Dr. Eric DePopas, MD
PainTheory Chief Medical Officer
Vascular & Interventional Radiologist
Table of Contents
If you begin feeling pain in two parts of your body simultaneously, you may wonder if the pain is related. This is often the case for patients experiencing both leg and back pain. Lower back pain is a common condition impacting 50 to 80% of adults each year. Although back pain is common, lower back pain with accompanying leg weakness (difficulty moving one or both of your legs) or leg pain could mean you’ll need more than just an ice pack and some time on the couch to feel better.
We’ve put together this guide to help you better understand how back and leg pain correlate and provide treatment options that will help you start moving pain-free again.
Lower back pain and leg weakness
Your spinal cord consists of 31 pairs of spinal nerves and roots. When one of these nerves gets pinched, it can alter the messages sent to other parts of your body, like your legs. If your back pain is causing leg weakness or leg tingling, these could be warning signs that you may be experiencing severe nerve compression, and we recommend a visit to your doctor.
PHYSICIAN INSIGHT
It’s important to note that lower back pain doesn’t cause all leg weakness. Trauma or rheumatoid arthritis could also make it difficult for you to move your legs.
Lower back pain and leg pain
When your spinal nerve roots are compressed or irritated, you may experience lower back pain, and this pain may radiate into your legs. This is a sign that you may have a condition called sciatica.
What is sciatica?
The sciatic nerve is the longest nerve in your body. It travels from your lower back down your legs. If one or more of the roots that make up the sciatic nerve get compressed, you may experience lower back and leg pain. Sciatica typically only impacts one leg but can occasionally affect both legs. You may find that the pain increases when you sit, cough, or sneeze.
What causes sciatica?
Several conditions can irritate the sciatic nerve, including:
- Herniated disc: A herniated disc in the lumbar spine causes pressure on the nerve roots, causing pain. This is the most likely cause of sciatica, making up 90% of cases.
- Lumbar spinal stenosis: Spinal stenosis is the narrowing of the spaces in your spine and can compress your nerve roots and spinal cord.
- Spondylolisthesis: Spondylolisthesis is a condition which occurs when one of your vertebrae slips out of place and onto the vertebrae below, which can pinch the sciatic nerve.
- Spinal cord injuries: Car accidents, falls, and exercise injuries can directly injure the sciatic nerve.
- Piriformis syndrome: When the piriformis muscle (a small muscle in your buttocks) becomes tight, it can spasm and irritate the sciatic nerve.
- Spinal tumor: On rare occasions, sciatic nerve pain can develop when a spinal canal tumor compresses the sciatic nerve.
Risk factors for sciatica
Sciatica is sometimes unavoidable, but certain factors can increase your risk of developing this condition. The most common risk factors are:
- Age: As we age, our spine can develop bone spurs and herniated discs. Both of these conditions are common causes for sciatica.
- Obesity: Excess weight increases stress on your spine. This excess stress can put you at risk for developing conditions associated with sciatica.
- Prolonged Sitting: Sitting for prolonged periods of time puts added pressure on the sciatic nerve, increasing your likelihood of developing sciatica.
- Pregnancy: Pregnant women, or those assigned female at birth who become pregnant, are more likely to develop sciatica because of the pressure from the uterus on the sciatic nerve.
- Diabetes: Diabetes affects how your body uses blood sugar, increasing your risk of nerve damage, which, in turn, increases your risk of developing sciatica.
Back pain and leg pain treatment
Anytime you experience pain, it’s a good idea to set up an appointment with your doctor to determine the cause of your pain. If your doctor determines that your back and leg pain are caused by sciatica, you have a few different treatment options.
Sciatica treatment options
- Physical therapy: Your therapist will work with you to find movements that reduce the pressure on your sciatic nerve during physical therapy. These movements may include a combination of stretching, strengthening, and aerobic conditioning.
- Medication: You can use over-the-counter medications like ibuprofen to help alleviate sciatica pain. Your doctor may prescribe additional muscle relaxants to help relieve any pain caused by muscle spasms.
- Spinal cord stimulation: Spinal cord stimulators interrupt pain signals before they reach the brain, reducing sciatic nerve pain. Up to 80% of patients experience pain relief when using this treatment.
- Spinal injections: Corticosteroid injections can help reduce inflammation and pain in the lower back. Often, spinal injections provide patients with enough pain relief to begin a physical therapy program.
- Surgery: If you haven't experienced an improvement in your pain after six to eight weeks of treatment, your doctor may consider surgery.
Although surgery made the list as a potential treatment option, for 70-80% of patients, non-surgical options relieve their symptoms and surgery isn’t necessary.
Talk With Your Doctor
Pain can make life uncomfortable when it doesn’t have to be. Talk with your doctor to identify the cause of your pain and begin a treatment plan. If you’ve spoken with your doctor already and are interested in learning more about spinal cord stimulation as a treatment plan, click here to chat with a PainTheory specialist.
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