Back Pain with Leg Pain — What Is Causing It?
Pain starting in the lower back and shooting down the leg. Numbness in the foot. This is sciatica — caused by nerve compression, and very treatable without surgery.
Pain that starts in the lower back and travels down the buttock, thigh, and leg — often to the foot — is sciatica, caused by irritation or compression of the sciatic nerve or its contributing nerve roots. It affects 1 in 10 Indians at some point in their lives and is one of the most common reasons patients visit Sri Anand Hospital. The good news: approximately 80–90% of sciatica cases resolve with physiotherapy and appropriate medical management, without surgery.
Seek Emergency Care Immediately If You Have:
- 1Leg weakness — foot drop, inability to lift foot — needs urgent evaluation
- 2Numbness in genitals or inner thighs (saddle anaesthesia) — emergency
- 3Loss of bladder or bowel control with back and leg pain — emergency (cauda equina)
- 4Progressive leg weakness over hours or days
- 5Leg pain with fever and night sweats (possible spinal infection)
Possible Causes of This Symptom
Lumbar Disc Prolapse (Most Common)
A bulging or ruptured intervertebral disc pressing on a nerve root in the lower back. Pain typically radiates in a specific pattern depending on which disc and nerve root is affected.
Lumbar Canal Stenosis
Narrowing of the spinal canal causing leg pain, heaviness, or weakness that comes on with walking and is relieved by sitting or bending forward. Typically in people over 50.
Piriformis Syndrome
The sciatic nerve passes through or near the piriformis muscle in the buttock. Tightness or spasm of this muscle can compress the nerve, causing sciatica-like symptoms without disc involvement.
Facet Joint Disease
Degenerative facet joints (spinal osteoarthritis) causing localised lower back pain, often radiating into the buttock, worse with extension and rotation movements.
Cauda Equina Syndrome (Emergency)
Massive disc prolapse compressing all the nerve roots at the base of the spine. Features: bilateral leg weakness, numbness in the saddle area (genitals, inner thighs), bladder/bowel dysfunction. A surgical emergency.
How We Diagnose the Cause
Straight Leg Raise and Neurological Exam
The SLR test reproduces sciatica with leg extension — highly sensitive for lumbar disc prolapse. Neurological examination identifies which nerve root is affected.
MRI Lumbar Spine
Gold standard for identifying disc prolapse, nerve root compression, and canal stenosis — arranged when neurological deficit is present or symptoms are not improving.
NCS for Nerve Damage Assessment
Nerve conduction studies assess the degree of nerve damage when weakness or prolonged symptoms are present.
Your Treating Specialist
Sri Anand Child and Neuro Center, Chanda Nagar, Hyderabad
In-house EEG and NCS — same-visit diagnosis, no referral delays
Frequently Asked Questions
Related Pages
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