Key Causes of Lower Back and Hip Pain – Physio Penrith

Evidence-Based Facts For Lower Back and Hip Pain

Lower back and hip pain are common complaints, and sometimes it’s hard to tell which one is actually causing the problem. Pain in these areas can be sharp or dull, come on suddenly or build over time, and can affect everything from walking to sleeping.In this blog, we’ll break down the key causes of lower back and hip pain, explain how they’re connected, and share tips to help you find relief.

Why Are Lower Back and Hip Pain So Often Linked?

Your lower back, hips, and pelvis are all part of the same movement system. When one part isn’t working right, it can easily cause pain elsewhere. For example, what feels like back pain might actually be coming from your hip—and vice versa. Low back pain may refer into the back of the hip, but hip pain rarely refers in to the low back.

Further to this, pain that is coming from the hip joint most often presents at the front or anterior hip and groin.

Dr. George Cyril, a physiatrist at Hospital for Special Surgery (HSS), says that in up to 90% of younger patients with lower back pain, the real issue is in the hip, such as hip impingement, hip dysplasia and common muscle strain injuries.

That’s why it’s so important to understand the different causes of pain in this area.

Top 5 Causes of Lower Back and Hip Pain

1. Herniated Disc

A herniated disc happens when one of the discs between your spinal bones bulges out or breaks open. It can press on nearby nerves, causing lower back pain that radiates into the hip and leg.

2. Pinched Nerve

Nerves in the lower spine can get compressed by tight muscles or spinal issues. This may cause sharp or burning pain that spreads into the hips, buttocks, or legs—often mistaken for hip pain when it’s really coming from the back.

3. Arthritis or joint pain

Osteoarthritis in the hip or spine can lead to stiffness, swelling, and pain, especially in older adults. The cartilage in the joints wears down over time, causing the bones to rub together and create discomfort in nearby areas.

4. Muscle Strain

Strained muscles from overuse, lifting something the wrong way, or poor posture are one of the most common causes of pain in the lower back or hip. This kind of pain often feels sore or stiff and may get worse with movement.

5. Sacroiliac (SI) Joint Dysfunction

The SI joint connects the spine to the pelvis. If it becomes irritated or inflamed, it can cause pain that feels like it’s in the lower back or hip—often on just one side of the body.

Low Back Pain vs. Sciatica – What’s the Difference?

Low Back Pain

This is usually localised pain in the lower back area. It can be caused by irritation to the intervertebral disc, joint or muscle. It doesn’t always spread to the legs.

Sciatica

Sciatica is caused by pressure, irritation or compression on the sciatic nerve. It leads to paraesthesia or changes in sensation, which includes pain, tingling, or numbness that travels from the lower back through the hip and buttocks and down the leg.

If your pain is sharp and shoots down your leg and goes beyond the knee, it could be sciatica—not just regular back pain

Low Back Pain with Radicular Pain

Radicular pain means the pain is coming from an irritated or compressed nerve root in the spine. It’s often caused by a herniated disc or spinal stenosis – either central canal stenosis or foraminal stenosis, and the pain can shoot down into the hip or leg. If you’re dealing with this kind of pain, it’s best to see a physiotherapist or doctor to confirm the source of the nerve irritation.

Low Back Pain Causes – A Quick List

Common Causes of Lower Back and Hip Pain

• Herniated disc
• Pinched nerves
• Hip impingement
• Arthritis or joint pain
• Hip osteoarthritis 
• Sacroiliac joint problems
• Muscle strain
• Hip-spine syndrome (combined hip and back pain)

What Can You Do About Low Back Pain Or Hip Pain?

Here are some practical steps you can take:

• See a physiotherapist: Especially if the pain has lasted more than a few weeks. They can help you figure out whether the pain is coming from your back or hip.
• Try physical therapy first: In many cases, targeted movement and strengthening exercises can reduce pain and improve function—without surgery. Specifically, when talking about hip osteoarthritic pain – the evidence supported recommendations are for weight loss and land-based strength training.
• Don’t ignore pain: If you’ve had persistent back or hip pain for months, it’s time to see a professional. Waiting often makes the problem worse.
• Look at the whole body: A good assessment will consider how your spine, hips, knees, and posture all work together. Treating just one area may not fix the root issue.

FAQs About Low Back Pain and Hip Pain

What’s the most common cause of lower back and hip pain?

The most common cause is muscle strain, but many people also experience pain from hip impingement, especially if they are active or younger.

Can hip problems cause back pain?

Yes, issues like hip impingement or arthritis can lead to changes in movement that put extra strain on the lower back. The is a predictive factor that says if you have less than 15degrees hip internal rotation then it is predictive of low back pain (with other contributing predictive factors).

How do I know if it’s my hip or my back causing pain?

It can be tricky to tell. If your pain worsens with certain hip movements, the hip might be the cause. A physiotherapist can help assess the true source by using hip and low back provocative special tests.

When should I see a doctor or physio?

If your pain has lasted more than a few weeks, or if you’ve tried basic treatments with no improvement, see a physiotherapist.

FAQs About Sydney Muscle & Joint Clinic

What does Sydney Muscle & Joint Clinic treat?

We specialise in diagnosing and treating muscle, joint, and nerve pain, including lower back pain, hip pain, sciatica, and more.

Do I need a referral to book an appointment?

No referral is needed. You can book directly with our team.

What treatment options do you offer?

We provide hands-on physiotherapy, exercise-based rehab, and evidence-based treatments tailored to your condition and goals.

Where are you located?

Sydney Muscle & Joint Clinic is located in Penrith, Sydney. Check out our “contact us” page on our website for the clinic address.

Final Thoughts

Lower back and hip pain can have many causes—and the tricky part is figuring out where the pain is really coming from. The good news is, with the right diagnosis and treatment, you can usually get back to moving well and feeling better.

If you’re in Sydney and struggling with persistent pain, our team at Sydney Muscle & Joint Clinic is here to help. We take the time to look at the full picture so we can find and treat the real problem—not just the symptoms. Check out our other blog on low back pain myths: https://www.physiopenrith.com.au/low-back-pain-truths/