Back Pain vs Hip Pain in Runners – How to Tell the Difference

Descending Mt Buffalo at the 2025 Up N Adam Bright Running Camp

Back Pain vs Hip Referral in Runners – Quick Checks Before You Panic

You’re out for a run and start feeling a dull ache down the back of your thigh. Is it a hamstring strain? Is it coming from your hip? Or could it be your lower back?

At Up N Adam Performance Training & Physiotherapy in Newcastle, we see this dilemma all the time. Back and hip problems can overlap, making it tricky to know where the pain is really coming from. Understanding the difference matters — because the right management starts with the right assessment.

Why This Confusion Happens

Both the hip joint and the lumbar spine share nerve pathways and can refer pain to similar areas. That’s why hip arthritis can feel like groin pain, or why a lumbar disc issue might cause pain in the buttock or thigh. For runners, the repetitive impact of training can highlight these issues quickly.

Common Causes of Pain in Runners

Back-related causes:

• Lumbar disc irritation

• Facet joint overload

• Nerve root referral (“sciatica”)

Hip-related causes:

• Hip joint impingement or arthritis

• Labral irritation

• Gluteal tendon overload

Key Differences – Back vs Hip

While an assessment with a physio is the only way to know for sure, here are some general patterns:

• Pain location: Hip joint pain often presents in the groin or front of the thigh. Back-related pain is more likely in the buttock, outer thigh, or down the leg.

• Aggravating activities: Hip pain: running uphill, deep squats, crossing legs. Back pain: sitting for long periods, bending/lifting, twisting.

• Associated signs: Back referral may include pins & needles, numbness, or weakness. Hip pain is less likely to cause these nerve-type symptoms.

When to See a Physio

If you’re experiencing:

• Pain that doesn’t improve with rest

• Night pain or pain affecting sleep

• Numbness, tingling, or weakness in your leg

• Difficulty continuing your normal runs

…it’s worth booking an assessment. Early physio review can help you understand what’s happening and set a plan.

How We Approach It at Up N Adam Physio

Our Newcastle team combines clinical expertise with objective testing:

• Movement and strength screening

• VALD technology (force plates, dynamometer) to measure muscle function

• Running gait analysis for load and technique

From there, we guide you with a step-by-step management plan:

• Load adjustments (how much you can safely run)

• Targeted strengthening for back, hips, and core

• Education to reduce flare-ups and build resilience

FAQs

Q: Can hip pain feel like back pain? Yes, hip joint pain can often be felt in the groin, thigh, or buttock, which can mimic back issues.

Q: Should I get a scan first? Not usually. Most running-related pain can be assessed without immediate imaging. Your physio will advise if scans are needed.

Q: Can I keep running with back or hip pain? Sometimes yes, with modifications. The key is adjusting load and monitoring symptoms under guidance.

Call to Action

If you’re a runner in Newcastle unsure whether your pain is from your back or hip, our team at Up N Adam Physiotherapy in Hamilton North can help you work it out.

Book Online Now to book your assessment www.upnadamptphysio.com

This is APA Sports Physiotherapist, Darren Glendenning, signing off for now!

You can book an appointment with Darren or Newcastle Knights Physiotherapists Katie or Hayd'n at www.upnadamptphysio.com to test your core and guide you on your journey.

Bookings also available on our website for the following services at Up N Adam Performance Training & Physiotherapy:

• Dietitian - Sweat testing, weight-loss or to optimise your training nutrition / fuelling www.nutrientnation.com.au

• VO2 Max testing - to discover more effective ways to train efficiently www.flowitri.com.au

• Strength & Conditioning Programs - contact us or book via the website or email us at upnadamptphysio@gmail.com

• Remedial Massage - to relieve accumulative muscle tension & keep you training well.

• CycleFit by Physiotherapist Dean Waterman - At Up N Adam, for all your bike fitting solutions www.cyclefitphysio.com