Why is Lower Back Pain Associated with Your Hip Flexors?

Lower back pain and hip flexors – how are they related? Sometimes physios will treat the hip flexors when clients present with lower back pain. This is because the hip flexor muscles attach to the front of the lumbar spine and also to the femur bone.

These muscles can become tight, particularly if someone is sitting for long periods of time.

Lower Back Pain 

Lower back pain can present as a persistent dull ache to sharp, stabbing pains that can radiate down the legs and up the spine. 

It is a common problem that affects a significant portion of the Australian population. 

According to the University of Sydney, a staggering 25% of Australians report experiencing lower back problems.

Causes of Lower Back Pain

The causes behind this widespread issue are as varied as the individuals it affects, so it is important to seek a professional diagnosis from a physiotherapist or a general practitioner.

It can severely restrict a patient’s mobility, making even the simplest tasks a challenge, whether it’s exercising, working, or getting a good night’s sleep. 

The pain can take a toll on mental well-being, potentially leading to irritability and distress.


Physiotherapy Treatment for Lower Back Pain

Physiotherapists can offer a multifaceted approach to alleviating this condition. 

Through techniques such as manual manipulation and dry needling, they can; 

  • ease muscle tension
  • improve blood flow
  • provide much-needed relief 

Additionally, physios can prescribe tailored exercises to strengthen the affected muscles and offer guidance on safely returning to work and daily activities.

Where are hip flexors located? 

A common but unknown factor contributing to lower back pain is hip flexor tension. 

The hip flexors attach through the front of the lumbar spine sequence, in particular L2, L3 and L4, and also attach to the front of the femur (thigh) bone. 

The hip flexors comprise of the psoas, iliacus, rectus femoris, pectineus and sartorius muscles.


How does sitting for long periods of time affect hip flexors?

The hip flexors can become tight in the majority of the population, due to many having sedentary jobs requiring sitting for extended periods of time. 

Sitting causes the hip flexors to become shortened, due to the right angle of the thigh to the hips. 

Hence, shortening the connection between the lumbar spine and the beginning of the femur.


Anterior pelvic tilt

Once standing, the shortened hip flexors place tension on the lower back resulting in an anterior pelvic tilt. 

An anterior pelvic tilt refers to a forward tilt of the pelvis, which protrudes the abdomen or lower stomach. 

This results in the lumber spine curving inwards, a process known as lordosis. The curvature causes lower back pain and stiffness. 

Posterior pelvic tilt

In posterior pelvic tilt, however, the front of the pelvis is tilted upwards while the tailbone is tucked in. This reduces the strain on the lower back, thus, preventing pain.


Treating Lower Back Pain & Hip Flexors

While your physiotherapist is addressing lower back pain, they may treat it through the hip flexors in order to correct your posture and reduce tension. 

In addition to this, they may use massage techniques or dry needling. 

A key part of treating this condition is; 

  • remaining active
  • implementing exercises 
  • stretching to elongate the hip flexors and strengthen them

Stretches for Hip Flexors

Common stretches for the hip flexors are

  • butterfly stretch
  • low lunge
  • kneeling hip flexor stretch

These stretches can be held for twenty to thirty seconds, and repeated daily. 

It is also recommended to exercise on a regular basis, whether this be walking each day or weight lifting. 

If possible, use of a sit-stand desk may prevent sitting down for too long, and could be an investment into long term prevention of lower back pain.


Here at Physio and Fitness Clinic we can assist you with your lower back injuries. Make an appointment with a physio today.