Is That Thigh Pain Really Sciatica?

One of the most common mistakes is to assume that all leg pain is sciatica and must be due to a disc pressing on a nerve. In fact, most leg pain is not pain from around the nerve root in your spine, and has nothing to do with a disc prolapse. There is much confusion about the term “sciatica”. Sciatica is pain in the distribution of the sciatic nerve, but different doctors and therapists use the term differently, varying from any leg pain to a precise definition of nerve root pain. It is best to understand the difference between referred leg pain, which “refers” from another spot and nerve root pain. Irritation of any of the tissues of the back can cause pain down one or both legs. Seventy percent of patients with back pain have some radiation of pain to their legs. This referred pain can come from the tissues, muscles, ligaments, facet joints, discs or other back structures. It is usually a dull ache that spreads into the buttocks and thighs. It may affect both legs. It usually does not go much below the knee. Referred pain is not due to anything pressing on a nerve. It is not sciatica. Irritation of the nerve root gives a quite different pain, which is sharp and specific to an area of your leg. Nerve root pain usually radiates to the foot or toes. Patients often describe the pain with sensations such as pins and needles, or numbness. It usually affects one leg only and is greater than the pain one has in the back. Nerve root pain is much less common than referred leg pain. If you have back pain alone and no leg pain or nerve symptoms, a nerve root problem is very unlikely. If you do have leg pain, then your legs should be examined by a physical therapist for signs of nerve irritation or nerve compression. Nerve irritation signs depend on tests that stretch or press on an irritable nerve root to cause root pain. The physical therapists at Reddy-Care Physical Therapy will perform different tests for nerve irritation. A common test is raising the leg straight in the air and looking for pain with limitation. The key finding is not the limitation, but the reason for it. Limitation due to back pain, cramping in the leg, or hamstring spasm probably has nothing to do with irritation of a nerve. Having a Reddy-Care Physical Therapy therapist evaluate your leg and back pain is critical to finding the cause so that proper treatment can be started to reduce your pain and get you back to your normal activities. Call us today to learn more.


“Before I started physical therapy I could not walk without a walker. I had severe pain in my lower back with radiating pain in my hips and tingling pain in my right leg down to my feet. Pain level was a 7-10 on the scale. Along with that, my right knee would buckle consistently. I had no strength and mobility and was depressed with my physical condition. Since the start of therapy, I can now walk without a walker, without a knee brace and sometimes without a cane. Pain level has decreased from 7-10 to 0-7. My strength has overall increased. Now I am hopeful! “
-Barbara S.


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