Chronic lower back pain has been one of the most common issues faced by older adults, leading to reduced mobility. Lower back pain can often be linked to weak or stiff hips rather than spinal issues alone.

According to WHO, approximately 1 in 13 people experienced lower back pain, around 60% increase from 1990. By 2050, it is expected to rise to an estimated 843 million people.

Dr Aravind P R, consultant, Rehabilitation Medicine, Aster Whitefield, Bangalore says that nearly half of the people with chronic back pain show signs of hip dysfunction, such as muscle weakness, reduced movement and only get better after hip-focused therapy. When hip muscles are weak or the joints become stiff, the spine deals with increased strain and discomfort.

He adds that sitting for a longer time, desk jobs and reduced movement weaken the gluteal muscles and tighten hip flexors, disrupting pelvic alignment and making everyday activities like walking, bending and even climbing stairs very painful.

“Back pain is not just about spine”, he says. “Even if the hips are weak or tight, the spine shows discomfort. This can trigger recurring pain that won’t fully go away until the lumbar spine is forced into an unnatural movement pattern.

Hip-focused therapy gaining attention

Physiotherapists are now prescribing hip-strengthening and hip-mobility exercises, such as glute bridges, clamshells, hip flexor stretches, along with core and spinal workouts. Dr Aravind says as people start hip exercises, within weeks they notice improvements in balance, posture and mobility.

A recent study shows that people with chronic back and hip pain, who received hip-focused physiotherapy, experienced better benefits in mobility and balance than those who underwent spinal cord physiotherapy. Researchers also found that addressing restricted hip extension and hip weakness improved walking endurance and most of the back pain-related issues.

Role of hip in back pain recovery

Experts say the hips play an important role in healthy spinal movement. When they become weak:

- The pelvis tilts forward or side/ways, leading to strain on the lumbar spine

- Core muscles fail to activate correctly

- Gait becomes unbalanced, increasing pressure on the lower back

- Compensatory spinal movements lead to inflammation and chronic pain

Dr Aravind says that many people experience relief when the treatment combines hip strengthening, core stability and spinal mobility.

Practical ways to ease back pain

Physiotherapists recommend that anyone with repeated lower-back pain:

- Get a hip mobility and gait assessment

- Work on glute strength

- Reduce prolonged sitting and take breaks in between

- Practice hip-flexor stretches and pelvic-stability exercises

- Combine hip training with core strengthening rather than focusing on the spine alone

With chronic back pain continuing to rise globally, experts believe hip-focused therapy could become one of the major treatments.,

“These days we cannot just treat the spine alone,” says Dr Aravind. “When we treat the hips, the back finally heals.”

Takeaways

Chronic back pain isn’t always about an issue with the spine. A recent study has shown that weak or stiff hips can play a significant role in lower back pain. When hip muscles lose strength, the spine often shows discomfort. Doctors are now focusing on hip-focused therapy to treat lower back pain, as poor hip strength can worsen the pain and limit movements.