How can I tell if the pain is from my back or a bad hip?

This is very difficult to know, without seeing your physician. Your doctor can do a simple in office exam procedure to see if you exhibit the Figure 4 sign. If you do, your pain comes from the hip. If not, it may be radiating from the spine.

Arthritic hip pain is typically felt in the hip and groin area, possibly down the leg but not past the knee. Back pain usually doesn’t radiate to the groin; it is usually in the low back, possibly radiating down the buttock and legs.

Dr. Langston T. Holly, MD

It can be difficult to determine if pain is caused by your back or hip. Generally speaking, if your pain is limited to the back, it is most likely due to a back issue. This question becomes more challenging when the pain is located in the buttock and hip; this can be caused by either a hip or a back issue. Pain associated with certain movements of the hip are often a clue that the pain is hip related rather than back related. Your physician will likely be able to determine this upon physical examination. X-ray or MRI studies can also help to determine the exact cause.

Brian Yee
Physical Medicine & Rehabilitation Specialist

Motion tests can usually differentiate the pain between the back and hip.

For example:

  1. If you lay on your back and bring you knee to your chest without moving your back - and pain occurs in the front or back of your hip - that would indicate a hip origin.
  2. If you stand and bend forwards, backwards, side to side, and your pain is reproduced - its most likely coming from your spine or pelvis.
  3. There is a test performed by Physical Therapists called a Slump Test that is a maneuver to determine sciatic nerve involvement - can also reproduce pain in the back and hip. In this case it may figure that the hip and back are both invovled, as the sciatic nerve is irritated.


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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.