Chronic lower back pain, a leading cause of reduced mobility among older adults, is increasingly being linked to problems in the hips rather than the spine alone, medical experts say.
According to the World Health Organization (WHO), nearly one in 13 people worldwide experience lower back pain — a figure that represents a 60% rise since 1990. The number is projected to climb to about 843 million by 2050, highlighting the growing public health burden.
Dr. Aravind P.R., Consultant in Rehabilitation Medicine at Aster Whitefield, Bengaluru, points out that nearly half of patients with long-standing back pain show signs of hip dysfunction, including muscle weakness and restricted movement. “Many of these patients report significant relief only after therapy focuses on the hips,” he says. Weak hip muscles or stiff hip joints place additional strain on the spine, often leading to persistent discomfort.
Sedentary lifestyles, prolonged sitting, desk-bound jobs and reduced physical activity weaken the gluteal muscles and tighten hip flexors, Dr. Aravind explains. This imbalance disrupts pelvic alignment and can make routine activities such as walking, bending or climbing stairs painful.
“Back pain is not just a spinal problem,” he notes. “When the hips are weak or tight, the spine compensates. This forces the lower back into unnatural movement patterns, triggering pain that tends to recur.”
Shift towards hip-focused therapy:
Physiotherapists are now placing greater emphasis on hip-strengthening and mobility exercises — including glute bridges, clamshells and hip-flexor stretches — alongside core and spinal training. According to Dr. Aravind, patients often notice improvements in posture, balance and mobility within weeks of beginning targeted hip exercises.
Recent studies indicate that individuals with chronic back and hip pain who underwent hip-focused physiotherapy showed greater improvements in mobility and balance compared to those who received spine-centred treatment alone. Addressing limited hip extension and muscle weakness was also found to enhance walking endurance and reduce back pain symptoms.
Why hips matter in recovery:
Experts underline the crucial role of the hips in supporting healthy spinal movement. When hip function is compromised, the pelvis may tilt forward or sideways, increasing strain on the lumbar spine. This can weaken core muscle activation, disrupt gait and lead to compensatory spinal movements that cause inflammation and long-term pain.
Dr. Aravind observes that a combined approach — strengthening the hips, stabilising the core and improving spinal mobility — often brings lasting relief.
Steps to manage lower back pain:
Physiotherapists recommend that people experiencing recurrent lower back pain consider:
Undergoing a hip mobility and gait assessment
Strengthening the gluteal muscles
Reducing prolonged sitting with regular movement breaks
Practising hip-flexor stretches and pelvic stability exercises
Integrating hip training with core strengthening rather than focusing only on the spine
As the prevalence of chronic back pain continues to rise globally, specialists believe hip-focused therapy may play a central role in future treatment strategies.
“We can no longer treat the spine in isolation,” Dr. Aravind says. “When the hips are addressed, the back finally begins to heal.”
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