SymptomBones, joints & muscles
Lower Body Pain: Causes by Location
Lower body pain is pain anywhere below the waist: the lower back, buttocks, hips, pelvis, groin and legs. The most common cause is a muscle or joint problem in the lower back, which can also send pain into the buttock and leg (sciatica). Pain on the lower right or left side of the body can come from the bowel, kidney, ovary or a hernia. Sudden severe pain, leg weakness, numbness in the groin or a cold, pale leg needs emergency care.
Also called: Lower extremity pain, pain below the waist, lower back and leg pain, pelvic and leg pain
At a glance
- What it covers
- Pain in the lower back, buttocks, hips, pelvis, groin or legs.
- Most common cause
- Low back strain or a disc problem, often with pain spreading down a leg.
- Other causes
- Hip arthritis, nerve compression, poor circulation, blood clots, kidney stones, hernias, gynecological problems.
- Red flags
- Loss of bladder or bowel control, numbness between the legs, a cold leg, a swollen calf, fever.
- First steps
- Stay active, use heat or ice and over-the-counter pain relief; most back-related pain improves in 4 to 6 weeks.
When to get help
Call 911 or go to the ER
- New numbness around the genitals, buttocks or inner thighs, trouble passing urine, or loss of bowel control (possible cauda equina syndrome)
- A suddenly cold, pale, painful or numb leg (blocked artery)
- Sudden severe tearing pain in the lower back or belly, especially if over 60 or a smoker (possible aortic aneurysm)
- Swelling and pain in one calf with sudden shortness of breath or chest pain (possible blood clot in the lung)
- Severe lower right abdominal pain with fever and vomiting
See a doctor within a day or two
- A hot, swollen, painful calf or thigh
- Back pain with fever, after recent infection or with a history of cancer or IV drug use
- Weakness in a leg or foot, or a foot that slaps or drags
- Severe one-sided flank pain spreading to the groin, with blood in the urine
- Pain after a fall in an older adult who cannot bear weight
Book a routine appointment
- Back or leg pain lasting more than 6 weeks
- Calf pain when walking that eases with rest
- Hip or groin pain that is slowly getting worse
- Lower body pain that wakes you at night or comes with weight loss
Usually safe to manage at home
- Low back pain after lifting or exercise, without leg weakness or numbness
- Muscle soreness in the legs after unusual activity
Lower body pain: causes by location
| Where it hurts | Common causes | Clues |
|---|---|---|
| Lower back only | Muscle strain, disc problem, facet joint arthritis | Worse with bending or sitting, eases with movement |
| Back and down one leg | Sciatica from a herniated disc | Shooting pain below the knee, tingling |
| Both legs when walking | Spinal stenosis, peripheral artery disease | Stenosis eases when sitting or bending forward; artery pain eases with standing still |
| Buttock | Sacroiliac joint, piriformis syndrome, referred back pain | Pain sitting, near the dimples of the lower back |
| Hip or groin | Hip osteoarthritis, labral tear, hernia, stress fracture | Groin pain on putting on socks or getting out of a car |
| Outer hip | Greater trochanteric pain (bursitis or tendinopathy) | Painful to lie on that side |
| Lower belly or pelvis | Bladder, bowel, uterus, ovaries, prostate | Linked to urination, bowel movements or periods |
| Calf | Cramp, strain, DVT, artery disease | One-sided swelling suggests a clot |
Back-related causes
Low back strain
Most low back pain comes from muscles, ligaments and joints. It often follows lifting, twisting or a long period of sitting, and usually settles within a few weeks.
Sciatica and herniated disc
A bulging or herniated disc can press on a nerve root, causing sciatica: burning or electric pain from the buttock down the back or side of the leg, often to the foot, with numbness or tingling. Leg pain is often worse than back pain.
Spinal stenosis
Narrowing of the spinal canal in older adults causes aching, heavy legs when walking or standing that eases when you sit or lean forward, such as on a shopping cart. See spinal stenosis.
Cauda equina syndrome
Severe compression of the nerve bundle at the bottom of the spine. It causes back and leg pain with saddle numbness, bladder or bowel problems and leg weakness. It needs emergency surgery.
Hip and pelvic causes
- Hip osteoarthritis: groin and front-of-thigh pain, stiffness after rest, difficulty with shoes and socks.
- Bursitis and tendinopathy on the outer hip.
- Stress fractures of the hip or pelvis in runners or people with osteoporosis.
- Pelvic organs: endometriosis, ovarian cysts, pelvic infection, prostatitis and bladder problems cause pain low in the belly and pelvis that can spread to the back and thighs. See pelvic pain.
Pain on the lower right or left side of the body
When people say "lower right side", they often mean the lower abdomen or flank:
| Lower right side | Lower left side | Either side |
|---|---|---|
| Appendicitis | Diverticulitis | Kidney stone |
| Right ovarian cyst or ectopic pregnancy | Left ovarian cyst or ectopic pregnancy | Inguinal hernia |
| Crohn's disease (end of the small bowel) | Constipation, IBS | Muscle strain |
Appendicitis typically starts around the belly button and moves to the lower right, with fever, nausea and pain on moving. Kidney stones cause waves of severe pain in the flank that travel to the groin. See side pain for more.
Circulation causes
- Peripheral artery disease: cramping pain in the calf, thigh or buttock when walking a set distance, relieved by stopping. Common in smokers and people with diabetes.
- Deep vein thrombosis: one swollen, warm, tender calf or thigh, often after travel, surgery, pregnancy or immobility.
- Varicose veins: heavy, aching legs worse at the end of the day.
Other causes
- nerve damage from diabetes (burning feet and legs at night)
- muscle cramps from dehydration, medicines or low minerals
- fibromyalgia and widespread pain conditions
- infections of bone, joint or skin
- rarely, bone tumors or cancer spread to the spine
How doctors find the cause
A doctor will ask exactly where the pain is, how it started, what makes it better or worse, and about numbness, weakness, bladder and bowel function, fever and weight loss. They will examine your back, hips, abdomen, pulses and leg nerves.
Most back pain does not need scans. Tests are used for red flags or pain that does not improve: blood tests for infection and inflammation, urine tests, X-rays of the hip, MRI of the spine, ultrasound for clots or pelvic organs, and ankle-brachial index for circulation.
Treatment and home care
For back-related and muscle pain:
- Stay active. Bed rest slows recovery. Walk and keep up normal activity as much as pain allows.
- Heat for stiffness and ice for the first day or two after a strain, 15 to 20 minutes at a time.
- Pain relief: ibuprofen or naproxen help back pain more than acetaminophen (paracetamol). Follow the label dose. Avoid NSAIDs if you have kidney disease, stomach ulcers or heart failure.
- Physical therapy for pain lasting more than a few weeks, with strengthening and stretching.
- Steroid injections or surgery are for persistent sciatica or stenosis that does not respond.
Other causes are treated directly: blood thinners for clots, procedures to restore circulation, antibiotics or surgery for appendicitis.
Frequently asked questions
What can cause pain in the lower right side of the body?
Common causes are a muscle strain, appendicitis, a kidney stone, an ovarian cyst or an inguinal hernia. Back problems can also refer pain to one side. Severe pain with fever or vomiting, or pain in pregnancy, needs urgent assessment.
Why do my lower back and legs hurt at the same time?
Usually because a nerve in the lower back is irritated, by a herniated disc or spinal stenosis. Pain travels along the nerve into the buttock and leg, often with tingling. Weakness, numbness between the legs or bladder changes need emergency care.
When should I worry about lower body pain?
Worry if you have new bladder or bowel problems, numbness in the groin, leg weakness, a cold or pale leg, a hot swollen calf, fever, unexplained weight loss, or pain after a significant fall. These signs need prompt or emergency assessment.
How long does lower back and leg pain last?
Most back strains improve within 2 to 6 weeks. Sciatica from a disc usually improves over 6 to 12 weeks. Pain lasting more than 3 months is considered chronic and benefits from a structured physical therapy program.
Can poor circulation cause leg pain?
Yes. Narrowed arteries cause cramping in the calves, thighs or buttocks when walking, which eases with rest. A blood clot in a vein causes swelling, warmth and pain in one leg. Both need medical assessment.
Sources
This guide was written from current patient and clinical guidance, including:
- American College of Physicians: Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain
- NHS: Sciatica
- MedlinePlus: Leg pain
- American Academy of Orthopaedic Surgeons: Lumbar Spinal Stenosis
- American Heart Association: Peripheral Artery Disease