Can a Hip Labral Tear Cause Low Back Pain?

Yes, a torn labrum in the hip can cause lower back pain by disrupting the balance of the nervous, muscular, and postural systems surrounding the hip.

The hip is a part of a mobile, kinetic chain connecting the core, lumbar spine (low back), pelvis, and legs.

The hip labrum stabilizes and cushions the hip joint. When it becomes frayed or torn, it compromises the joint's stability, leading to abnormal movements in the hip, pelvis, and the connected structures in the lower back, potentially causing pain or discomfort.

How does a hip labral tear cause lower back pain?

A hip labral tear contributes to low back pain in 4 ways:

1. Reduced motion in the hip. A labral tear causes pain and stiffness in the hip, reducing hip mobility – which is a cause for low back pain.¹Nishimura T, Miyachi R. Relationship between low back pain and lumbar and hip joint movement in desk workers. J Phys Ther Sci. 2020;32(10):680-685. doi:10.1589/jpts.32.680
2. Referred pain. A vast network of nerves extends through your lower back, hip, and buttocks. Hip labral tear pain can be "referred" to these nearby areas when the brain misinterprets the pain signals from the labrum as originating from the lower back.
3. Compensatory movements and postures. Hip labral tear pain tends to intensify with hip flexion (bending the hip forward) and rotational movements, such as getting in and out of a car. Pain also increases after prolonged periods of sitting or lying down, prompting adjustments in posture like twisting the hip, shifting the weight to one side, or bending the back to avoid pain. These unbalanced postures strain your lower back muscles and joints, leading to pain and stiffness.
4. Muscular imbalances. Your hip and lower back are interconnected by muscles. When a hip labral tear disrupts hip joint mechanics, it causes muscle tightness and imbalances in the surrounding muscles, including those in the lower back. This imbalance translates to pain in the lower back.

In most cases, a combination of these factors is responsible for low back pain that co-occurs with a torn labrum.

See Hip Pain and Other Symptoms of a Hip Labral Tear 

How do I know if my back pain is linked to my hip labrum pain?

Your low back pain likely is connected to a hip labral tear if:

• You have pain in the front of your hip and/or inner side of your thigh (groin) – the hallmark symptoms of a hip labral tear – in addition to back pain
• Your back pain flares up with activities that stress the labrum, such as getting in and out of a car, sitting for extended periods, squatting, or lying down
• You feel clicking, snapping, or grinding with hip rotation
• You have a diagnosis of hip impingement (femoroacetabular impingement), a common cause of hip labral tears, and a condition that typically co-occurs with hip labral tears.²Su T, Chen GX, Yang L. Diagnosis and treatment of labral tear. Chin Med J (Engl). 2019;132(2):211-219. doi:10.1097/CM9.0000000000000020^,3Berthelot JM, Brulefert K, Arnolfo P, Le Goff B, Darrieutort-Laffite C. Update on contribution of hip labral tears to hip pain: A narrative review. Joint Bone Spine. 2023;90(1):105465. doi:10.1016/j.jbspin.2022.105465 There is a correlation between hip impingement and low back pain – approximately one out of four individuals with hip impingement has low back pain.⁴Clohisy JC, Baca G, Beaulé PE, et al. Descriptive epidemiology of femoroacetabular impingement: a North American cohort of patients undergoing surgery. Am J Sports Med. 2013;41(6):1348-1356. doi:10.1177/0363546513488861

Research indicates that hip labral tears and lower back pain co-occur in many patients, and treating both conditions is likely to reduce pain and provide better symptom relief.⁵Groh MM, Herrera J. A comprehensive review of hip labral tears. Curr Rev Musculoskelet Med. 2009;2(2):105-117. doi:10.1007/s12178-009-9052-9

Early diagnosis and targeted treatments of both hip labral pain and lower back pain are useful to:

• Prevent long-term hip joint complications and worsening of low back pain
• Rule out conditions that mimic labral tears, such as groin strain, sacroiliac joint dysfunction, hip osteoarthritis, or disc problems in the upper lumbar spine
• Coordinate rehabilitation and other treatments for both sources of pain

Hip labral tears and causes of lower back pain are diagnosed and treated by physiatrists, sports medicine specialists, physical therapists, and orthopedic surgeons.

Read more: Why Does My Lower Back and Hip Hurt? on Spine-health.com

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