How Hip Arthritis Can Cause Back Pain: Understanding the Hidden Connection

Many people are surprised to learn that hip problems can often be the real reason behind persistent lower back pain. While the ache might feel like it’s coming from the spine, the source may actually be the hip joint — particularly if arthritis has begun to affect its smooth movement.

The hip and lower back are deeply connected through shared muscles, nerves, and movement patterns. When one isn’t functioning properly, the other is forced to compensate — often resulting in pain, stiffness, and fatigue in both areas.

Understanding Hip Arthritis

The hip joint is a ball-and-socket joint that allows smooth movement of the thigh in multiple directions. The surfaces of the joint are lined with cartilage, which cushions the bones and allows pain-free motion.

In hip osteoarthritis, this cartilage wears down over time, leading to:

Stiffness, especially in the morning or after sitting
Groin, buttock, or thigh pain
Clicking or catching sensations
Reduced range of motion (difficulty crossing legs, putting on shoes, or getting out of a car)

As the joint becomes stiff or painful, the body begins to move differently — and that’s where the trouble for the back begins.

How Hip Arthritis Leads to Back Pain

1. Altered Movement and Compensation

When the hip loses flexibility, you subconsciously change the way you walk or stand to avoid discomfort. This compensation often means:

Overusing muscles in the lower back and pelvis
Shifting weight unevenly to one side
Rotating or tilting the pelvis abnormally

Over time, this creates strain on the lumbar spine, leading to chronic tightness and lower back pain.

2. Pelvic Imbalance

The pelvis acts as the bridge between the spine and the hips. If one hip joint stiffens due to arthritis, the pelvis can tilt or twist — known as pelvic asymmetry. This uneven foundation alters spinal alignment, increasing pressure on the lower back joints and discs.

3. Shared Nerve Pathways

The hip and lower back share nerve supply from the lumbar plexus — a network of nerves that controls sensation and muscle function in the lower body. When inflammation from hip arthritis irritates these nerves, pain may radiate into the lower back, buttock, or thigh, mimicking spinal issues like sciatica.

4. Reduced Core and Glute Strength

Hip pain often causes people to move less, weakening the gluteal and core muscles that stabilise the pelvis and spine. Weaker support muscles mean the lower back has to work harder to maintain posture, increasing fatigue and strain.

5. Inflammation and Referred Pain

Inflamed tissue in the hip can send pain signals through interconnected nerve pathways, creating a phenomenon known as referred pain — where discomfort is felt in the back even though the source is elsewhere.

Recognising the Difference: Hip vs Back Pain

It’s not always easy to tell whether pain is coming from the hip or the back, but there are some clues:

Feature	Hip Arthritis	Lower Back Pain (Spine Origin)
Pain location	Groin, buttock, front of thigh	Lower back, buttock, leg
Aggravated by	Walking, climbing stairs, sitting-to-standing	Bending, twisting, prolonged sitting
Relief position	Often eased by sitting	Often worsened by sitting
Range of motion	Difficulty rotating hip or crossing legs	Stiffness mainly when bending or arching the spine

In many cases, both areas are involved — which is why accurate diagnosis and targeted treatment are essential.

How to Manage and Prevent Back Pain from Hip Arthritis

1. Restore Hip Mobility

Gentle stretching and mobility exercises help maintain hip motion and prevent the pelvis from compensating. Examples include:

Hip flexor stretches
Glute bridges
Side-lying leg raises
Controlled hip rotations

A physiotherapist or sports medicine specialist can tailor a safe mobility plan based on your condition.

2. Strengthen the Core and Glutes

Building strength in the gluteal, abdominal, and spinal muscles stabilises the pelvis and reduces pressure on the lower back. Exercises like squats, bridges, and side planks are particularly effective when performed correctly and consistently.

3. Improve Posture and Walking Mechanics

Good alignment during walking or sitting prevents overuse of one side of the body. Small adjustments such as using supportive footwear or working with a gait specialist can make a big difference.

4. Manage Inflammation

Anti-inflammatory nutrition (omega-3s, colourful vegetables, turmeric), adequate hydration, and regenerative therapies can help reduce local irritation and support joint health.

5. Weight Management

Even a small reduction in body weight can significantly decrease stress on both the hips and the lower back — easing pain and improving mobility.

6. Consider Regenerative or Targeted Therapies

In early to moderate arthritis, regenerative treatments such as platelet-rich plasma (PRP) or stem cell therapy can support cartilage health and delay progression. For advanced cases, surgical options such as hip replacement can dramatically reduce pain and restore alignment — often relieving secondary back discomfort as well.

Frequently Asked Questions

Can hip arthritis cause sciatica?
It can mimic sciatica. Hip arthritis can irritate nearby nerves, producing pain that radiates down the thigh or buttock, similar to nerve compression from the spine.

If my back hurts, how can I tell if the hip is the real cause?
Groin or thigh pain, difficulty rotating your leg, or pain when putting on shoes often indicate a hip source. A physical assessment and imaging (such as X-ray or MRI) can confirm the diagnosis.

Will treating my hip help my back pain?
Yes. In many patients, addressing hip arthritis — whether through physiotherapy, injection, or surgery — significantly reduces or eliminates associated back pain.

Should I still exercise if I have hip arthritis?
Absolutely. Controlled, low-impact activity helps maintain mobility and strength. Avoid high-impact or twisting movements that worsen symptoms.

In Summary

The hip and lower back work as a team — when one fails, the other feels the strain. Hip arthritis doesn’t just affect your ability to walk; it can quietly reshape posture, muscle balance, and spinal alignment, leading to chronic back pain.

By restoring hip mobility, strengthening supportive muscles, and managing inflammation early, you can protect both your hips and your back — keeping your body aligned, balanced, and pain-free for the long term.

Healthy hips mean a healthy back.
Move well, align well, and your spine will thank you.