Low Back Pain That Radiates To Groin: Is it your back, your hip, or something else?
Low back pain that radiates to the groin can be confusing because the source of pain is not always where you feel it. The low back, hips, pelvis, and groin share nerve, muscle, and fascial connections that commonly create referred pain patterns.
This type of pain can be related to spinal nerve irritation, hip joint stiffness, muscle compensation, or nervous system overload. Identifying the real driver behind the symptoms is the key to resolving the issue instead of chasing temporary relief.
A thorough physical therapy assessment can determine whether the root cause is coming from the spine, hip, movement dysfunction, or nervous system stress so the right treatment approach can be used.
You wake up and feel that dull ache in your low back. You keep trying to ignore it, assuming it will go away eventually.
But now you notice pain and tightness in your groin. It’s kind of hard to localize, but it’s somewhere in the front of the hip and upper thigh.
It feels kind of different throughout the day and the pain and tightness move around.
Stretching helps temporarily, but the aching and tightness always come back.
What the heck is going on?
Is this a back issue? Hip issue? Hernia? Something more?
When pain travels like this, it usually means the body is protecting something, NOT that something is seriously wrong.
This pattern is actually quite common and totally fixable! It’s a matter of identifying the root cause of the problem and implementing the most effective solution.
We will break it all down for you today.
Here’s what we are going to talk about in this blog post:
Why pain can travel from the low back to the groin
Common causes of low back pain that radiates to groin
The nervous system piece most people miss
Signs your pain is coming from movement dysfunction
What actually helps low back pain that radiates to groin
How physical therapy addresses the root cause
When to seek help for low back pain that radiates to groin
Why pain can travel from the low back to the groin
The simple answer is that it’s all connected.
The back, pelvis, hips, and groin are all located so close to each other. They share nerve, muscle, and fascia connections. Movement (or lack there of) at one joint also affects movement at the surrounding joints.
It’s important to note that where you feel pain isn’t necessarily where the cause of the problem originates.
This is called referred pain and it is very common.
For example, when nerve roots from the spine are irritated, they send pain signals to other parts of the body. The groin and front of the thigh is a common pain referral area for these nerves.
Muscles of the core, low back, and hips can also cause pain or tightness in the groin and front of the hip. The psoas muscle is a common culprit, but not for the reasons you think! Read the rest of this blog before you aggressively stretch the psoas. That could actually make the problem worse.
The big takeaway here is that the body is an integrated and highly connected system. When one area gets overloaded or irritated, nearby structures often step in to protect it.
Common causes of low back pain that radiates to groin
There are several causes of low back pain that radiates to groin, so we are going to break it down by body part.
Spine irritation
Before you start freaking out about the words “spine irritation”, know that this simply refers to the presence of inflammation around the spinal nerves that pisses off the nerves. Don’t go down the rabbit hole of imaging findings, disc “problems”, or “degenerative changes”. These anatomical findings are completely NORMAL and often have no correlation to the pain you’re feeling.
It is very common for irritation of the nerves around T10-L3 to radiate to the hip, groin, and front of the thigh. Even though it is common, it is often missed clinically. This is why we take great care to assess for referred pain from this part of the spine when clients come to us with hip, groin, and back pain!
Additionally, too much or too little movement in the joints that connect the spine can be a trigger for low back pain that radiates to groin.
Hip joint
Tightness in the hip joint itself can often manifest as deep groin pain. The hip and low back are also very intimately connected. Too much or too little motion at one area will almost always affect the other area.
An example of this is seen in golfers. Many golfers experience back pain because of hip joint stiffness. The body will always get motion from somewhere when it can’t get it from the ideal source. In this example, golfers need lots of rotational mobility. Most of it should come from the hips. When it doesn’t, the path of least resistance is to get that mobility from the low back. This is a common cause of back pain in golfers. And it isn’t really a back problem- it’s a hip mobility problem.
Muscles and fascia of the deep core and hip
Many deep core and hip muscles have attachment points at both the hip and low back. As a result, one area will always affect the other! Muscles also have referral patterns, and many referral patterns include the groin.
Primary muscles at play here are the psoas, iliacus, obliques, quadratus lumborum (aka QL), hip rotators, and glutes. If any of these muscles are weak or overworked, they can refer pain to the hip and groin.
The muscles are all connected by fascia. Dysfunction in these fascia connections can also contribute to low back pain that radiates to groin.
Muscle guarding from stress or overload
Sometimes muscles are tight because the nervous system is overloaded. In this scenario, the nervous system is trying so hard to protect you. One of the ways it does this is by increasing muscle tension as a protective mechanism.
This is why over-stretching can actually make the problem worse. Overstretching perpetuates the danger signals perceived by the nervous system and it lights fire on the muscle tension and guarding response.
The nervous system piece most people miss
The nervous system is the queen of the body. It literally controls all bodily function, movement, and sensation.
Sometimes you feel low back pain that radiates to groin not because something is physically wrong, but because your nervous system perceives a threat and is trying to protect you.
When you operate in high stress, whether or not you’re aware of it, the nervous system responds.
A common response is holding tension in the hips and low back. This is known as protective muscle guarding.
When the nervous system feels overloaded, it creates tension in the hips, low back, and abdomen to stabilize and protect itself.
Here are signs your pain is coming from nervous system overload:
You feel tightness in your hips and hip flexors
You feel back pain or stiffness
You feel back pain that radiates to groin, hips, or thighs
Pain is worse during times of stress or chaos
Activities like yoga and walking help your pain and stiffness
You feel better on vacation or when you’re in relaxing environments
Again, do not overstretch in this scenario. It can actually make the problem worse.
Sometimes pain is less about structural problems and more about a body that is stuck in protection mode. This body needs the right type of support, not just doing more from a physical perspective.
Signs your pain is coming from movement dysfunction
The nervous system can play a big role in low back pain that radiates to groin. So can movement dysfunction. This can be an AND (not OR) scenario, where both the nervous system and movement patterns need to be addressed.
Here are signs your pain is coming from movement dysfunction:
You can correlate pain with specific activities or positions
Pain is worse after sitting for long periods of time
You feel pain on one side of the body
Pain may improve with exercise, but can feel worse the next day
Stretching only helps temporarily
These are very treatable patterns that we see all the time!
Remember, everybody compensates. As those compensations get repeated over time (usually outside of your conscious awareness), pain and tightness can develop. Especially with how intimately connected the low back, hips, and groin are, it is very common for compensations at each of these body parts to affect the others.
The key here is figuring out the root of the compensatory pattern and fixing that part. Then everything else gets better!
What actually helps low back pain that radiates to groin
Key areas to focus on to help low back pain that radiates to groin are:
Restoring hip joint mobility
Improving spinal movement
Improving deep core activation and strength
Regulating the nervous system
Optimizing movement patterns
The body operates as a system, not muscles and joints in isolation. It is important to optimize mobility, strength, and movement patterns of the whole region to experience lasting relief.
This is where physical therapy really shines. We can figure out WHY your body is compensating, taking into account both the nervous system and movement pieces. Integrating both underlying factors is key to designing a whole-body plan to recovery that actually lasts.
How physical therapy addresses the root cause
Physical therapists are perfectly equipped with the tools and knowledge in our scope of practice that allows for noninvasive and effective treatment that actually solves your problems.
At Empower Physio and Wellness, we look at you as a whole person- mind, body, and spirit. We are very thorough in our evaluation process and look at the whole movement system, as well as stressors in your life. We will even ask about stressors that drive this pattern that you may not be aware of.
It is important that we identify the true driver(s) of your pain so that we are most effective in your treatment plan. We always assess your progress to make sure we are on track.
Once the root problem is identified, we use a combination of hands-on treatment, movement retraining, strength training, and nervous system regulation. This allows you to get real results, notice real improvement, and regain confidence in your body’s ability to move.
But most importantly, it empowers you to take an active role in your care so that you maintain this transformation on your own!
Pain relief is important, but the real goal is helping you feel strong, resilient, confident, and empowered for the long-term.
When to seek help for low back pain that radiates to groin
It’s a good idea to reach out to a physical therapist for help if you experience:
Pain that lasts more than 2-3 weeks
Recurring pain flare ups
Feeling limited in workouts or daily life
Relief with rest, but pain flares again with activity
Frustration with not being able to fix the problem on your own
Worry about being told to stop doing an activity you love
Desire for true, lasting relief
Remember: Your body isn’t broken. It just needs the right support!
Where to find physical therapy for low back pain that radiates to groin
Have you tried fixing this problem on your own, or have been bounced around the medical system, and want more individualized support?
If you are located in or near Westerville, Ohio we can help you with physical therapy to improve your low back pain that radiates to groin!
You can get started right away by learning more about our physical therapy services or getting in contact with us.
If you have additional questions, we would love to talk with you, hear your story, answer all your questions, and see how we could help.
You can call or text us at (614) 423-9731 orschedule a free discovery call. You can also learn more aboutEmpower Physio and Wellness + our team or check out otherservices we offer.