip and Nerve Pain

There are two main nerves running from your spine down your legs, the sciatic nerve runs down the back of your thigh and the femoral nerve runs down the front.

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If you have a nerve root irritation at one of the slightly higher lumbar levels eg the second lumbar vertebra then pain may be felt in the femoral nerve area which includes the groin and the hip area.  The nerve may be irritated by a number of things, these include

Your doctor will be able to rule out the more worrying things for you.

Lower Back and Groin Pain - Referred Pain from the Lumbar Spine

Another source of lower back and hip pain is referred pain from the facet joints at the second and third lumbar vertebrae. 

It is a confusing fact that pain can often be felt some way away from the tissues that are causing it. Many research studies have looked at these facet joints and found that if you irritate the facet joint the pain may be felt some way away from it. So pain in the groin may indeed be coming from a joint in the lower back. (Search  for Nikolai Bogduks vast body of work on Pubmed if you want more detail or see the refernce below)

However, I have been a physiotherapist for too long to get fooled by this.

Many patients I see have actually got lower back and a separate hip problem. So many people have lower back pain (80% of us) that having hip pain at the same time is not uncommon and it can be confusing when the two become mistakenly linked.

There are other common causes of hip pain that have nothing to do with the spine such as osteoarthritis and muscle problems.

Before deciding you have a back problem hip joint pain needs to be ruled out.

Make sure the problem is not back pain kidney related.  

In order to find out the exact source of your pain you will need to be examined by someone who is familiar with working out the causes of back pain such as your doctor or physical therapist.

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Back Pain Symptoms Hub

Lower Back Pain Toolkit Home Page

References

1.  Schwarzer, A.C. et al. Clinical features of patients with pain stemming from the lumbar zygapophysial joints. Is the lumbar facet syndrome a clinical entity? Spine 19, 1132-1137 (1994).

1-feb-13