What is Referred Pain from the Hip or Lumbar Spine?

Referred pain occurs when problems in the hip or lumbar spine actually cause discomfort in the knee. Nerves and biomechanical links mean pain may be felt in the knee even though the primary issue lies elsewhere.

What happens in referred pain?

Hip joint arthritis, labral tears, or lumbar spine issues such as disc bulges can irritate nerves or alter movement patterns. This can create knee pain without direct knee injury.

Common causes

  • Lumbar spine disc bulge or herniation
  • Lumbar facet joint irritation
  • Hip osteoarthritis
  • Hip labral tear
  • Muscle imbalance or tightness in the hips and lower back

Who is most affected?

  • Adults with lumbar spine degeneration
  • Athletes with hip mobility restrictions
  • Older adults with hip or spine arthritis
  • In Australia, referred pain to the knee is common in footballers and runners with hip pathology

Symptoms of Referred Pain

  • Knee pain without a clear knee injury
  • Pain changes with spine or hip movement
  • Back or hip stiffness alongside knee pain
  • Numbness, tingling, or radiating symptoms

📞 If you have unexplained knee pain, book a full hip and spine assessment at Spinal and Sports Care Bella Vista or Parramatta.

Diagnosis

Detailed history and physical examination.

  • Lumbar spine and hip mobility tests
  • Neurological screening
  • Imaging: MRI or X-rays of the hip or lumbar spine to confirm the primary source of pain

Treatment options

Non-surgical:

  • Physiotherapy for hip and spine mobility
  • Core and gluteal strengthening
  • Postural retraining
  • Manual therapy for the hip or spine
  • Pain management strategies

Surgical:

  • Occasionally required for severe hip arthritis or lumbar disc pathology

Role of physiotherapy

  • Identify whether knee pain is referred from the hip or spine
  • Treat the underlying cause with targeted rehab
  • Educate the patient on posture and biomechanics
  • Guide safe return to sport and function

Recovery timeline

  • Mild cases: 4–6 weeks
  • Moderate: 8–12 weeks
  • Severe degenerative causes: ongoing management

Prevention

  • Maintain hip and spine mobility
  • Strengthen core and glutes
  • Good posture and lifting technique
  • Regular screening for athletes with persistent knee pain

Taping and bracing

  • Not typically required for referred pain
  • Focus is on treating the underlying cause

When to see a physiotherapist or chiropractor

📞 If knee pain persists without a clear cause or alongside back/hip stiffness, book an assessment at Spinal and Sports Care.

Frequently Asked Questions

Pain felt in one area but caused by a problem elsewhere.

Yes, hip arthritis or labral tears often refer pain to the knee.

Yes, lumbar disc bulges or nerve irritation can cause knee pain.

Through history, examination, and imaging of the hip/spine.

No, treatment focuses on the hip or spine.

Knee pain with associated back or hip stiffness, sometimes tingling or numbness.

Physiotherapy for hip/spine mobility and strengthening.

Football, running, and sports requiring hip mobility.

With hip and spine strengthening and mobility programs.

If you have unexplained knee pain or pain linked to hip or back movement.