Author: Rachel Nall, MSN, CRNA
When pain in the lower back occurs alongside hip pain, there may be a common cause. Certain health conditions or injuries can affect the nerves in both of these areas.
These pains usually occur as a result of overuse or injury, but they can also be a symptom of an underlying medical condition. People may notice the pain on the left or right side of the body or both.
In this article, we look at possible causes of lower back and hip pain. We also discuss the various treatment options and how to relieve pain.
It is easy to overwork the lower back and hips because they are responsible for lifting, twisting, and moving the legs and trunk. Pains due to overuse and minor injury are common in these areas of the body.
Although these pains are common, people should not ignore them. Rest and early treatment can significantly improve a person’s outlook.
The causes are similar in males and females. The following are some of the most common causes of lower back and hip pain.
Sprains and strains are a common cause of pain around the back and hips. A sprain is a torn or overstretched ligament, while a strain is a torn or overstretched tendon or muscle.
People with sprains and strains are likely to experience discomfort that worsens with activity and gets better with rest.
Common causes of sprains and strains in this area include:
- sports injuries
- a fall or trauma
- twisting the body in an awkward way
- lifting something heavy
Playing a sport or engaging in other physical activity without warming up properly can contribute to muscle strain.
Damage to the ligaments, tendons, or muscles in the hip or lower back can cause:
- muscle pain
- muscle weakness
- reduced range of motion
People will usually find that their symptoms improve with a few days of rest.
Gentle stretching can speed up recovery. Applying a cloth-covered ice pack to the affected area for 10 to 15 minutes at a time can also help.
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, can reduce the pain and swelling that these muscle injuries cause.
If these treatments do not reduce symptoms, the injury may be more serious, for example, a muscle tear. In this case, a person should see their doctor.
The hip flexors are muscles that extend from the hips to the knees. They are responsible for the range of motion in the legs and hips. If these muscles are stiff and tight, often due to remaining in a seated position for too long, a person may experience back and hip pain.
Hip flexor strains, which are strains in the hip flexor muscles, can also cause sharp pain in the back and hips.
Symptoms of tight hip flexor muscles include:
- tenderness in the upper leg
- muscle spasms in the hips or thighs
- soreness in the hips and thighs
Some people may also experience a sense of weakness when trying to kick the leg or lift the knee toward the chest.
Physical therapy exercises and stretching can help relieve tight hip flexors and reduce discomfort. Examples include pulling the knee toward the chest or lunging one leg forward from a kneeling position to create a stretch in the hips.
Avoiding activities that can increase hip flexor tightness, such as sitting too long at a desk or wearing high heels for extended periods, can also help.
A herniated disk occurs when one of the cushioning disks between the vertebrae slips out of place. The disk can put pressure on a nearby nerve, which may cause tingling and burning pain in the lower back that extends to the hips and legs.
Older adults are prone to herniated disks because of the natural wear and tear of the spine that occurs over time. The disks also become less flexible with age.
Common causes of a herniated disk include:
- improper lifting or twisting while lifting
- a fall or trauma
- being overweight
- repetitive strain on the back
- driving for long periods
Symptoms of a herniated disk include:
- sciatica, or a sharp, shooting pain from the buttocks down the back of one leg
- numbness in the leg or foot
- muscle weakness in the leg or foot
In severe cases, people may experience a loss of bowel and bladder function. If this occurs, they should go to the hospital or call 911 right away.
The treatment for a herniated disk involves relieving pain and discomfort while it heals. Bed rest will usually help relieve the pain too.
Other treatment options include:
- physical therapy exercises
- taking NSAIDs to relieve pain and inflammation
- epidural steroid injections, which involve injecting corticosteroids into the epidural space containing the inflamed nerves
In severe cases, a doctor may recommend surgery to correct a herniated disk.
The sacroiliac (SI) joints connect the lower portion of the spine to the pelvis. If these joints move too much or too little, people may feel pain in the back and hips.
The symptoms of SI joint dysfunction include an aching lower back that makes it difficult for a person to find a comfortable position. The pain will usually worsen with physical activity, such as running or climbing stairs.
A herniated disk and arthritis can cause symptoms similar to those of SI joint dysfunction.
Treatment options for SI joint dysfunction include:
- NSAIDs to relieve pain and inflammation
- physical therapy exercises to strengthen the core and pelvic muscles
- stretching and applying ice to the affected areas
- the injection of a steroid into the SI joint
A doctor may suggest that a person has corticosteroid injections to reduce spinal inflammation. In rare instances, they may recommend surgery to fuse the joints.
Osteoarthritis of the back can result in the breakdown of the protective and cushioning cartilage of the spine. This loss of cushioning can cause the spinal bones to rub together and place greater pressure on the nerves, including the nerves that go to the lower back and hips.
Arthritis in the back and hips causes joint stiffness and pain. A person may also experience weakness in the legs and hips, which can interfere with their everyday activities.
Doctors do not have a cure for arthritis, but people can manage their symptoms using medication and lifestyle methods. These include:
- exercises that strengthen the back and hips muscles to improve flexibility and range of motion
- trying home remedies for arthritis
- alternative therapies, such as massage, acupuncture, and nutritional supplementation
- surgery, if arthritis causes significant spinal canal narrowing
Ankylosing spondylitis is a form of arthritis that primarily affects the spine, causing chronic inflammation in the spinal joints. Lower back and hip pain are often some of the first symptoms that a person with ankylosing spondylitis experiences.
Symptoms include muscle pain and stiffness that is usually worse in the morning. Other symptoms may include:
- low-grade fever
- appetite loss
- malaise, which is a general feeling of discomfort
Doctors do not have a cure for ankylosing spondylitis, but, as with other forms of arthritis, people can manage the condition with a range of medical and at-home treatments.
Prescription medications, such as tumor necrosis factor (TNF) blockers and NSAIDs, can help. Certain lifestyle measures, including doing regular physical activity, icing affected areas, and not smoking, can also be beneficial.
Paget’s disease of bone is a rare disorder that affects an estimated 1% of people in the United States, according to the American College of Rheumatology.
This condition causes a person’s bones to remodel abnormally, leading to bone softening, which can affect the pelvis, lower back, hips, and arms. A person with Paget’s disease has a higher risk of bone pain and fractures.
The symptoms of Paget’s disease include:
- hip pain
- hearing loss
- bowed legs, where the knees are wider apart than usual
- tingling and numbness down the legs
The treatment for Paget’s disease involves medications to reduce the likelihood of the bones breaking. Doctors usually prescribe these medicines to treat osteoporosis. In rare cases, a doctor may recommend surgery to repair bones and restore alignment.
People should seek emergency attention if they experience any of the following symptoms alongside lower back and hip pain:
- loss of bowel and bladder function
- inability to move one or both legs
- loss of sensation in one or both legs
- visible deformity in the legs or back, such as the inability to stand up straight
If a person experiences less severe symptoms that do not improve with rest and over-the-counter treatments, they should make an appointment with their doctor. A doctor can evaluate their symptoms, make a diagnosis, and recommend the most effective treatments.
When a person experiences lower back and hip pain simultaneously, there may be an underlying injury or medical condition causing both of these symptoms. In other cases, the causes may be distinct.
Lower back and hip pain can make performing daily activities difficult. If these symptoms do not resolve or suddenly get worse, a person should seek medical attention.
Regardless of the cause, early treatment helps improve the outlook of a person with back and hip pain. Without treatment, some causes of the pain can get worse and may ultimately affect a person’s mobility and quality of life.