Stiff Low-Back and Aching Hip Pain: What's Causing It?

From verywellhealth.com

Sudden pain could be the result of a minor injury, such as a strain 

Low-back and hip pain typically affects one side of the body. However, it is possible to have pain on both sides depending on the underlying cause or if you experience pain that radiates or is widespread. 

Low-back pain is one of the most common reasons for healthcare provider visits and time missed from work. It often occurs with hip pain, but back pain can sometimes be mistaken for hip pain. This is because the hip joint is located near the lumbar spine (low back). A hip injury might also mimic back pain.  

Hip and back pain might also occur with the following:

• Referred back pain
• Groin pain on the same side
• Stiffness and tenderness 
• Pain with movement and walking 
• Leg pain on the affected side

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Referred back pain is pain from a source in the low back that is felt in the upper thigh, buttock, and groin. Referred back pain typically does not occur below the knee and might occur with specific causes, including kidney stones and gallstones.

Right-sided pain might be linked to specific causes, such as kidney and gallbladder problems. However, it's possible to experience pain on either side (depending on which kidney is affected) or pain that radiates throughout the back and into the abdomen.

One-sided back and hip pain can occur on the left or right side and is linked to multiple causes, including muscle strains, a pinched nerve, arthritis, herniated discs, and sacroiliac (SI) joint problems. Some low-back and hip pain causes might be specific to people assigned female at birth, such as pregnancy and gynaecological problems.

Fortunately, hip and back pain and their underlying causes are manageable and treatable. Surgery is rarely needed to manage pain and other symptoms. 

This article will cover the causes of one-sided low-back and hip pain, pain management, emergency care, and tips on living with chronic back and hip pain.  

What Causes One-Sided Low-Back and Hip Pain? 

The most common causes of hip and back pain are injuries, arthritis, and disc problems. You might also experience it as a result of an underlying health condition. Many causes of one-sided back pain might also affect both sides of the body.

Overuse Injury 

Back and hip strains can be caused by overuse, in which repetitive movements damage muscles over time. Stressful, repetitive motions can cause the low-back muscles to become stiff and sore. They might also lead to overstretched muscles and small tears in affected muscle areas.

Sports like baseball, tennis, and golf can contribute to strain because they involve sudden, forceful movements.

A chronic strain of the low back can cause significant pain over time. You might also have severe pain in a muscle area that is already inflamed and experiences extra stress. 

Vertebral Fracture

A vertebral spine fracture occurs when one or more vertebrae (bones of the spine) are compressed or cracked. Vertebral fractures are common in older adults, people with osteoporosis (a bone-thinning disease), or after a severe traumatic injury (i.e., an automobile accident or fall).

Symptoms of a vertebral fracture include a sudden popping sound in the low back and back pain that radiates in the hip, buttocks, and legs. 

Arthritis

Arthritis is a common cause of one-sided back and hip pain, although some types may affect the entire lower back and both hips. Back pain associated with arthritis is considered chronic. Arthritis can cause radiating back pain that comes and goes, back stiffness, hip pain, and reduced mobility. 

Axial spondyloarthritis (axSpA) is a type of inflammatory arthritis that primarily affects the spine and causes severe low-back and hip pain. Additional symptoms include fatigue, joint pain, heel pain, and eye inflammation. 

Additional arthritis types that might lead to low-back and hip pain are: 

• Psoriatic arthritis (PsA): Psoriatic arthritis is a type of inflammatory arthritis that attacks the joints and skin. In about 20% of people with the condition, PsA involves the spine and can lead to the fusing of one or more vertebrae.
• Osteoarthritis (OA): OA is the most common type of arthritis. When it affects the spine, it can lead to loss of cartilage in the facet joints where the vertebrae meet, leading to pain and the formation of bone spurs that might press on nearby nerves and cause further pain.
• Reactive arthritis: This type of arthritis occurs after a genital, urinary, or gastrointestinal system infection. It can cause inflammation of the joints, including the sacroiliac joint, leading to low-back and hip pain. You have two SI joints where the lower spine and pelvis connect.
• Enteropathic arthritis: This arthritis type sometimes occurs with inflammatory bowel disease and commonly affects the SI joint, causing low-back and hip pain on one or both sides of the body.
• Spinal stenosis: Caused by a bony overgrowth of the vertebrae and thickening of ligaments, spinal stenosis (narrowing of the spinal canal) may cause low-back pain, hip pain, pain and numbness of the legs, and bladder and bowel problems. It may result from changes related to OA and other arthritis types. 

Disc Injury

A disc injury, such as a tear or herniation, can cause low-back and hip pain. A small tear in the disc's outer part can occur due to aging. If this occurs, you may experience severe pain lasting for weeks or months. 

You might develop a herniated disc from lifting, bending, or twisting. A herniated disc occurs when the gel-like centre of the disc (nucleus) pushes against the outer part. The nucleus may press through if the disc is significantly worn out or experiences trauma.

If the disc bulges or protrudes (bulging disc), it may pressure the spinal nerves, causing pain. This pressure may cause low-back pain extending into the hip, the buttock, and the leg. 

Degenerative Disc Disease 

The intervertebral discs between adjoining vertebrae in the vertebral column can wear away and shrink. When this happens, they can collapse and lead to facet joint pain. The facets are located between each vertebra at the back part of the spine. When the discs and the facets rub against each other, you will experience pain. 

Pain from degenerative disc disease affects the low-back and hips on one side or both. It may radiate into the buttocks and hips and worsen with lifting, bending, and twisting. It might improve with activity, including walking and running.

Piriformis Syndrome

Piriformis syndrome is an injury caused by compression of the sciatic nerve. the piriformis muscle sits deep in the buttock. When it spasms, it may compress and irritate the sciatic nerve, causing radiating symptoms down the leg. The nerve can become compressed from an injury, muscle spasms, or inflammation. 

This condition can cause one-sided pain in the low back, hip, buttock, and back of the leg. It can also cause sciatic nerve pain (sciatica), including sharp, shooting leg pain. 

Sciatica pain results from irritation of the sciatic nerve—the largest nerve in the body, which starts in the low back and goes down into the foot. You have two sciatic nerves, one on each side of the body.

Sciatica can occur with various low-back pain conditions. It does not cause back pain but can be a symptom of an underlying back pain cause.

A Pinched Nerve 

A pinched nerve in the back might cause low-back and hip pain. This type of pain is often severe and accompanied by numbness.

If you have a pinched nerve, pain may come on suddenly and progress. Pain might radiate into the legs. You might experience weakness of the lower extremities. 

A pinched nerve might occur for various reasons. Causes include peripheral neuropathy, disc herniations, or arthritic spine changes.

Sacroiliac Joint Dysfunction

Sacroiliac joint dysfunction can cause low-back and hip pain. Low-back pain related to SI dysfunction can be dull and achy and is typically felt on one side. It may spread into the hips, buttocks, and groin. 

Sacroiliitis (inflammation of the SI joints) might also lead to low-back pain and hip pain. It commonly occurs in people with inflammatory arthritis, including ankylosing spondylitis and rheumatoid arthritis. It often affects one side of the body but can sometimes affect both.

Infection 

An infection can occur anywhere in the spinal column, including intervertebral disc space, the spinal canal, and nearby tissues. A spinal infection can also occur after a spinal trauma or surgery to the spine. 

Symptoms that might occur with a spinal infection include severe back pain, fever, chills, muscle pain and spasms, weakness and numbness in the arms and legs, and bladder or bowel incontinence. 

Poor Posture 

Poor posture and slouching can lead to low-back and hip pain on one or both sides. You may experience pain while sitting, but pain might also occur when standing and walking, especially after sitting for an extended period. 

Kidney Pain

You can feel pain in the area of your back where your kidneys are located. Kidney pain can affect one side of the back or both.

But having pain in both of the areas of your back closest to your kidneys does not mean you have a problem with one or both kidneys. This is because there are many muscles, bones, and organs around and near your kidneys and, without diagnostic testing, it is hard to pinpoint a cause.

See a Healthcare Provider

If you have constant back pain that is limited to the area where your kidneys are located, or you think you might have a kidney problem, contact your healthcare provider right away.

Pelvic Floor Dysfunction 

The pelvic floor is the group of muscles in the pelvic region that support the organs of the pelvis (bladder, rectum, uterus, etc.). The pelvic floor muscles control urination, bowel movements, and sexual intercourse. 

Pelvic floor dysfunction is the inability to control pelvic floor muscles, leading to urinary incontinence and inability to complete bowel movements. It may also cause low-back, hip, and pelvic pain on one or both sides of the body.

Gynaecologic Conditions 

Back and hip pain can affect anyone. But people assigned female at birth will experience back pain more often than those assigned male at birth. Researchers have long suspected that body structure and hormone differences are to blame. 

Various gynaecologic conditions can cause low-back and hip pain. Such conditions only affect people assigned female at birth. Pain might occur on one or both sides of the body.

Gynaecologic conditions that can lead to back pain that affects one side or both include:

• Premenstrual syndrome (PMS): A group of mental and physical changes that occur days or a week before a monthly menstrual cycle
• Endometriosis: A condition with growths of tissue like the lining of the uterus (endometrium) in the abdomen and pelvic area resulting in painful and heavy periods and fertility issues
• Dysmenorrhea: Painful periods
• Premenstrual dysmorphic disorder (PMDD): A more severe form of PMS
• Adenomyosis: Painful and heavy periods as a result of endometrial tissue growth 
• Polycystic ovary syndrome (PCOS): A hormonal disorder that causes numerous small cysts to form on the ovaries, can cause low-back and sacral pain (at the bottom of the lumbar spine)
  
• Ectopic pregnancy (or other pregnancy-related complications): A pregnancy complication where the embryo attaches outside the uterus
• Pregnancy: Common occurrence that may be due to hormone increases, additional weight, centre of gravity changes, posture changes, and stress on the body.
  

Is Low-Back and Hip Pain Ever a Sign of Cancer?

It is rare, but low-back and hip pain might be related to some cancer types. For example, back pain might be an early sign of prostate cancer, or it may occur with spinal cancer. But if back and hip pain occur in people with cancer, they will present with other symptoms, including severe fatigue, fever, and weight loss. 

Different Ways to Manage Low-Back and Hip Pain

Depending on the cause of your low-back and hip pain, your healthcare provider might prescribe treatments to manage symptoms. 

Your treatment options might include:

• Physical therapy to reduce stiffness and keep you mobile 
• Prescription pain relievers to relieve pain and bring down inflammation 
• Oral and injection corticosteroids to ease inflammation and pain
• Muscle relaxers to help with muscle pain and spasms 
• Hormonal birth control to treat gynaecological back pain causes 
• Antidepressants to help relieve chronic back and hip pain and the symptoms of PMS or PMDD
• Surgery in rare instances, which may include surgery to repair discs and other vertebrae problems, or to remove endometrial-like tissue in people with endometriosis 
  

Follow Your Treatment Plan

Pain relief and improvement can take time and commitment. Therefore, it is important to be patient and follow your treatment plan.

Let your healthcare provider know if treatments are not helping or causing severe side effects. You should also notify them about back pain that continues up to six weeks after treatment or that interrupts your sleep for at least three nights over one week. They can change your treatment plan or order testing to determine additional causes of hip and back pain.

Emergency Low-Back, Hip, and Pelvic Symptoms 

If you experience pain that comes on suddenly and worsens quickly, you might have a serious condition that requires emergency medical attention. 

Low-back, hip, and pelvic symptoms that require emergency care include:

• Pain going down one leg below the knee
• Back or hip pain after a fall or injury
  
• Back or hip pain accompanied by a fever
• A sharp, shooting pain rather than a dull ache
• Sudden leg weakness 
• Bladder or bowel incontinence 
• Saddle anaesthesia (a loss of feeling in the buttocks, groin area, and insides of the thighs) 

If you are experiencing leg weakness, saddle anaesthesia, and incontinence, this could be a sign of a  severe condition called cauda equina syndrome(CES). CES is caused by nerve compression. It is a medical emergency that requires immediate nerve decompression surgery to reduce permanent damage. 

Tips for Living With Chronic Low-Back and Hip Pain

Chronic low-back and hip pain can affect more than just the body. It can stop you from doing the things you enjoy and lead to feelings of depression. Fortunately, there are measures you can take to manage pain and help yourself feel better emotionally and physically. 

Tips for managing chronic low-back and hip pain include: 

• Stay active: Exercise is vital to any chronic back pain treatment plan. It is one of the first therapies your healthcare provider will recommend. A physical therapist can tailor a plan designed for your unique health situation and suggest ways to make exercise a part of your daily routine. 
• Improve posture: Be aware of your posture and take steps to improve it. Pay attention to your posture while sitting, standing, and walking, learn to properly lift heavy items, and avoid sitting for long periods. 
• Address sleep problems: Adults need seven to nine hours of sleep at night. Ways to improve your sleep quality include making sure your bed is comfortable, keeping smartphones and other devices out of the bedroom, and keeping your bedroom dark and at an ideal temperature. Talk to a healthcare provider if you still have difficulties with sleep, even after addressing sleep hygiene. 
• Manage stress: If you are dealing with significant stress, you may find it harder to manage back and hip pain. Consider different ways to relax, such as mindfulness, meditation, deep breathing, and yoga. Smartphone apps can be helpful guides to relaxation and meditation techniques. 
• Use pain-relief creams: You can find various over-the-counter (OTC) pain-relieving creams and ointments at your local pharmacy and online. Many of these have cooling and numbing effects for pain relief. Some newer creams contain cannabidiol (CBD). Research on CBD ointments and creams has shown they are effective in managing back pain following spinal surgery.
• Consider alternative therapies: Acupuncture, massage, laser therapy, and electrical nerve stimulation can be extremely helpful for managing chronic back and hip pain. Ask your healthcare provider which alternative therapies might help you.
• Make changes to your diet: If you eat foods considered inflammatory, you might experience more back and hip pain. This includes trans fats, refined sugars, and processed foods. Talk to your healthcare provider to see if diet changes might improve your hip and back pain. Keeping a healthy weight might also improve back and hip pain because it reduces spinal pressure. 
  

Summary 

Low-back and hip pain are common problems. Back and hip pain occurs because the back muscles and spine support much of the body's weight with walking, standing, sitting, and other activities.

Common causes of back and hip pain include injuries, arthritis, poor posture, or repetitive stress on the lower back. Some causes of low-back and hip pain are specific to people assigned female at birth, including pregnancy, PMS, endometriosis, and dysmenorrhea.

Back pain is considered chronic if it lasts three or more months. Chronic back pain can cause additional symptoms, including hip, leg, and buttock pain. Back and hip pain typically affect one side of the body, but it is possible to have pain that radiates throughout the entire lower back and affects both hips.

You can manage low-back and hip pain with lifestyle medications and self-care. Your healthcare provider can prescribe additional therapies to help you manage underlying causes and treat severe pain. Surgery is rarely needed to treat back and hip pain.

Contact a healthcare provider if back and hip pain does not improve or worsen. You should seek emergency care for back and hip pain that presents with leg weakness, saddle anaesthesia, and incontinence. These are signs of cauda equina syndrome, which is a medical emergency.

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