Squats and Core Exercises for Lower Back and Hip Pain: An Integrative, Evidence-Based Approach

Lower back and hip pain are extremely common problems. Many people feel discomfort when sitting too long, lifting objects, exercising, or even walking. Muscle strains, poor posture, weak core muscles, tight hips, and spinal instability often work together to create pain. Research and clinical experience show that properly performed squats and core exercises can play a powerful role in reducing these issues when used correctly and combined with professional care.

This article explains how squats and core exercises help, when they may not be enough, and why an integrative approach with a chiropractor or nurse practitioner often works best. The information is written clearly and practically, without focusing on students or classrooms.

Understanding Lower Back and Hip Pain

Lower back and hip pain are rarely caused by just one problem. Most cases involve a combination of:

• Weak core stabilizer muscles

• Tight hip flexors and glute muscles

• Poor posture and movement patterns

• Lumbar (lower spine) instability

• Joint stiffness or misalignment

When these issues are present, the lower back often works harder than it should. Over time, this overload leads to pain, stiffness, and limited movement (Healthline, 2020).

Common symptoms include:

• Achy or sharp lower back pain

• Hip tightness or pinching

• Pain when squatting, bending, or standing up

• Mild sciatica symptoms (buttock or leg discomfort)

• Fatigue or weakness in the core

Why Squats Matter for Back and Hip Health

Squats are one of the most natural human movements. When done correctly, they train the body to move as a unit rather than stressing the lower back.

How Squats Help

Squats support lower back and hip health by:

• Strengthening the glutes, hips, and thighs

• Teaching proper hip hinge mechanics

• Reducing strain on the lumbar spine

• Improving posture and balance

• Enhancing joint coordination

Studies show that engaging the hips and core during squatting reduces stress on the lower back, especially in people with movement-related pain (Redefine Your Pain, n.d.; HSS, n.d.).

Squats Improve Load Distribution

When the hips and glutes are weak or tight, the lower back compensates. Proper squats:

• Shift force away from the spine

• Allow hips to absorb movement stress

• Improve alignment during daily tasks

This is why many clinicians recommend squats as part of rehabilitation for chronic low back pain (Carter PT, n.d.).

The Role of Core Muscles in Spinal Stability

The “core” is more than just abdominal muscles. It includes:

• Deep abdominal muscles

• Back stabilizers

• Pelvic floor muscles

• Diaphragm

Together, these muscles protect the spine during movement.

Benefits of Core Strengthening

Strong core muscles:

• Stabilize the spine during activity

• Reduce excessive spinal motion

• Improve posture and breathing

• Lower the risk of reinjury

Research shows that core stabilization exercises (CSE) improve spinal control and reduce nonspecific low back pain in adults (PMC, 2022).

Why Squats and Core Exercises Work Together

Squats and core exercises are most effective when combined.

They work together to:

• Keep the spine neutral

• Support the hips during movement

• Prevent excessive forward or backward bending

• Improve coordination between muscles

When the core is engaged, the spine stays stable while the hips do the work. This is critical for reducing back strain (Harvard Health, 2011).

Common Causes of Pain During Squats

Pain during squats does not always mean they are bad. It often means something needs correction.

Frequent Problems include:

• Tight hip flexors or glutes

• Poor ankle mobility

• Weak core muscles

• Loss of neutral spine

• Poor squat depth or control

If these issues are not addressed, squats can increase discomfort rather than reduce it (Squat University, 2017; Movement Solutions, n.d.).

Signs You Need Professional Evaluation

Exercise should not cause sharp or worsening pain. You should stop and seek care if you experience:

• Numbness or tingling in the legs

• Muscle weakness

• Pain radiating down the leg

• Loss of bladder or bowel control

• Pain that does not improve with rest

These symptoms may indicate nerve involvement or a more serious condition (Hinge Health, n.d.).

Sciatica, Hip Pain, and Core Weakness

Mild sciatica is often related to poor spinal support and hip dysfunction.

Core and hip strengthening can help by:

• Reducing nerve compression

• Improving pelvic alignment

• Decreasing muscle tension

Strengthening the core and hips has been shown to support sciatica recovery when combined with professional care (Pecan Country Chiropractic, n.d.).

The Importance of Proper Technique

Correct form is critical. Effective squats and core exercises require:

• Neutral spine

• Engaged core muscles

• Controlled movement

• Hip-dominant motion

Poor form increases stress on the lower back and hips (Orthopedic Institute SF, n.d.).

Key Technique Tips

• Keep chest upright

• Brace your core gently before moving

• Push through the heels

• Avoid rounding the lower back

• Move within a pain-free range

Integrative Care: Why Exercise Alone Is Not Always Enough

Exercise is powerful, but it does not fix everything on its own.

An integrative approach combines:

• Targeted exercises

• Chiropractic adjustments

• Nurse practitioner evaluation

• Movement correction

• Lifestyle and posture guidance

This approach addresses both symptoms and root causes.

Clinical Observations from Dr. Alexander Jimenez

According to clinical observations shared by Dr. Alexander Jimenez, DC, APRN, FNP-BC, many patients with lower back and hip pain show:

• Muscle imbalances between the hips and the spine

• Joint dysfunction limiting movement

• Weak core stabilizers

• Compensatory movement patterns

Dr. Jimenez emphasizes that when exercises are paired with proper spinal alignment and medical evaluation, patients often experience faster and longer-lasting improvement (Jimenez, n.d.).

How Chiropractors and Nurse Practitioners Work Together

Chiropractors and nurse practitioners often collaborate to:

• Restore joint alignment

• Reduce inflammation and pain

• Evaluate nerve involvement

• Guide safe exercise progression

• Monitor recovery

Research supports integrative care as a way to improve pain outcomes while reducing reliance on medication (Duke Health, n.d.; West Texas Chiropractic, n.d.).

Short-Term and Long-Term Benefits

Short-Term Relief

• Reduced pain and stiffness

• Improved movement confidence

• Better posture

Long-Term Benefits

• Increased strength and stability

• Reduced injury recurrence

• Improved mobility and performance

This combination makes squats and core exercises effective for both rehabilitation and prevention.

When to Start an Exercise Program

Before beginning any exercise program, especially after injury, consult a:

• Chiropractor

• Nurse practitioner

• Physical therapist

• Medical provider

Professional guidance ensures exercises match your condition and ability level (Cary Ortho, n.d.).

Key Takeaways

• Squats and core exercises support back and hip health

• Proper form is essential

• Pain during exercise is a warning sign

• Integrative care improves outcomes

• Professional evaluation ensures safety

References

Healthline. (2020). Lower back pain when squatting. https://www.healthline.com/health/back-pain/lower-back-pain-when-squatting

Redefine Your Pain. (n.d.). Does squatting help or hurt lower back pain? https://redefineyourpain.com/does-squatting-help-or-hurt-lower-back-pain/

Orthopedic Institute of San Francisco. (n.d.). Prevent back pain during exercise. https://orthopedicinstitutesf.com/5-ways-to-prevent-back-pain-during-exercise-or-everyday-activities-according-to-experts/

Carter Physical Therapy. (n.d.). Lower back pain when squatting. https://carterpt.com/blog/lower-back-pain-when-squatting

Hinge Health. (n.d.). Hip pain when squatting. https://www.hingehealth.com/resources/articles/hip-pain-when-squatting/

Cary Orthopaedics. (n.d.). Reduce low back pain. https://caryortho.com/reduce-low-back-pain/

Hospital for Special Surgery. (n.d.). Back pain after squats. https://www.hss.edu/health-library/move-better/back-pain-after-squats

Harvard Health Publishing. (2011). Strengthening your core the right way. https://www.health.harvard.edu/blog/strengthening-your-core-right-and-wrong-ways-to-do-lunges-squats-and-planks-201106292810

PMC. (2022). Core stabilization exercises and low back pain. https://pmc.ncbi.nlm.nih.gov/articles/PMC9340836/

Pecan Country Chiropractic. (n.d.). Core and hip strengthening for sciatica. https://www.pecancountrychiropractic.com/how-strengthening-core-a-hips-helps-alleviate-sciatica

Duke Health. (n.d.). Improving pain management through integrative care. https://physicians.dukehealth.org/articles/improving-pain-management-through-integrative-care-options

Jimenez, A. (n.d.). Clinical insights. https://dralexjimenez.com/