Why Does My Lower Back and Hip Hurt?

Your lower back and hip are codependent structures. A problem in one of these structures can cause dysfunction and pain in the other.

¹
Reiman MP, Weisbach PC, Glynn PE. The Hip’s Influence on Low Back Pain: A Distal Link to a Proximal Problem. Journal of Sport Rehabilitation. 2009;18(1):24-32. doi:10.1123/jsr.18.1.24

• If you have chronic lower back pain, the movements in your hip may be reduced and the muscles surrounding your hip joint can become tense and painful.

  ²
  Lee SW, Kim SY. Comparison of chronic low-back pain patients hip range of motion with lumbar instability. J Phys Ther Sci. 2015;27(2):349–351. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4339135/
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  Lee SW, Kim SY. Effects of hip exercises for chronic low-back pain patients with lumbar instability. J Phys Ther Sci. 2015;27(2):345–348. doi:10.1589/jpts.27. 345

• If there’s an abnormality in your hip function, the mechanics of your lower back may be altered, causing pain in both regions.

  ⁴
  Harris-Hayes M, Sahrmann SA, Van Dillen LR. Relationship between the hip and low back pain in athletes who participate in rotation-related sports. J Sport Rehabil. 2009;18(1):60–75. doi:10.1123/jsr.18.1.60

The lower back and hip share many groups of muscles. When a specific muscle is affected, it may lead to compensatory movements, fatigue, and pain in the other surrounding muscles.

¹
Reiman MP, Weisbach PC, Glynn PE. The Hip’s Influence on Low Back Pain: A Distal Link to a Proximal Problem. Journal of Sport Rehabilitation. 2009;18(1):24-32. doi:10.1123/jsr.18.1.24

Read on to learn how lower back and hip pain can occur together. While some conditions may affect one side of your lower back and hip, others can cause pain on both sides at the same time.

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Sharp pain in the lower back and hip on one side

A shooting and sharp pain felt on one side on your lower back and hip may be caused by muscle spasm, joint dysfunction, and/or nerve compression in the region. Common conditions that cause this type of pain are discussed below.

Piriformis Syndrome Video

Piriformis syndrome

Spasm of the piriformis muscle located deep in the buttock may cause

⁵
Hicks BL, Varacallo M. Piriformis Syndrome. [Updated 2019 Dec 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448172/
:

• Moderate to severe lower back, hip, and buttock pain
• Referred pain that may extend into the back of the thigh
• Inability to sit for a long time

The pain is typically felt on one side and may be worsened by hip movements, such as when getting out of bed.

⁵
Hicks BL, Varacallo M. Piriformis Syndrome. [Updated 2019 Dec 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih. gov/books/NBK448172/

Piriformis syndrome is commonly caused by overactivity of the hip rotator muscles (which help rotate the hip inward or laterally) or sitting on hard surfaces for prolonged periods of time. An injury to the buttock may also cause this pain.

⁶
Papadopoulos EC, Khan SN. Piriformis syndrome and low back pain: a new classification and review of the literature. Orthopedic Clinics of North America. 2004;35(1):65-71. doi:10.1016/s0030-5898(03)00105-6

Read more: What Is Piriformis Syndrome?

Sacroiliac joint dysfunction

Inflammation within the joint that connects your lower spine to your pelvis, the sacroiliac joint, can cause

⁷
Raj MA, Varacallo M. Sacroiliac (SI) Joint Pain. [Updated 2019 May 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470299/
:

• A sharp, stabbing pain felt directly over the lower back, hip, and buttock
• Pain that may extend down the back of your thigh, but typically does not extend below the knee

Certain positions or activities may cause your pain to flare up, such as going from standing to sitting, climbing stairs, or lying on the affected side.

⁷
Raj MA, Varacallo M. Sacroiliac (SI) Joint Pain. [Updated 2019 May 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470299/

Sacroiliac joint dysfunction can cause pain in the lower back, hip and buttock. Watch Sacroiliac Joint Dysfunction Video

The sacroiliac joint may become a source of lower back, hip, and buttock pain due to arthritis, trauma, or repetitive stress within the joint.

⁷
Raj MA, Varacallo M. Sacroiliac (SI) Joint Pain. [Updated 2019 May 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470299/
This joint is also a common source of pain in pregnant women due to hormonal and bodily changes at the time.

⁸
Cohen SP, Chen Y, Neufeld NJ. Sacroiliac joint pain: a comprehensive review of epidemiology, diagnosis and treatment. Expert Review of Neurotherapeutics. 2013;13(1):99-116. doi:10.1586/ern.12.148
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9
Filipec M, Jadanec M, Kostovic-Srzentic M, van der Vaart H, Matijevic R. Incidence, pain, and mobility assessment of pregnant women with sacroiliac dysfunction. International Journal of Gynecology & Obstetrics. 2018;142(3):283-287. doi:10.1002/ijgo.12560

While more common on one side, sacroiliac joint pain can also affect both sides of the lower back and hip.

Read more about Sacroiliac Joint Dysfunction (SI Joint Pain)

The symptoms of piriformis syndrome and sacroiliac joint dysfunction may mimic lumbar radiculopathy, commonly called sciatica.

Pain and stiffness in the lower back and hip

A feeling of stiffness can accompany pain in the lower back and hip. This symptom is typically a protective mechanism of the body to prevent further injury in the area. Stiffness that occurs with pain can be debilitating and reduce function in the back, hip, and leg considerably. Here are a few common conditions that may cause these symptoms to occur together.

Strained hamstrings

Tightness in your hamstrings due to a strain injury may alter the biomechanics of your spine.

Tight hamstrings are shorter in length and this change can affect the curvature of the lower part of your spine, disrupting the alignment of the lower back with your hip. A feeling of stiffness in your lower back with or without pain may be experienced.

¹⁰
Jandre Reis FJ, Macedo AR. Influence of Hamstring Tightness in Pelvic, Lumbar and Trunk Range of Motion in Low Back Pain and Asymptomatic Volunteers during Forward Bending. Asian Spine J. 2015;9(4):535–540. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4522442/

The stiffness is usually more pronounced when you bend your spine forward. Some people also walk with a stiff leg to avoid bending their hip and knee joints.

¹¹
Chu SK, Rho ME. Hamstring Injuries in the Athlete: Diagnosis, Treatment, and Return to Play. Curr Sports Med Rep. 2016;15(3):184–190. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5003616/

View Slideshow: Hamstring Stretches for Back Pain Relief

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Osteoarthritis of the hip

Age-related degeneration of the hip joint (hip osteoarthritis) can cause pain in the lower back and stiffness in the hip.

Hip osteoarthritis causes stiffness and a significant decrease in the hip’s range of motion. This change can cause the hip to incline forward, disrupting the curvature of the lower spine. The inward curvature (lordosis) of the lower spine may become more pronounced, sometimes causing the lower spinal discs to bulge or herniate.

¹²
Shigeharu Tanaka, Shinsuke Matsumoto, Kengo Fujii, Kotaro Tamari, Shigeru Mitani, Akio Tsubahara. Factors related to low back pain in patients with hip osteoarthritis. BMR. 2015;28(2):409-414. doi:10.3233/BMR-140535
^,
13
Rivière C, Lazic S, Dagneaux L, Van Der Straeten C, Cobb J, Muirhead-Allwood S. Spine-hip relations in patients with hip osteoarthritis. EFORT Open Rev. 2018;3(2):39–44. Published 2018 Feb 21. doi:10.1302/2058-5241.3.170020

This condition may over time cause degeneration of the spinal joints too, resulting in a more advanced problem called hip-spine syndrome.

Learn more about Hip Osteoarthritis on Arthritis-health.com

This list is not exhaustive of all possible causes of lower back and hip pain. If you experience pain and/or stiffness in your lower back and hip that does not resolve with self-care and affects your daily activities, talk to your doctor. A doctor can accurately diagnose the cause of your lower back problem and formulate a treatment plan for the underlying condition.

Learn more:

Sacroiliac Joint Dysfunction Symptoms and Causes

Symptoms and Diagnosis of Piriformis Syndrome

Dr. Benjamin Bjerke is an orthopedic surgeon. He specializes in minimally invasive and motion-preserving spine surgery.

• 1
  Reiman MP, Weisbach PC, Glynn PE. The Hip’s Influence on Low Back Pain: A Distal Link to a Proximal Problem. Journal of Sport Rehabilitation. 2009;18(1):24-32. doi:10.1123/jsr.18.1.24
• 2
  Lee SW, Kim SY. Comparison of chronic low-back pain patients hip range of motion with lumbar instability. J Phys Ther Sci. 2015;27(2):349–351. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4339135/
• 3
  Lee SW, Kim SY. Effects of hip exercises for chronic low-back pain patients with lumbar instability. J Phys Ther Sci. 2015;27(2):345–348. doi:10.1589/jpts.27.345
• 4
  Harris-Hayes M, Sahrmann SA, Van Dillen LR. Relationship between the hip and low back pain in athletes who participate in rotation-related sports. J Sport Rehabil. 2009;18(1):60–75. doi:10.1123/jsr.18.1.60
• 5
  Hicks BL, Varacallo M. Piriformis Syndrome. [Updated 2019 Dec 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448172/
• 6
  Papadopoulos EC, Khan SN. Piriformis syndrome and low back pain: a new classification and review of the literature. Orthopedic Clinics of North America. 2004;35(1):65-71. doi:10.1016/s0030-5898(03)00105-6
• 7
  Raj MA, Varacallo M. Sacroiliac (SI) Joint Pain. [Updated 2019 May 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470299/
• 8
  Cohen SP, Chen Y, Neufeld NJ. Sacroiliac joint pain: a comprehensive review of epidemiology, diagnosis and treatment. Expert Review of Neurotherapeutics. 2013;13(1):99-116. doi:10.1586/ern.12.148
• 9
  Filipec M, Jadanec M, Kostovic-Srzentic M, van der Vaart H, Matijevic R. Incidence, pain, and mobility assessment of pregnant women with sacroiliac dysfunction. International Journal of Gynecology & Obstetrics. 2018;142(3):283-287. doi:10.1002/ijgo.12560
• 10
  Jandre Reis FJ, Macedo AR. Influence of Hamstring Tightness in Pelvic, Lumbar and Trunk Range of Motion in Low Back Pain and Asymptomatic Volunteers during Forward Bending. Asian Spine J. 2015;9(4):535–540. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4522442/
• 11
  Chu SK, Rho ME. Hamstring Injuries in the Athlete: Diagnosis, Treatment, and Return to Play. Curr Sports Med Rep. 2016;15(3):184–190. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5003616/
• 12
  Shigeharu Tanaka, Shinsuke Matsumoto, Kengo Fujii, Kotaro Tamari, Shigeru Mitani, Akio Tsubahara. Factors related to low back pain in patients with hip osteoarthritis. BMR. 2015;28(2):409-414. doi:10.3233/BMR-140535
• 13
  Rivière C, Lazic S, Dagneaux L, Van Der Straeten C, Cobb J, Muirhead-Allwood S. Spine-hip relations in patients with hip osteoarthritis. EFORT Open Rev. 2018;3(2):39–44. Published 2018 Feb 21. doi:10.1302/2058-5241.3.170020

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Why does my lower back and hip hurt?

Sometimes lower back occurs alongside hip pain. This may happen on one side or both. Certain health conditions or injuries can affect the nerves in both the hips and the lower back.

These pains usually occur as a result of overuse or injury, but they can also be a symptom of an underlying medical condition. People may notice the pain on the left or right side of the body or both.

In this article, we look at possible causes of lower back and hip pain. We also discuss the various treatment options and how to relieve pain.

Share on PinterestPossible causes of lower back and hip pain include sprains, strains, and a herniated disk.

It is easy to overwork the lower back and hips because they are responsible for lifting, twisting, and moving the legs and trunk. Pains due to overuse and minor injury are common in these areas of the body.

Although these pains are common, people should not ignore them. Rest and early treatment can significantly improve a person’s outlook.

The causes are similar in males and females. The following are some of the most common causes of lower back and hip pain.

Sprains and strains are a common cause of pain around the back and hips. A sprain is a torn or overstretched ligament, while a strain is a torn or overstretched tendon or muscle.

People with sprains and strains are likely to experience discomfort that worsens with activity and gets better with rest.

Common causes of sprains and strains in this area include:

• sports injuries
• a fall or trauma
• twisting the body in an awkward way
• lifting something heavy

Playing a sport or engaging in other physical activity without warming up properly can contribute to muscle strain.

Damage to the ligaments, tendons, or muscles in the hip or lower back can cause:

• muscle pain
• muscle weakness
• tenderness
• swelling
• reduced range of motion

Treatment

People will usually find that their symptoms improve with a few days of rest.

Gentle stretching can speed up recovery. Applying a cloth-covered ice pack to the affected area for 10 to 15 minutes at a time can also help.

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, can reduce the pain and swelling that these muscle injuries cause.

If these treatments do not reduce symptoms, the injury may be more serious, for example, a muscle tear. In this case, a person should see their doctor.

The hip flexors are muscles that extend from the hips to the knees. They are responsible for the range of motion in the legs and hips. If these muscles are stiff and tight, often due to remaining in a seated position for too long, a person may experience back and hip pain.

Hip flexor strains, which are strains in the hip flexor muscles, can also cause sharp pain in the back and hips.

Symptoms of tight hip flexor muscles include:

• tenderness in the upper leg
• muscle spasms in the hips or thighs
• soreness in the hips and thighs

Some people may also experience a sense of weakness when trying to kick the leg or lift the knee toward the chest.

Read about 10 stretches for tight hips here.

Treatment

Physical therapy exercises and stretching can help relieve tight hip flexors and reduce discomfort. Examples include pulling the knee toward the chest or lunging one leg forward from a kneeling position to create a stretch in the hips.

Avoiding activities that can increase hip flexor tightness, such as sitting too long at a desk or wearing high heels for extended periods, can also help.

Share on PinterestA herniated disk may cause pain in the lower back, legs, and hips.

A herniated disk occurs when one of the cushioning disks between the vertebrae slips out of place. The disk can put pressure on a nearby nerve, which may cause tingling and burning pain in the lower back that extends to the hips and legs.

Older adults are prone to herniated disks because of the natural wear and tear of the spine that occurs over time. The disks also become less flexible with age.

Common causes of a herniated disk include:

• improper lifting or twisting while lifting
• a fall or trauma
• being overweight
• repetitive strain on the back
• driving for long periods
• smoking

Symptoms of a herniated disk include:

• sciatica, or a sharp, shooting pain from the buttocks down the back of one leg
• numbness in the leg or foot
• muscle weakness in the leg or foot

In severe cases, people may experience a loss of bowel and bladder function. If this occurs, they should go to the hospital or call 911 right away.

Treatment

The treatment for a herniated disk involves relieving pain and discomfort while it heals. Bed rest will usually help relieve the pain too.

Other treatment options include:

• physical therapy exercises
• taking NSAIDs to relieve pain and inflammation
• epidural steroid injections, which involve injecting corticosteroids into the epidural space containing the inflamed nerves

In severe cases, a doctor may recommend surgery to correct a herniated disk.

The sacroiliac (SI) joints connect the lower portion of the spine to the pelvis. If these joints move too much or too little, people may feel pain in the back and hips.

The symptoms of SI joint dysfunction include an aching lower back that makes it difficult for a person to find a comfortable position. The pain will usually worsen with physical activity, such as running or climbing stairs.

A herniated disk and arthritis can cause symptoms similar to those of SI joint dysfunction.

Treatment

Treatment options for SI joint dysfunction include:

• NSAIDs to relieve pain and inflammation
• physical therapy exercises to strengthen the core and pelvic muscles
• stretching and applying ice to the affected areas
• the injection of a steroid into the SI joint

A doctor may suggest that a person has corticosteroid injections to reduce spinal inflammation. In rare instances, they may recommend surgery to fuse the joints.

Osteoarthritis of the back can result in the breakdown of the protective and cushioning cartilage of the spine. This loss of cushioning can cause the spinal bones to rub together and place greater pressure on the nerves, including the nerves that go to the lower back and hips.

Arthritis in the back and hips causes joint stiffness and pain. A person may also experience weakness in the legs and hips, which can interfere with their everyday activities.

Treatment

Doctors do not have a cure for arthritis, but people can manage their symptoms using medication and lifestyle methods. These include:

• exercises that strengthen the back and hips muscles to improve flexibility and range of motion
• trying home remedies for arthritis
• alternative therapies, such as massage, acupuncture, and nutritional supplementation
• surgery, if arthritis causes significant spinal canal narrowing
• NSAIDs

Ankylosing spondylitis is a form of arthritis that primarily affects the spine, causing chronic inflammation in the spinal joints. Lower back and hip pain are often some of the first symptoms that a person with ankylosing spondylitis experiences.

Symptoms include muscle pain and stiffness that is usually worse in the morning. Other symptoms may include:

• low-grade fever
• appetite loss
• malaise, which is a general feeling of discomfort

Treatment

Doctors do not have a cure for ankylosing spondylitis, but, as with other forms of arthritis, people can manage the condition with a range of medical and at-home treatments.

Prescription medications, such as tumor necrosis factor (TNF) blockers and NSAIDs, can help. Certain lifestyle measures, including doing regular physical activity, icing affected areas, and not smoking, can also be beneficial.

Share on PinterestHeadaches may be a symptom of Paget’s disease.

Paget’s disease of bone is a rare disorder that affects an estimated 1% of people in the United States, according to the American College of Rheumatology.

This condition causes a person’s bones to remodel abnormally, leading to bone softening, which can affect the pelvis, lower back, hips, and arms. A person with Paget’s disease has a higher risk of bone pain and fractures.

The symptoms of Paget’s disease include:

• hip pain
• hearing loss
• bowed legs, where the knees are wider apart than usual
• headaches
• tingling and numbness down the legs

Treatment

The treatment for Paget’s disease involves medications to reduce the likelihood of the bones breaking. Doctors usually prescribe these medicines to treat osteoporosis. In rare cases, a doctor may recommend surgery to repair bones and restore alignment.

People should seek emergency attention if they experience any of the following symptoms alongside lower back and hip pain:

• loss of bowel and bladder function
• inability to move one or both legs
• loss of sensation in one or both legs
• visible deformity in the legs or back, such as the inability to stand up straight

If a person experiences less severe symptoms that do not improve with rest and over-the-counter treatments, they should make an appointment with their doctor. A doctor can evaluate their symptoms, make a diagnosis, and recommend the most effective treatments.

When a person experiences lower back and hip pain simultaneously, there may be an underlying injury or medical condition causing both of these symptoms. In other cases, the causes may be distinct.

Lower back and hip pain can make performing daily activities difficult. If these symptoms do not resolve or suddenly get worse, a person should seek medical attention.

Regardless of the cause, early treatment helps improve the outlook of a person with back and hip pain. Without treatment, some causes of the pain can get worse and may ultimately affect a person’s mobility and quality of life.

Does the back of the thigh hurt? Need a foot massage! :: Massage for health

Overexertion of the muscles of the back of the thighs is a common problem among both athletes and people who lead a less active lifestyle. Many of us spend whole days in a sitting position, forgetting to keep our back straight at our desk or driving a car. All this leads to a deterioration in posture – a round back and shoulders, pushing the head forward, skewed pelvis. All parts of our body are connected by kinetic chains, and if some of their elements become shorter, weaker or overstressed, discord occurs in the entire chain, which leads, for example, to pain and weakness of the muscles of the back of the thighs.

Everyone knows that short and tight hamstring muscles can cause lower back pain, but not everyone knows that the same problem can lead to plantar fasciitis, a disease of the feet.

All the muscles in our body are connected to other tissues. One of the most famous American chiropractors, Thomas Myers, in his works calls these connections “anatomical trains.”

Your hamstrings are directly connected to your heels. The so-called “superficial branch of the back”, along which the very “anatomical trains” pass, goes almost from the big toe to the very forehead!

These connections also have their advantages – if you return the tissues to normal at one point of this “branch”, then at another point you will notice significant improvements in mobility and tone. So, for example, if your muscles of the back of the thigh hurt and nothing helps you, you can approach this problem from a different angle – work out the foot. The heel massage relaxes the connective tissues at the starting point of a kinetic chain that runs all the way down the back to the forehead.

Our experts will design the most suitable foot massage course for you, but you can start at home! Now we will tell you about how you can do heel massage at home. It will be great if you do it in between visits to professional foot massage sessions.

You will need a small ball for the massage (you can get a special massage ball from the drugstore, but a tennis ball is also suitable)

• Place your foot on the ball and apply as much pressure as possible – the main thing is that this does not cause you pain. You may feel a little uncomfortable at first.
• Begin to roll this ball in a circular motion, moving it along the surface of the foot at a speed of about 2-3 centimeters per second. When you reach a painful point, stop and take a few deep breaths. Hold the ball at this point until the pain goes away.
• Press a little harder – as the tissues relax, the pain threshold will decrease.
• To find and isolate pain points, roll the ball under your toes, in the ball of your foot, and then all over the sole to the heel.
• The longer you do this massage, the better the tissues will relax.

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Hip pain | Voltaren

Hip pain symptoms

Hip pain can be felt as pain in the thighs, groin, buttocks and hip joint.

Sometimes the only symptom of hip problems is knee pain. Such pain is called reflected; it occurs quite often.

Pain in the hip may worsen with physical exertion, such as after sports, long walks and runs.

With pain in the hip, it becomes more difficult for a person to move the leg in the hip joint due to a decrease in the range of motion. In severe cases, lameness develops.

How does hip pain affect us?

The hip joints provide freedom of movement, so hip pain affects our lives. With hip pain, even getting out of bed, climbing stairs, and walking, not to mention jogging, is a problem. In severe cases, a person cannot move the leg at the joint and transfer body weight to it. In such cases, you should consult a doctor.

Ease the pain

DID YOU KNOW?

There are blood vessels and nerves in the thigh area, in particular the sciatic nerve (at the back of the thigh) and the femoral nerve (at the front of the thigh).*

50% of people have experienced hip pain.**

Get rid of for pain

*American National Association of Joint Patients: http://www.arthritis.org/about-arthritis/where-it-hurts/hip-pain/hip-anatomy.php
**Global Pain Index 2014: GSK-supported study, full report, p. 62

Why does hip pain occur?

The structure of the hip joint provides it with freedom of movement and reliability during constant work. But due to constant stress over the years, the muscles, nerves, ligaments and tendons of the thigh can become inflamed, resulting in pain.

Find the cause of the pain

Pain can be felt in various parts of the thigh. The location of the pain helps to understand its causes. Pain in the groin area and inside the thigh can be a sign of problems with the hip joint. Hip pain outside the hip joint, in the upper thigh and buttocks, usually indicates a soft tissue problem.

More serious causes of hip pain

More serious causes of hip pain include osteoarthritis, fractures, dislocations due to trauma, and bursitis. In these cases, you should consult a doctor.

Treatment

If you have been diagnosed with hip pain due to muscle or tendon damage or tendon inflammation (tendonitis), over-the-counter medications can help relieve pain and swelling. You can relieve pain and improve joint mobility with the help of therapeutic exercises. But if your hip still hurts badly or doesn’t feel better after taking pain medication, you should see a doctor. Be sure to see your doctor if you fall, the pain gets worse, you have a fever, or you feel unwell.

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