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Do you get back pain with hip arthritis?

Yes, it is common for back pain to occur along with hip arthritis. The hip joint and spine work together closely, so problems with one can lead to problems with the other. When the hip joint is damaged due to arthritis, it can change your posture and the way you walk, placing extra strain on the structures of the lower back. This often leads to back pain. Understanding the connection between hip arthritis and back pain can help you find the right treatment approaches.

What is hip arthritis?

Hip arthritis, also known as hip osteoarthritis, is a degenerative condition where the cartilage in the hip joint breaks down over time. This leads to pain, stiffness, and reduced range of motion in the hip joint. Some common symptoms of hip arthritis include:

  • Hip pain – This may occur in the groin, outer hip, or buttocks.
  • Stiffness in the hip joint, especially after periods of inactivity.
  • Loss of flexibility and range of motion in the hip.
  • A crunching or grinding sensation in the hip joint.
  • Difficulty with activities due to hip pain, like walking, climbing stairs, or bending over.

Over time, the breakdown of cartilage can result in bone rubbing directly on bone within the hip joint, causing even more pain. Hip arthritis often develops slowly and worsens gradually.

What causes hip arthritis?

Some of the most common causes of hip arthritis include:

  • Normal age-related wear and tear – The cartilage in the hips gradually deteriorates with age.
  • Injuries – Past injuries such as hip fractures or dislocations can lead to arthritis later on.
  • Abnormal hip structure – Having a misshapen hip joint from birth puts extra stress on the cartilage.
  • Other types of arthritis – Rheumatoid arthritis or gout can also affect the hip joint.
  • Excess weight – Being overweight or obese adds additional pressure onto the hip joints.

Factors like genetics, activity level, and occupation can also play a role in the development of hip osteoarthritis.

The connection between back pain and hip arthritis

How hip arthritis leads to back pain

There are several ways that arthritis in the hip joint can contribute to pain and problems in your lower back:

  • Altered posture – Damaged hip joints may cause you to stand with shifted weight or a swayed back. This puts strain on the structures of the lower back, resulting in pain.
  • Abnormal gait – Arthritis often causes a limping, uneven gait. The changes in how you walk can aggravate muscles and joints in the lower back.
  • Compensating movements – If arthritic hip pain makes bending and rotating difficult, you may twist your back more to make up for loss of mobility in the hips.
  • Leg length discrepancy – If one arthritic hip sinks lower, it can create a leg length difference that leads to scoliosis and low back pain.

Over time, these types of compensation for the hip arthritis put repetitive stress and strain on the structures of the lower spine. The muscles, ligaments, facet joints, and discs can become irritated and inflamed, resulting in chronic or worsening back pain.

How back pain can aggravate hip arthritis

On the other hand, pre-existing back pain can also hasten the progression of hip arthritis in some cases:

  • Poor posture and weakness – Chronic back pain often leads to poor posture, limited core strength, and weakened back muscles. This transfers more stress onto the hip joints.
  • Reduced activity – Being less active due to back pain can cause stiffness in the hips and accelerate degeneration.
  • Leg length differences – A back condition like scoliosis may create a leg length discrepancy that puts more pressure on one hip.
  • Gait disturbances – Altered walking patterns from a back issue can strain the hip joints.
  • Weight gain – Inactivity and reduced exercise due to back pain may lead to weight gain and increased loading on arthritic hip joints.

So in many cases, back pain and hip arthritis develop concurrently and exacerbate each other over time. Treating only one area rarely leads to a full recovery. A comprehensive approach is needed.

Symptoms of back pain related to hip arthritis

Location of pain

Back pain associated with hip arthritis most often occurs in the low back or sacral regions. But symptoms can also radiate into the upper back. Common areas include:

  • Lower lumbar spine
  • Sacrum
  • Sacroiliac joints
  • Upper buttocks
  • Lateral hip areas
  • Lower thoracic spine between shoulder blades

The location of back pain can help pinpoint its relation to hip arthritis. For example, sacroiliac joint dysfunction or sciatica indicate the arthritis is putting strain on the lower back and pelvic areas. Upper back pain may result from posture changes to accommodate the hip discomfort.

Type and nature of pain

Back pain from hip arthritis may feel like:

  • A constant dull ache
  • Stabbing pain with certain movements
  • Muscle tightness and spasms
  • Stiffness worse in the morning
  • Diffuse radiating pain into the buttocks or legs
  • Aggravated by activity and relieved by rest

The pain may come and go but often settles into a chronic pattern over time. Flare-ups can occur due to increased physical activity or trauma. Getting an accurate description of your symptoms will help determine if hip arthritis is contributing to back pain.

When does the back pain occur?

Paying attention to when back pain appears can also indicate a connection with hip problems:

  • At night or early morning – Arthritic hips often stiffen overnight. This can strain the lower back and cause morning back stiffness.
  • During or after activity – Joint degeneration in the hips may flare up with physical exertion, exercise, or weightbearing. This places more demand on the spine and leads to muscle fatigue and soreness.
  • When standing up or walking – The posture and gait changes from hip arthritis shift strain to the back with these activities.
  • After long periods of sitting – Stiff arthritic hips that have been immobile can abruptly alter forces on the back when standing.
  • During cold damp weather – Many types of arthritis worsen in cold conditions. The hips and back may both get aggravated.

Paying attention to back pain patterns provides insight into how it relates to hip arthritis symptoms.

Diagnosing the cause of back pain

To confirm that hip arthritis is causing or contributing to back pain, doctors use several diagnostic techniques:

Medical history

Looking at your full medical history provides insight. The doctor will ask about:

  • Any past back injuries
  • Past hip injuries or trauma
  • Onset date and location of back symptoms
  • Pain triggers and relievers
  • Changes to gait and posture
  • Morning stiffness duration
  • Intensity of pain

These details help determine if hip arthritis could be related to your back pain.

Physical examination

During the physical exam, the doctor looks for:

  • Decreased hip mobility
  • Muscle weakness
  • Gait abnormalities
  • Leg length discrepancies
  • Reduced spinal flexibility
  • Areas of tenderness in back and hips

Abnormalities point to an association between your back and hip pain.

Imaging tests

Imaging techniques like x-rays, MRI scans, and CT scans help confirm hip joint damage and sources of back pain through pictures. Examples of findings include:

  • Narrowed hip joint space
  • Bone spurs
  • Loss of cartilage
  • Spinal misalignments
  • Herniated discs
  • Spinal stenosis

These objective findings help support a diagnosis of back pain secondary to hip arthritis.

Treating back pain related to hip arthritis

Once a diagnosis is made, treatment focuses on relieving both the back and the hip pain. Options may include:


Medications that help reduce inflammation and pain in both the back and hips, such as:

  • NSAIDs like ibuprofen or naproxen
  • Analgesics like acetaminophen
  • Cortisone injections into the hips or back
  • Disease-modifying antirheumatic drugs (DMARDs)

Physical therapy

Stretching, strengthening exercises, manual therapy, and modalities to improve mobility and support the spine and hips. A physical therapist can also advise about proper posture, gait, sleep positions, and using assistive devices like canes or walkers.

Weight loss

Losing excess weight reduces stress on both the back and hip joints to ease pain. Dietary changes and exercise programs can promote weight loss.

Braces or shoe inserts

These supports correct postural imbalances and leg length discrepancies between arthritic and healthy hips to stabilize the pelvis and spine.


If conservative treatments fail, surgery may be warranted. This could involve spinal procedures or hip replacement to definitively correct the source of pain.

Alternative therapies

Options like massage, acupuncture, heat/ice application, yoga, or chiropractic care can provide additional pain relief in some cases.

A combination approach focused on relieving both hip and back pain often works best. Keeping active with appropriate exercises and stretches is also key. Proper treatment can help manage back pain related to hip arthritis.


You can take proactive steps to help prevent back pain caused by hip arthritis:

  • Maintain a healthy body weight to reduce joint loading.
  • Follow an exercise program to support overall mobility and strength.
  • Use proper lifting techniques and posture during daily activities.
  • Take frequent breaks from prolonged sitting or standing.
  • Wear shock-absorbing shoes.
  • Modify activities to reduce hip stress.
  • Treat other causes of back pain promptly.
  • Use assistive devices if necessary for walking.

Making positive lifestyle modifications can go a long way in preventing secondary back pain from hip arthritis.


Hip arthritis and back pain often co-exist due to the interdependent mechanics of the spine and hips. Damaged hips shift stress to the back while back problems can accelerate hip joint degeneration. Typical symptoms include chronic low back/sacral pain that worsens with physical activities due to postural changes and altered gait from the hip arthritis. A combination of anti-inflammatory medications, physical therapy, weight loss, braces, and surgery when needed can effectively treat both the back and hip pain. Preventive strategies also play a key role in interrupting this cycle. With the right comprehensive treatment plan, it is possible to manage back pain related to hip arthritis and improve overall quality of life.