You’ve tried stretching your back, resting, medicating, and nothing seems to keep your back pain away. Maybe it’s because your back isn’t your real problem. Sure, that’s where you feel the pain, but the source of the pain may be somewhere else. In some cases, back pain actually originates in the hips, and finding a long-term solution often means treating the pain at its source, not just where you feel it. If you find yourself dealing with recurring pain in your lower back, you may want to consider the possibility that you’re only treating a symptom and neglecting the real cause.
Why Back Pain Isn’t Always About the Back
Our bodies are composed of interconnected systems working together as one. When one system or component is lacking, other systems or components may work extra hard to compensate. Your lower back, for instance, is closely connected to your hips. If your hips aren’t moving well, your back may compensate, and the extra strain on your back can lead to pain.
There is a concept known as “regional interdependence” that emerged from musculoskeletal science. This is a term used to describe how seemingly unrelated impairments in one part or region of the body may contribute to a patient reporting symptoms in another part of the body. Similarly, interventions applied to one part of the body can influence outcomes in another part1.
This concept is similar to concepts developed over thousands of years in traditional Chinese medicine, where the interconnectedness of different body parts or regions has been a fundamental tenet of their approach to treatment. While modern western medicine and traditional Chinese medicine take very different approaches, this is one of many areas where there is some overlap2.
The Role of the Hips in Movement and Stability
Our hips are often doing more work than we realize. They play a key role in many of our most basic movements: walking, sitting, standing, bending, lifting, etc. All of these movements require our hips to be both mobile and stable. They have to be flexible enough to provide a full range of motion, yet stable enough for strength and control during these movements.
If your hips are lacking in either of these aspects, you may find that your back ends up doing a lot of the work instead. This can lead to pain or stiffness in your back that you have no idea actually originates in your hips.
Some Common Hip Problems That Lead to Back Pain
There are some common problems that many people experience in their hips, and many of these can lead to pain you feel in your back. For instance, sitting for long periods can cause your hip flexors to tighten, which can pull your pelvis forward and put strain on your lower back. Weak glutes (which should be among the strongest muscles in your body) can cause your back muscles to overcompensate.
If your hips are lacking in mobility, meaning they are less able to rotate or extend as they should, this can lead to altered movement patterns that put undue stress on your spine. Another common problem is an imbalance between the left and right sides of the hips, which can force an uneven weight distribution and chronic discomfort.
Much back pain, especially low back pain, can be considered “non-specific”. This is low back pain without an obvious cause that can be seen in x-rays or MRI (magnetic resonance imaging). This has become even more common in recent years as more people work at desks and sit for long periods. Evidence indicates that much of this non-specific low back pain may result from an imbalance in movement between the hip joints and the lumbar spine3.
How do You Know if Your Hips are the Real Source of Your Pain?
If you are dealing with persistent or recurring back pain, it may be the case that your hips are the real culprit, but how can you tell? Your best option would be to contact a qualified physical therapist for an evaluation. Short of that, there are some signs to look out for. Some indications that your hips may be causing your back pain include:
- Pain that worsens after sitting
- Experiencing stiffness when standing up
- Pain during walking or after activity
- One-sided back pain
- Limited range of motion in your hips
These situations may not always indicate that your hips are causing your pain, but they are indications that are often overlooked.
It’s important to know if your hips are the problem because treating your pain successfully requires that you treat the actual source of the pain, not just the symptoms. Stretching your back, resting, or taking pain medications may mask the pain and give you some temporary relief, but these approaches are only treating the symptoms if your hips are the real cause.
A Better Approach: Addressing the Root Cause
Treating symptoms only can also lead to other problems, particularly if that treatment includes dangerous pain medication. Even over-the-counter medications can be overused and come with unhealthy side effects. This is even more true of many prescription medications.
To escape from the pain, people often jump too quickly to these sorts of interventions. In many cases, these dangerous and minimally-effective efforts are not necessary. A better approach is to reach out to a skilled physical therapist for a professional evaluation. PTs are trained to treat your body holistically and are uniquely qualified to identify the root cause of pain that may not have an obvious source.
A skilled physical therapist can not only help you identify the source of your pain, but can prescribe a personalized treatment plan to help you manage and overcome it. If you are dealing with back pain that doesn’t seem to stay away, don’t hesitate to contact a local physical therapy clinic and schedule an appointment. The sooner you start, the greater the likelihood of positive outcomes.
Sources
- Sueki, Derrick G, et al. “A Regional Interdependence Model of Musculoskeletal Dysfunction: Research, Mechanisms, and Clinical Implications.” Journal of Manual & Manipulative Therapy, vol. 21, no. 2, May 2013, pp. 90–102, www.ncbi.nlm.nih.gov/pmc/articles/PMC3649356/, https://doi.org/10.1179/2042618612y.0000000027.
- Dong, Jingcheng. “The Relationship between Traditional Chinese Medicine and Modern Medicine.” Evidence-Based Complementary and Alternative Medicine, vol. 2013, no. 23983772, 2013, pp. 1–10, www.hindawi.com/journals/ecam/2013/153148/, https://doi.org/10.1155/2013/153148.
- Nishimura, Takaaki, and Ryo Miyachi. “Relationship between Low Back Pain and Lumbar and Hip Joint Movement in Desk Workers.” Journal of Physical Therapy Science, vol. 32, no. 10, 2020, pp. 680–685, https://doi.org/10.1589/jpts.32.680.
