Why your back pain may not be only a back problem
Nicola Tik
If you have been managing lower back pain and it keeps coming back, the hips may be part of the reason. This article explains the connection between the two regions and what it means for how you approach recovery.
The hip flexors are a group of muscles that run from the front of the lower spine and pelvis down into the upper thigh. Their job is to bring the thigh towards the body, which happens every time you take a step, climb a stair, or sit down.
When you spend a lot of time sitting, the hip flexors stay in a shortened position for extended periods. Over time, this shortening can become their resting state, meaning they stay slightly contracted even when you stand up. A shortened hip flexor pulls the front of the pelvis downward and forward, a position called anterior pelvic tilt.
The pelvis and the lower spine move together. When the front of the pelvis tips forward, the lower back responds by increasing its curve. That increased curve compresses the structures at the back of the lumbar spine, the joints, discs, and surrounding soft tissue, more than they would be under a neutral load.
That compression is not dangerous in itself, but it does mean the lower back is working under more load than it needs to be. Over time, or during a flare-up when the area is already sensitised, that extra load can be enough to maintain symptoms or prevent them from settling fully.
Lower back pain tends to get most of the attention because it is where the symptoms are felt. But if the hip flexors are shortened and the pelvis is sitting in a forward tilt, the compressive load on the lumbar spine does not change just because the back itself is being managed. The source of that load is still present.
This is why some people find that their back settles for a short period and then returns. The back responds to treatment or rest, but the hip position that was driving the extra load has not shifted, so the pattern re-establishes.
Addressing both regions together is not about doing more work. It is about removing the underlying load that keeps pulling the back into a compressed position in the first place.
Recognising whether your back pain has a hip component
A few patterns suggest the hips may be contributing. Back pain that is worse after long periods of sitting and takes a while to ease when you first stand up is a common sign. Pain or stiffness at the front of the hip or upper thigh alongside back symptoms is another. If your back tends to feel better when you are walking but tightens again after sitting, that points towards the hip flexor mechanism rather than the back alone.
None of these are definitive, but if several feel familiar, the hips are worth including in how you think about your recovery.
Why starting with the hips can break the cycle
Because the hip flexors are the upstream part of this chain, releasing tension there tends to reduce the load reaching the lower back. Many people find that when hip flexor tension eases, the back follows relatively quickly, sometimes within the same session.
This means that on days when your back feels too sensitive to address directly, working on hip flexibility can still move things forward. You are reducing the load on the back indirectly, which is often more comfortable and more effective than trying to manage the back when it is at its most reactive.
If you would like a guided stretch targeting the hip flexors and the lumbar region together, VIDA has short videos you can follow when you have a minute or two.
The same mechanism that drives the feedback loop can work in your favour. When the hip flexors lengthen and the pelvis returns towards a more neutral position, the compressive load on the lower back reduces. That reduction can create a noticeable shift in how the back feels, not because anything has changed in the back itself, but because the load driving the symptoms has decreased.
Small, consistent progress in hip flexibility tends to have a compounding effect on back symptoms over time. Progress in one region is genuinely useful for the other.
It is worth paying attention to whether your back and hip symptoms tend to arrive and ease together, or whether one consistently leads the other. If the hip stiffens first and the back follows, that points clearly towards the hip as the starting point. If the back flares independently, the picture may be more mixed, but addressing the hips is still likely to reduce the load on the lumbar spine.
Your VIDA pain check-in is a good way to track how both regions shift over time, particularly as you introduce changes to how you manage them.