What’s Behind Your Leg Pain?
Many patients are referred to me for treatment because they are experiencing pain running down the back of their leg(s). Their first question for me is “Why?” and their second is “What can be done to get rid of it?”
In response, I have a few questions of my own that need answering.
- When does the pain occur? (Sitting, standing, walking, etc.)
- What, if anything, relieves or eases the pain? (Sitting, lying down, etc.)
- Is there a daily pain pattern? (i.e. worse in the morning, better midday, worse again in the evening)
You see, while there are many possibilities for the cause of such pain, there are four common reasons why pain can course down the back of the thigh and lower leg that I am trying to “tease out”.
The first, intermittent claudication, is a circulation problem. This condition has a telltale presentation: pain develops after walking awhile, continues to intensify the further you walk, but is eased/eliminated almost immediately upon sitting or bending forward.
The second common culprit, true sciatica, is caused by mechanic compression of the sciatic nerve by a particular muscle in the buttock region, the piriformis. (So it is truly your behind that is behind your pain with this diagnosis!)
Now the term “sciatica” is frequently used (incorrectly) to describe any pain in the leg. That said, leg pain can also be caused either a bulging/herniated lumbar disc (reason #3) or by the narrowing of the spinal canal through which your spinal cord and/or spinal nerves run (central or lateral stenosis, reason #4).
Disc pain follows the daily pattern I described above in my questioning section. Additionally, the pain is increased (or onset) by sitting and bending forward.
Stenosis, on the other hand, likes the seated position because this opens up the spaces where the spinal cord and nerves run through. Therefore pain occurs in the leg(s) with prolonged standing and walking because those postures put more compressive force on the nerve(s).
As you may suspect, the treatment approach for each of these conditions varies. So if you or someone you care about is experiencing radiating pain down their leg(s), see your doctor, pronto, and then, if warranted, begin manual physical therapy with someone who has healing hands!