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One of the most common and debilitating symptoms for hip pain is the jolt of pain that travels down the leg that seems to come out of nowhere. It often starts in the lower back or hip, and then radiates down the leg to the foot. The hip and leg pain is frequently associated with low back pain. This is also sometimes called sciatic hip pain or sciatica.
The area that people most often feel hip and leg pain follows a path that travels through the back of the hip or buttock area, to the side of the hip, and down the side of the leg. Sometimes this pain can travel down to the side of the lower leg and foot. Another common area to feel hip and leg pain is the back of the thigh, which radiates through the calf.
Frequently, people also have numbness or tingling in the leg, a feeling like a certain part of the leg is “asleep,” or a feeling of pins and needles. These symptoms can have the same origin as the pain. Where do these sensations come from? And what can we do about them?
Hip pain can sometimes be the cause of leg pain, but both are often part of a cluster of symptoms that are most commonly associated with spinal pathology. It is sometimes hard to distinguish if the low back, hip, or leg pain started first.
If you have developed low back or hip pain and it goes untreated, hip pain can certainly contribute to leg pain. Even an old back injury that healed years ago can become aggravated and cause hip and leg pain.
One of the most common causes of sciatic or radiating hip and leg pain is spinal disc pathology, which starts developing as early as age 25. This can include a herniated disc, disc bulge, or a narrowing in the spine’s disc space due to degeneration associated with trauma or overuse of the spine.
Some of the risk factors associated with hip pain radiating down the leg to the foot include older age, lack of exercise, excess weight, psychological conditions such as anxiety and depression, and smoking. All of these variables would increase the likelihood that someone would develop spinal pathology which can lead to hip and leg pain.
Large nerves exit and enter the vertebral column to transmit information to the spinal cord and brain about sensation such as sharp and dull touch, and to control movement, such as walking. These nerves are located very close to the discs and joints of the spine, so with enough stress to the surrounding structures, the space that contains the nerve becomes crowded and the nerve can become irritated and inflamed.
This can subsequently cause pain in the hip and leg, or cause other sensations such as numbness or pins and needles. It can also contribute to a feeling of weakness in the leg.
A less common cause of hip and leg pain is direct trauma to the buttock area. Several spinal nerves join together in the lower back to form the sciatic nerve, which is located in the back of the thigh and knee, and separates into smaller nerves in the lower leg.
In the buttock, the sciatic nerve is located underneath a muscle called the piriformis. Trauma such as a fall onto the buttocks can cause bruising, pain, and inflammation in this area, which might affect either the piriformis muscle, the sciatic nerve, or both. This is called Piriformis Syndrome. Pain from Piriformis Syndrome can feel identical to pain from spinal pathology, however often is not accompanied by low back pain.
Regardless of the cause of the hip and leg pain, both can be irritated by the same factors - poor posture and ergonomics, weakness in the muscles or poor mobility, excess weight, smoking, and bad habits such as sitting for too long.
Another form of spinal pathology is known as spinal stenosis. Stenosis means narrowing, and in this case, the stenosis is referring to the central canal of the vertebral column, where the spinal cord runs.
In many cases, central canal stenosis can cause hip pain that radiates down the leg in both legs. Sometimes the pain stops at the knee, and sometimes it radiates further down the legs.
This is sometimes called Shopping Cart Syndrome. This means that the hip and leg pain is often relieved by leaning forward, as if over a shopping cart. The pain typically is made worse by standing or walking for long periods, which put the spine in more extension. Flexion activities are the opposite of this and tend to reduce stress on the narrow central canal and provide relief.
In order to stop hip pain that travels down the leg to the foot, it is important to address the risk factors mentioned above. Losing excess weight will reduce the amount of stress placed on the structures of the spine such as the joints, discs, nerves, and muscles during your day to day activities.
Swimming is an excellent form of exercise that does not cause a lot of impact through the spine.
Starting a smoking cessation program can help hip and leg pain because quitting smoking will restore natural delivery of nutrients to the discs of the back. Nicotine restricts blood flow, and with reduced blood flow, the discs can wear away faster.
This means they lose their ability to absorb shock as you walk, run, and exercise. Over time, this can cause the nerves of the lower back to become pinched and cause sciatic hip pain.
Taking an honest look at how much you move around throughout the day and making any adjustments is also very helpful to stop sciatic hip pain.
Many jobs these days require sitting in an office chair for 8 hours or more. Prolonged sitting puts asymmetrical pressure on the structures of the lower back, and causes muscle weakness since you are not using your muscles for 8 hours.
Both of these things can aggravate or cause sciatic hip pain. Setting a timer at your desk to stand up and stretch every 30 minutes can help. Or, if you have a standing desk, utilizing the standing function throughout the day can break up long periods of sitting and relieve or prevent hip and leg pain.
Finally, if you are not currently doing any exercise, it can be beneficial to start since increasing your overall activity can help sciatic hip pain, as well as depression and anxiety, which are also contributing factors to spinal pathology. Choose a form of exercise that is fun for you or find a workout partner to keep you accountable.
The most important thing is consistency, not the difficulty or intensity of the workout. Try some light stretching or core exercise on a semi-daily basis.
It is important to consult with your primary care physician, orthopedic doctor, neurologist, or physical therapist to determine what the best course of action is to relieve your sciatic hip pain. These medical providers can help identify your risk factors and form a plan to address them.
Check out this video to learn some strategies to manage your sciatic hip pain.