Lower Back and Leg Pain

Learning how to evaluate and separate your lower back and leg pain can help you decide when you need to see the doctor. When you educate yourself and understand your condition, if you do see a doctor, you are more prepared to participate in your treatment.






"you could have two separate problems"

There are many types of lower back and leg pain. Some back pain may cause leg pain, and some back pain may cause sciatic nerve pain.  But it may be that your lower back pain and leg pain are unrelated.  

Just because you have lower back and leg pain, it does not mean that your leg pain is coming from your back.  It is always possible, that you could have two separate problems. 

"evaluate the leg separately"

So if you are having leg pain, with or without back pain, it is always important to evaluate the leg separately. Things that must be considered would include diseases of the nerves or blood vessels, arthritis in the joints, and problems with the muscle.

Diagnose Your Lower Back and Leg Pain

Arthritis of the hip may cause hip or buttock pain that radiates into the thigh. Diabetic neuropathy may cause pain and numbness in the leg or calf as a complication of diabetes.

"decreased blood supply to the muscle"

Peripheral vascular disease can cause pain in the calf muscle with walking as a result of decreased blood supply to the muscle.

Piriformis syndrome will cause pain or sciatica in the upper thigh from pressure on the sciatic nerve by the piriformis muscle.

When you have back pain that radiates into the hip or buttock causing pain in the region of the sciatic nerve, you have to think about things that would cause pressure on the nerves. Spinal stenosis and spondylolisthesis are two conditions that may squeeze the nerves causing pain or dysfunction in the area that the nerve serves.

"common possible diagnosis"

The sciatic nerve is commonly affected causing sciatica, or sciatic nerve pain. But there are many other nerves that may cause problems as well.

The more common possible diagnosis causing lower back and leg pain would include spondylolisthesis, spinal stenosis, and a herniated disc(also spelled herniated disk).

A spondylolisthesis occurs when one vertebra slips forward on the one beneath it. Because the nerves exit the spinal canal between the vertebrae, a spondylolisthesis will often pinch the nerve, causing pain and other problems in the region that nerve serves.

"putting pressure on a nerve"

Spinal stenosis is a gradual narrowing of the space for the nerves that develops over years. Because it develops so slowly, the symptoms are often considered just a "normal part of aging" until they become quite severe. This can cause back pain from the arthritis in your back and leg pain from pressure on one or more nerves.

In people less than 40 years old a common cause of lower back and leg pain is a herniated disc or herniated disk. The disc is a cushion that sits between the vertebrae and it may bulge, causing pressure on the nerves. Or sometimes the tough outer part will crack or burst and the softer inner part will herniate out, putting pressure on a nerve and causing pain.

"to help determine a diagnosis"

When considering the causes of back pain that does radiate into one or both lower extremities there are many things to consider.

  • Has there been any recent trauma such as a car or accident?
  • How long have you had lower back pain?
  • How long have you had lower extremity pain?
  • How bad is the pain? Does it keep you from caring for yourself?
  • Is the pain getting worse?
  • Are you having any weakness? Do you fall?
  • Are you having problems controlling your bowels or bladder?

These are all questions that your doctor will need to ask, to help determine a diagnosis and develop an appropriate treatment plan.

"red flags to look for"

As with many things related to your health, early diagnosis and treatment is important if you hope to avoid permanent injury and disability. But, especially with pain radiating into your hip, buttock, or thigh there are certain red flags to look for that could indicate a true emergency.

If you begin having progressive weakness in your legs, or if you have sudden onset of weakness that prevents you from walking, you need to seek treatment at the emergency room or call 911. If you have suddenly become unable to control your bowels or bladder, you need to seek immediate treatment at the emergency room or call 911.

"signs of cauda equina syndrome"

These are signs of cauda equina syndrome, which is a true surgical emergency. If these conditions are allowed to continue, many times the damage becomes irreversible.

Treatment options for lower back and leg pain will depend on your doctor's evaluation. If your doctor thinks your symptoms are coming from the alignment of your spine, he may refer you to a chiropractor for evaluation. If studies show a herniated disc, or a spondylolisthesis, or spinal stenosis, and your sciatica or other sciatic nerve symptoms are mild you may be referred to physical therapy to learn exercises for rehabilitation.

"to achieve a quick and effective treatment plan"

The causes of back pain that radiates into the lower extremities are many and the evaluation can be complicated. Never the less, a thorough evaluation and treatment by an experienced doctor is the first step to achieve a quick and effective treatment plan. 



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