Back pain doesn’t always start in your spine. Tight hips or a restricted SI joint often force your low back to overwork, leading to chronic tension and discomfort. At Active Sports Therapy in Hendersonville, TN, we help active adults uncover the true cause of their pain so they can move, lift, and live stronger without surgery.
The Hidden Connection Between Your Hips and Low Back
There’s a reason we say, if you don’t use it, you lose it. Modern careers demand long hours sitting at desks or behind the wheel, and as we hit our thirties and forties, it’s easy to shift focus from our own health to providing for our families. Over time, this lack of movement causes the hips to tighten and lose range of motion.
When that happens, the lower back is forced to compensate. Every time you bend to lift, clean the garage, or play with your kids, your spine works overtime because your hips can’t. That extra stress is one of the most common reasons people develop persistent low back pain, even when imaging shows no major spinal damage. This is also a common theme seen in our post on understanding the real causes of back pain in golfers.
A Case Study: Kevin’s Story
Recently, a patient we’ll call Kevin came to our clinic with ongoing hip pain. He’s insured through a specialized Vanderbilt bundle program, which requires him to follow a specific care pathway. His first stop was an orthopedic surgeon, who evaluated his hips and told him, “Your hips are tight, but this looks more like a back problem.”
Kevin followed the protocol, completing ten sessions of traditional therapy. After all that time, he was no better. Ironically, the same orthopedic surgeon had originally mentioned Active Sports Therapy as a clinic that could look deeper into the root cause, but Kevin didn’t end up with us until his wife, who also had back pain, came in for care and experienced great results.
Once she started improving, she encouraged Kevin to come in. During his evaluation, we confirmed something important, the pain he felt in his hip actually originated in his lower back. Tests that put pressure on his spine reproduced his pain exactly, even though he was convinced it was a hip issue.
Why Hip Tightness Causes Back Pain
The low back and hips are designed to share the workload. When hip flexors tighten and glutes weaken, your body takes the path of least resistance, usually by overextending through the lumbar spine. This pattern leads to pain in the low back, buttocks, or even groin.
Here’s how that works:
- Facet joints in the lower spine act like hinges. When overloaded, they send referred pain that feels like it’s in your hip.
- Nerve roots exit the spine like exit ramps off Vietnam Veterans Boulevard. Each nerve serves a region of the hip and leg, so irritation at one level can mimic hip or SI joint pain.
- Tight hip flexors and hamstrings change pelvic alignment, forcing the lumbar spine into overdrive during everyday movement.
In Kevin’s case, years of driving for work, spending 50 to 60 hours a week seated, caused his hips to adapt to that posture. His body became efficient at sitting but terrible at squatting, bending, or sprinting. Over time, that lack of flexibility overloaded his back.
The Active Sports Therapy Approach
When Kevin came to Active Sports Therapy, our goal was to identify both the pain source and the movement dysfunction that created it. Our findings showed a two-part problem, he needed to restore hip and core mobility, and he had to retrain his body to stop overusing his low back during movement.
We treated him with a combination of:
- Dry needling to release deep hip flexor tension
- Chiropractic adjustments to improve spinal mechanics
- Active Release Technique (ART) for soft-tissue restrictions
- Targeted strengthening for glutes and core stability, similar to what we teach in our rehabilitative exercise programs
- Mobility drills to retrain the hips for daily use
After a few weeks of consistent care, Kevin was able to run, coach his child’s football practices, and work out again without flare-ups. The key wasn’t just treating the site of pain but addressing the pattern that caused it.
Understanding SI Joint Dysfunction
The sacroiliac (SI) joint, where the spine meets the pelvis, can also mimic back or hip pain. When tight hips limit motion, the SI joint often takes the hit, leading to sharp or radiating pain near the beltline. This type of issue often responds well to spinal decompression therapy and individualized movement retraining.
If you notice any of the following, your SI joint might be involved:
- Pain when standing up from sitting
- Discomfort while rolling over in bed
- Pain that switches sides depending on how you move
- Tenderness over the dimples of your lower back
These symptoms often overlap with lumbar or hip conditions, which is why a thorough, movement-based exam, like the one we perform at Active Sports Therapy, is essential. Learn more about SI joint function from experts at the Cleveland Clinic.
What You Can Do Today
You don’t have to live with back or hip pain. Here are a few steps to get started:
- Move every hour. Even a two-minute walk resets hip mobility and circulation.
- Stretch your hip flexors daily. Kneeling hip flexor and pigeon stretches work best.
- Strengthen your glutes. Exercises like bridges, squats, and step-ups build balance across the pelvis.
- Get evaluated. If your pain hasn’t improved after a few weeks, a detailed movement assessment can reveal whether your hips, back, or SI joint is the main cause.
At Active Sports Therapy, we help identify these problems early, before they turn into chronic pain or lead to unnecessary imaging or procedures. According to research from NIH on hip-spine syndrome, addressing hip mobility can significantly reduce chronic low back strain and improve long-term outcomes.
Ready to find relief? Book your appointment online or visit our contact page to schedule a consultation with our team in Hendersonville, TN.
FAQ
How can I tell if my back pain is coming from my hips?
If your pain worsens with sitting, twisting, or crossing your legs, limited hip motion may be contributing.
What is SI joint pain?
It’s inflammation or dysfunction at the joint where your spine meets your pelvis, often mistaken for a lumbar problem.
What treatments help hip-related back pain?
A combination of chiropractic adjustments, dry needling, soft-tissue therapy, and mobility training.
Can sitting too long cause this problem?
Yes, prolonged sitting shortens hip flexors and weakens glutes, which puts stress on the lumbar spine.
When should I see a chiropractor or sports therapist?
If your pain hasn’t improved after 2–3 weeks of self-care or is limiting daily activity.
