Is My Hip Pain Sciatica?
Someone came in last week and told Dr. Brandon about their hip pain. “It shot down the leg into my heel! It almost dropped me to my knees!” This kind of radiating symptom occurs often in both hip and low back pain. It’s often called sciatica, but sometimes it can be mistaken for other types of pain radiating down the leg.
How does hip pain start?
There are tons of ways you can get hip pain these days. Sitting too much at a workstation. Driving too much in a car. Impact injuries from sports. Hobby-related injuries. The symptoms for hip pain are so variable, that any one of these causes could also have pain radiating down the leg.
You could have hip pain and feel like you have sciatica, and here’s why. Several nerves run from the base of the spine, down the front, back, and sides of the legs. These are the nerves for all the muscles in the leg. One of them, starting at your lumbar vertebrae and running down between layers of butt muscle and through the hip joint, is called the sciatic nerve.
That nerve can get irritated for many different reasons, starting at the low back with lumbar joint restrictions, in the butt with muscle adhesions, and in the hip joint with hip joint restrictions. Irritation of the nerve in any of these places can cause sciatica. This is why it can be so important to get a thorough assessment to find out the root cause of the hip pain.
Where does hip pain radiate?
The structures of the hip and the structures of the lower back are all very close together. They interact with each other. It can be challenging to pinpoint the cause of a hip problem that seems like sciatica because of that.
Tightness in the lower back can cause a need for laxity in the hips that could be responsible for irritating the sciatic nerve. Of course, this tightness could also irritate the femoral nerve, which runs down the front of the leg and has different sensations.
Instability in the lower back can cause tightness in the hip which irritates the nerve. This sometimes causes sciatica. The confusing part is that the same tightness in the hip could irritate the same structure but for a different reason! The body is so complex, and we are only scratching the surface of how all our systems interact. This is again why getting a comprehensive assessment is important.
What causes hip pain that radiates down the leg?
One of the most common causes of hip pain we see in the clinic is excessive chair sitting. When we spend too much time in a chair, our body gets better at it and starts to change shape. The front muscles of our hips get shorter and weaker, and the back muscles get longer and less stable. These imbalances can cause general low back pain, hip pain, or even disc-related low back pain.
Another cause of sciatica can be excessive standing, such as on a manufacturing line. When we stand all day, we get pretty tired, and our posture gets less and less active. Again, the body gets better at taking positions we spend a lot of time in, so we get imbalances that can lead to sciatica.
Will my hip pain cause lower back pain?
This is a question that we get all the time. The short answer is not necessarily. But it could. We see cases in the clinic all the time where the root cause of their back pain is one or both of their hips.
But just because you have low back pain does not mean you have sciatica. Even having pain that moves from the low back to the butt is not necessarily sciatica. Sometimes pain moves around and has different qualities and levels of intensity. Pain can be very strange, especially where there is excess stress.
I think the most important way to make sure that hip pain doesn’t become low back pain is to KEEP MOVING! At the very least, make sure you’re walking. Even better if it’s in nature and on an uneven trail.
If you find that certain positions cause you pain, you need to find ways to cut time there. If you’ve found that you’ve been sitting too much, my favorite solution is floor-sitting. The main issue with chair sitting is that it restricts your hips by keeping them in one position. Sitting on the floor provides a large variety of positions and angles for the hips to take.
Another option here is a standing desk, but this is less ideal because we’re not made to stand in one place all day, either.
Some ways to manage hip pain
If you’ve identified with any of this article so far, there’s hope here as well. You can learn from your pain, and find messages in your symptoms. You’ve adapted, through daily decisions, to become the person you are right now. You can make choices daily in favor of the person you want to be in months or years.
We are the culmination of our habits, so let’s get some health-affirming habits, shall we?
- Ground living: I mentioned it already. It’s critical to change lifestyles in a major way when you’ve been dealing with hip pain or sciatica for a long time. You need to make it easy to do the stretches and exercises that will in turn make the next stages easier. Ground living is very simple. Sit on the floor or the ground at every opportunity. If sitting directly on the floor is too challenging or painful at this point, use a firm cushion.
- Mindfulness: Meditation can be a great way to manage sciatica, hip pain, and low back pain. Mindfulness keeps your nervous system closer to a restful state. This allows you to experience relief and healing.
- Rehab exercises: You’ve likely seen dozens of rehab exercises on social media, today alone! If you’re just starting your journey, and you haven’t found a guide yet, it’s important to keep in mind that you don’t want to move into increasing pain. There are certainly more or less useful exercises for you, but that takes experimentation and reflection to figure out.
- Walking: if doing most things hurts you, you need to figure out exactly how far you can walk without pain. Then you walk that far as often every day as you can. Occasionally then you try to walk a little further, without pain. You’ve probably adapted and gotten stronger, so it’ll be easier. Keep pushing! Do the hard things!
- Heat or Ice: I feel that heat is best used in the capacity of relaxing your whole system. So you want to do it while lying down and listening to non-sleep deep rest meditations to get the most out of it. Ice can be nice to soothe an area, and you’re doing something for yourself.
Hip pain can sometimes be sciatica
To wrap up this journey, let’s look back to the beginning. Someone wanted to know if they had sciatica because of their hip pain. In their case, no. It wasn’t sciatica, because the pain ran down the side of his leg and stopped above his knee. He was glad that he scheduled with us though, because Dr. Brandon was able to work out the root cause of his hip pain.
He’s been doing strengthening exercises and mobility routines daily, and his hip strength is coming along so well that he has no problem keeping up with the maintenance of his house. He even got back into cycling, but that’s probably on pause for the season.
Back pain sufferers, like you, should follow a plan that can take you from healing to thriving. It should be collaborative, and it should matter to you.
The problem I often see is, that too many people are focusing on getting rid of their pain.
And this makes sense because we’ve all heard the same message our entire lives. We need to avoid pain. We need to get rid of it at all costs. If you’re experiencing chronic, long-term pain, this makes even more sense. Who knows what you would be capable of if you didn’t have to deal with pain all the time?
But what if I told you that there is a different way to think about your health? It can free you from the confines of pain and disability. It can empower you to take control of your life and your health, with guidance and support from pros who care. We call it the Movement Method, and we’ll use it as a trail guide to the active and full life that you’ve been missing.
Sign up for our free back pain guide, and together we can get your journey started.