Is Your Hip Pain Really a Hip Problem? Understanding the Spine-Hip Connection

If you’re dealing with nagging hip pain, you might assume the problem is entirely within your hip joint. However, research suggests otherwise—about 71% of hip pain cases actually originate from the lower back. This means that treating the hip alone may not be enough to relieve your discomfort. At Boulder Sports Chiropractic, we take a comprehensive approach to diagnosing and treating hip pain by assessing the spine and surrounding structures to uncover the true source of your pain.

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Is Your Hip Pain Actually Coming From Your Spine?

In many cases, hip pain isn’t coming from the hip joint at all.

It can be referred pain from the lower back, sacroiliac (SI) joint, or surrounding nerves.

This is why treatments focused only on the hip—like stretching or foam rolling—don’t always work.

The key is identifying the true source of the problem.

Book a full evaluation in Boulder to determine the real cause of your pain

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How the Lower Back Can Cause Hip Pain

The lumbar spine (lower back) and the hip joint share nerve pathways, which means pain signals from the spine can be “referred” to the hip. Several conditions that affect the lower back can mimic hip pain, including:

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• Lumbar Disc Herniation – A bulging or herniated disc can put pressure on nerves that travel to the hip, causing deep, aching pain.
• Sciatica – Compression of the sciatic nerve in the lower back can lead to radiating pain in the hip, buttock, and down the leg.
• Facet Joint Dysfunction – Dysfunction in the small joints of the spine can cause pain that spreads into the hip region.
• Sacroiliac (SI) Joint Dysfunction – The SI joint connects the spine to the pelvis and can cause hip pain when inflamed or misaligned.

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Because these spinal conditions can create pain patterns similar to hip joint problems, it’s essential to differentiate between true hip pain and referred pain from the spine.

Signs Your Hip Pain May Be Coming from Your Lower Back

If your hip pain is actually stemming from your lower back, you might experience:

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• Pain that worsens with prolonged sitting or bending forward (a common sign of lumbar disc involvement)
• Pain that radiates down the leg rather than staying localized in the hip joint
• Numbness, tingling, or burning sensations in the hip, thigh, or leg
• Pain that improves with changes in position (such as lying down or standing up after sitting)
• Lower back discomfort in addition to hip pain

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If any of these symptoms sound familiar, it’s time to take a closer look at your spine.

Why Hip Pain Is Often Misdiagnosed

The hip and lower back are closely connected, both structurally and neurologically.

Pain can be:

• Referred from the lumbar spine
• Related to SI joint dysfunction
• Caused by nerve irritation

Because of this, the location of pain doesn’t always tell you where the problem is.

Treating the wrong area is one of the most common reasons pain keeps coming back.

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Hip Pain Treatment in Boulder, Colorado

If you're dealing with hip pain in Boulder, Longmont, Louisville, or Lafayette, one of the most important steps is getting the right diagnosis.

At Boulder Sports Clinic, we frequently see patients who:

• Have been told they have “tight hips”
• Have tried stretching or massage with limited results
• Continue to have recurring pain with running, lifting, or sitting

In many of these cases, the issue is actually coming from the spine or surrounding structures—not the hip itself.

Our evaluation process looks at:

• Lumbar spine mobility
• Pelvic alignment and SI joint function
• Muscle strength and control
• Movement patterns (running, lifting, daily activities)

This allows us to create a treatment plan that addresses the root cause—not just the symptoms.

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A Common Scenario We See

Many patients come in thinking they have a “hip problem,” but after evaluation we find:

• Limited lumbar spine mobility
• Weakness in the core or glutes
• Compensation patterns during movement

Once we address those factors, hip pain often improves quickly—and stays away longer.

This is why diagnosis matters more than guessing.

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Who This Is Most Relevant For

This is especially common in:

• Runners with recurring hip or IT band pain
• CrossFit athletes with lifting-related hip discomfort
• Desk workers with stiffness from prolonged sitting
• Active adults with pain during walking, hiking, or exercise

If your pain keeps coming back despite doing “the right things,” it’s worth looking deeper.

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Our Approach to Diagnosing Hip Pain

At Boulder Sports Chiropractic, we take a whole-body approach to diagnosis. Our process includes:

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1. Comprehensive Patient History – Understanding when and how your pain started helps us identify the root cause.
2. Physical Examination – We assess your posture, movement, and muscle strength to pinpoint dysfunction.
3. Orthopedic and Neurological Testing – Specific tests help us determine whether your pain originates in the hip joint or if it’s referred from the lower back.
4. Functional Movement Assessment – We evaluate how your hip and spine work together to identify biomechanical issues contributing to your discomfort.

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By thoroughly examining both your hip and spine, we can develop an accurate diagnosis and an effective treatment plan.

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Effective Treatment Strategies

If we determine that your hip pain is due to a spinal issue, our treatments focus on addressing the underlying cause. Some of our most effective treatment options include:

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• Chiropractic Adjustments – Gentle spinal manipulations can restore proper movement and reduce nerve irritation contributing to hip pain.
• Class IV Laser Therapy – This advanced treatment helps reduce inflammation and accelerate tissue healing in both the lower back and hip.
• Dry Needling – By targeting tight muscles and trigger points, dry needling can alleviate referred pain and improve mobility.
• Shockwave Therapy – This technique stimulates healing in soft tissues and can be beneficial for both spinal and hip-related conditions.
• Physical Therapy and Rehab Exercises – Strengthening the core, glutes, and hip stabilizers helps restore balance and prevent future pain.

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Staying Active in Boulder Without Recurring Hip Pain

Living in Boulder means staying active—whether that’s trail running, lifting, hiking, or skiing.

Hip pain can quickly limit those activities if the root cause isn’t addressed.

The goal isn’t just to reduce pain—it’s to:

• Restore proper movement
• Improve strength and control
• Prevent the issue from returning

That requires a comprehensive approach—not just treating symptoms.

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Take the Next Step Toward Pain Relief

Hip pain doesn’t have to limit your life, and treating the right area is the key to lasting relief. If you’ve been struggling with hip discomfort that hasn’t responded to traditional treatments, the true source of your pain may be your lower back.

At Boulder Sports Chiropractic, we specialize in uncovering and treating the root cause of musculoskeletal pain. Contact us today to schedule an evaluation and get back to moving pain-free!

Rosedale R, Rastogi R, Kidd J, Lynch G, Supp G, Robbins SM. A study exploring the prevalence of Extremity Pain of Spinal Source (EXPOSS). Journal of Manual & Manipulative Therapy. 2020 Aug 7;28(4):222-30