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If you have leg pain without significant back pain, it can be hard to tell if the problem is your back or your hip. Vinita Mathew, MD, a physical medicine and rehabilitation physician at »ªÌå»á, explains what to look for and what to expect if you see your physician for leg pain. 

Leg Pain From Back Disorders

Leg pain coming from the low back, or the lumbar spine, is commonly referred to as . Sciatica involves pain in the buttocks, down the thigh, into the leg or in the foot. It is often associated with numbness or tingling, and sometimes weakness. 

Sciatica has multiple possible causes, such as:

• Herniated or ruptured disc
• Nerve root compression
• Arthritis in the spine
• Lumbar spinal stenosis (narrowing of the canal through which the nerve root travels) 

Leg Pain From Hip Disorders

Pain caused by hip problems may be felt in the following areas:

• Groin pain on the affected side
• Reduced range of motion
• Thigh pain
• Knee pain
• Buttocks pain

The pain usually does not go down below the knee, and there is no associated numbness or tingling. It may worsen when walking or standing and improve with rest. You may have limited range of motion when getting out of a car, chair or bed. 

Occasionally, pain in the hip joint could be secondary to inflammation of a , also called hip bursitis. This can happen if you have tight leg abductor muscles, a difference in leg length or hip arthritis. It can also indicate more serious but less common medical conditions:

• Fractures
• Tumors
• Infection
• Avascular necrosis, a condition where parts of the hip bone die because of reduced blood flow to the area
• Decreased articular cartilage in the joint. The femoral head sits in a pocket of cartilage that can wear down over time or because of a chronic condition like rheumatoid arthritis. This can cause pain and stiffness in the joint.

Accurate Diagnosis Is Key

If your physician cannot reproduce your leg pain by moving your hip but can by examining your back, the spine is usually the source of the problem.

Some people may have only localized hip pain that originates from the spine. Others may have only leg pain that originates from the hip, not the spine. That's why imaging is important in addition to a good physical examination.

Plain X-rays may be helpful, but sometimes an MRI is needed for a deeper look at your bones, joints, muscles and tendons.

Sometimes imaging can show abnormalities in both the hip and the spine, making it hard to determine the source of the pain. In these cases, your physician may inject directly into the area suspected of causing pain. Whether or not you get pain relief from the injection can help your physician better understand where the pain is originating from.

Treatment Plan

Your physician may recommend anti-inflammatory medications, physical therapy or injections. If these treatments don’t help, or your condition continues to get worse, surgery may be an option.