Lower back pain and groin pain often show up together because the two areas share muscles, nerves, and joint structures that directly connect the lumbar spine to the pelvis. Relief depends on identifying which structure is driving the pain, but several self-care strategies can help regardless of the underlying cause. Stretching the deep hip flexor muscles, adjusting how you sit, and using short-term anti-inflammatory medication are the most effective starting points for most people.
Why These Two Areas Hurt at the Same Time
The most common link between lower back and groin pain is a deep muscle called the psoas major. It originates at the lowest thoracic vertebra and runs through all five lumbar vertebrae, then passes under the inguinal ligament (the crease of your groin) and attaches to the top of your thighbone. When this muscle is tight, strained, or in spasm, it can pull on the lower spine and radiate pain into the groin simultaneously. Prolonged sitting is one of the most common ways the psoas becomes shortened and irritated.
Nerve compression is another frequent cause. The upper lumbar nerve roots, particularly at the L1 and L2 levels, supply sensation to the groin area. A herniated disc or spinal narrowing at these levels can send pain shooting from the lower back directly into the groin, even though nothing is wrong with the groin itself. In one study of patients with lumbar disc herniations and groin pain, the L2 and L4 nerve roots were the most commonly affected.
Hip joint problems can also create this pattern. A condition sometimes called “hip-spine syndrome” describes the overlap between hip osteoarthritis and degenerative lumbar stenosis, where both structures contribute to pain that’s hard to pin down. Groin pain is a key signal of hip involvement. If your pain worsens when rotating your leg inward or bringing your knee toward your opposite shoulder, the hip joint may be part of the picture.
Pelvic floor muscle tension is an overlooked contributor, especially in women. Overly tight pelvic floor muscles can cause referred pain in the lower back because these muscles connect to the tailbone, which is directly linked to the spine. Tight muscles also tend to be weak, since they’re already stuck in a contracted state, creating a cycle of pain and dysfunction.
Stretches That Target Both Areas
Because the psoas muscle physically bridges the lower back and groin, stretching it is one of the most effective ways to reduce pain in both regions. Physical therapists at the Hospital for Special Surgery recommend holding each stretch for 30 seconds per side, repeating for three sets, at least twice a day.
Half-Kneeling Hip Flexor Stretch
Kneel on the floor and bring one foot forward so your front thigh is parallel to the ground with the knee bent at 90 degrees. Keep your back knee on the floor with the shin pointing straight behind you. Place your hands on your hips, squeeze your glutes, and feel your pelvis tuck underneath you. With a straight back, shift your weight forward until you feel a stretch through the front of the back thigh and into the groin. For a deeper stretch, reach the arm on the kneeling side overhead and lean slightly toward the opposite side.
90/90 Stretch
Sit on the floor with your front leg bent at 90 degrees in front of you and your back leg bent at 90 degrees out to the side. Square your shoulders forward and keep your back straight. Focus on sinking both hips into the floor. To deepen the stretch, lean your chest forward without collapsing your upper body or letting your hips lift. This opens up the deep hip rotators that often contribute to referred groin pain.
Supine Hip Flexor Stretch
Lie on your back at the edge of your bed with both legs extended. Bend the leg closer to the center of the bed, keeping that foot flat on the mattress. Press your lower back flat against the bed and let the outer leg hang off the side. Gravity gently pulls the hanging leg into extension, stretching the psoas without any effort. This is a good option if kneeling is uncomfortable.
Sitting Adjustments That Reduce Strain
Prolonged sitting compresses the lumbar discs and keeps the psoas in a shortened position, which is exactly the combination that produces lower back and groin pain. A few specific adjustments make a significant difference.
Start by sitting with your upper arms parallel to your spine and your elbows bent at 90 degrees. You should be able to slide your fingers under your thigh at the front edge of the chair. If that space is too tight, use a footrest to take pressure off the backs of your thighs. If there’s more than a finger width of space, your chair is too low. Press your buttocks against the chair back and check that you can pass a clenched fist between the back of your calf and the front of the seat. If you can’t, the seat is too deep, and you’ll need a lumbar support cushion or a shallower chair.
Your lower back should have a slight inward curve supported by a cushion or the chair’s built-in lumbar support. Slouching flattens this curve and overloads the spinal discs and ligaments. Adjust armrests so they just barely lift your shoulders, which prevents you from leaning forward. No matter how well your chair fits, stand up, stretch, and walk for at least a minute or two every 30 minutes. Static posture, even good static posture, increases pressure on the back over time.
Anti-Inflammatory Medication for Short-Term Relief
Over-the-counter anti-inflammatory drugs are recommended by every major back pain guideline as one option for symptom relief. A large Cochrane review of clinical trials found no meaningful difference in effectiveness between different types of anti-inflammatories, so the best choice is whichever you tolerate well at the lowest effective dose. In the studies reviewed, typical courses lasted 7 to 14 days for acute back pain.
These medications work best for inflammatory pain, such as a flared-up joint or an irritated nerve root, rather than pure muscle tightness. They’re most useful as a bridge that reduces pain enough for you to start stretching and moving, which is what produces lasting improvement. Long-term daily use increases the risk of stomach and kidney problems, so they’re better suited as a short course rather than an ongoing strategy.
Strengthening the Muscles That Stabilize Both Regions
Stretching alone addresses tightness but not the weakness that often underlies it. The glutes, deep core muscles, and pelvic floor all work together to stabilize the pelvis and lower spine. When any of these groups are weak, the psoas compensates by overworking, which tightens it further.
Glute bridges are a simple starting point: lie on your back with knees bent, squeeze your glutes, and lift your hips until your body forms a straight line from shoulders to knees. Hold for a few seconds and lower slowly. Bird-dogs, where you extend opposite arm and leg from a hands-and-knees position, train the deep stabilizers of the lumbar spine without compressing the joints. Both exercises are low-impact enough to do during a pain flare and effective enough to build meaningful stability over weeks.
If pelvic floor tension is part of your pattern, traditional strengthening exercises like Kegels can actually make things worse by further tightening already-tense muscles. Diaphragmatic breathing, where you breathe deeply into your belly and let the pelvic floor relax on each inhale, is often more helpful. A pelvic floor physical therapist can assess whether your muscles need strengthening, relaxation, or a combination.
Signs That Need Medical Evaluation
Most combined lower back and groin pain improves with consistent self-care over a few weeks. Certain patterns, however, point to something that requires imaging or a clinical workup. Pain that doesn’t respond to any over-the-counter pain relief, progressive weakness in one or both legs, or numbness that spreads across the inner thighs and groin (sometimes called saddle numbness) can indicate compression of the nerves at the base of the spine. This is especially urgent if you notice changes in bladder or bowel control, or difficulty with urination that’s new.
Groin pain that worsens specifically with hip rotation, rather than with bending or lifting, suggests the hip joint rather than the spine. An X-ray of the pelvis can screen for hip arthritis, and if the picture is unclear, a diagnostic injection into the hip joint under imaging guidance can confirm whether the hip is the pain source. When both the hip and the spine appear to be contributing, addressing only one often leaves residual pain, so accurate diagnosis matters before pursuing any targeted treatment.