Back Pain · Physical Therapy · Jul 02, 2026

What Your Lower Back Pain Location Might Be Telling You

Back pain is both very common and very annoying. Lower back pain in particular is one of the most common reasons for people to seek medical help. This is partly due to how frequently it occurs, and also due to how much it can frustrate so many of the basic daily tasks we take for granted. In fact, lower back pain is one of the most common and most costly causes of workplace disability, accounting for as much as one-third of all workers’ compensation costs¹.

It’s true that lower back pain is very common, but not all back pain feels the same. One person may experience a dull ache across the whole lower back, while another person may experience a sharp pain on one side. You may feel it near your hips or traveling to the buttock or leg. It may be an acute pain that comes on suddenly or a chronic pain that recurs over time.

While the specific location of your pain alone can’t provide a perfect diagnosis of the cause, it can provide some useful clues. If you see a physical therapist about your lower back pain, they can evaluate where the pain is, how it responds to different movements, and whether there are additional symptoms like numbness, weakness, or tingling. All of this information can help to identify the underlying cause of the pain and provide a strategy to effectively treat it.

Why Pain Location Matters

The location where you feel the pain may not always be the same as the location of the cause. Often though, knowing where you feel the pain is the only information you have to work with. The lower back is a complex region that is deeply involved in many of our bodies’ movements. There are many potential sources of pain, including:

muscles
joints
ligaments
discs
nerves
referred pain from nearby areas

Lower back pain can stem from a chronic condition like arthritis or something as simple as bad posture or poor movement patterns. It can also result from your body unconsciously compensating for pain or discomfort in some other part.

The location of your pain cannot provide a diagnosis by itself. In fact, two different people can have similar pain locations with completely different causes. To a trained medical professional, though, the location of the pain provides an important clue that can help narrow the list of potential causes and arrive at an accurate diagnosis more quickly. Different types of pain can often be linked to different types of causes.

When You Feel Pain Across the Whole Lower Back

A common type of lower back pain can feel like aching or stiffness across the whole lower back. This type of pain may feel worse after sitting or standing too long, lifting, bending, or doing yardwork. This type of pain is often mechanical, influenced by posture, movement, and underlying strength. Causes of this type of pain vary, but some potential culprits may include:

muscle strain
ligament sprain
muscular deconditioning
arthritis or degenerative changes

This type of pain is often associated with prolonged sitting, poor posture, or overuse. Physical therapy can often address this pain by helping improve core and hip strength to better support your spine, helping to improve lumbar mobility and flexibility, and helping you address poor posture and/or body mechanics².

When You Feel Pain on One Side of the Lower Back

This type of pain can often make people worry that something is seriously wrong. It can sometimes come on very quickly and powerfully. Very often, this type of pain is related to how one side of the body is moving, loading, or compensating. Some common causes of this type of pain can include:

muscle strain
joint irritation
hip weakness or mobility issues
uneven movement patterns
compensation from walking, lifting, or a previous injury

Compensating for an unknown injury, stiffness, or weakness on one side of the body can often lead to pain on the other side. This type of pain can often benefit from improving hip mobility, glute strength, and/or movement patterns.

It should also be noted that one-sided back pain accompanied by fever, urinary symptoms, or other severe unexplained symptoms can sometimes indicate a more serious problem that should be evaluated medically.

When You Feel Pain Near the Hips or Pelvis

Because the lower back, pelvis, and hips all work together, pain in this area can be confusing, and may not be coming all from one particular structure. Also, one pain in this area can often contribute to pain in other parts of the area. A lower back problem can lead to hip pain, and a stiff or weak hip can place extra stress on your lower back. If you feel pain near the hips or pelvis, potential causes can include:

sacroiliac joint irritation
hip mobility limitations
hip arthritis or tendon irritation
muscles tightness around the pelvis

This type of pain is often experienced while walking, standing, climbing stairs, or getting out of a chair. Because this is such a complicated area of the body involved in so many different movements, it’s often a good idea to have this type of pain evaluated by a qualified physical therapist. A professional evaluation and a personalized treatment plan can help you address this type of pain safely and effectively.

When You Feel Pain That Travels Into the Buttock or Leg

This type of pain can often involve nerve irritation. This doesn’t always mean there’s a severe injury, but these symptoms should be taken seriously, especially if they are worsening. This type of pain can be caused by:

sciatica
lumbar nerve irritation
disc-related irritation
spinal stenosis
piriformis/deep glute irritation

Lower back pain that is travelling into the buttock or leg is often a good reason to seek out a medical evaluation before the pain gets worse or becomes chronic.

When You Feel Pain Low in the Back Near the Tailbone

Pain near the tailbone may feel worse when sitting, especially on hard surfaces, or when transitioning from sitting to standing. It can develop gradually from pressure, posture, or movement habits, or it can come on quickly after a fall. This type of pain can sometimes indicate:

coccyx irritation
lower lumbar or sacral irritation
pelvic floor involvement

Sometimes correcting this pain can be as simple as improving your sitting posture or hip mobility. Sometimes you may just need to rest after a fall. If the pain lingers or worsens, seek out a physical therapist for an evaluation.

When Lower Back Pain Needs Medical Attention

While most lower back pain is not an emergency, there are some symptoms that should not be ignored. You should reach out to a medical professional if your back pain:

lasts for more than a few weeks
doesn’t improve with rest
spreads down your leg(s), especially past the knee
is paired with unexpected weight loss

Often, back pain will improve over time with home treatment and self-care, but in some rare cases it can indicate a serious medical problem³. Seek immediate medical care if your back pain:

follows a major fall or other physical trauma
is accompanied by a fever
is associated with bowel or bladder changes

Again, most back pain will not require emergency care, but often it will benefit from professional evaluation and treatment from a medical professional. If you or a loved one is experiencing back pain that won’t go away or is causing problems in your daily life, contact a skilled physical therapist to get a professional evaluation. They can help identify the root cause of the problem and give you a treatment plan tailored to your exact needs and abilities, helping you get back to living the pain-free life you deserve.

Sources

Atlas, S J, and R A Deyo. “Evaluating and Managing Acute Low Back Pain in the Primary Care Setting.” Journal of General Internal Medicine vol. 16,2 (2001): 120-31. doi:10.1111/j.1525-1497.2001.91141.x, https://pmc.ncbi.nlm.nih.gov/articles/PMC1495170/.
“Low Back Pain: Causes, Diagnosis & Treatments.” Cleveland Clinic, 2021, my.clevelandclinic.org/health/diseases/7936-lower-back-pain.
Mayo Clinic. “Back Pain.” Mayo Clinic, Mayo Clinic, 2018, www.mayoclinic.org/diseases-conditions/back-pain/symptoms-causes/syc-20369906.