What’s causing the pain in the Low Back and Leg?

The treating team at National Spine & Pain Centers (NSPC) has two goals for a patient during a clinic visit. First is to understand the cause of the pain. Second is to treat the pain with conservative and minimally invasive solutions.

Many patients come to an NSPC office reporting pain in the low back, buttocks, groin, and/or leg. Pain can be increased with prolonged sitting, walking, bending, lying in bed, or high impact activities, interfering significantly with quality of life. These symptoms can start suddenly, or can develop slowly over the course of years. Often the patient as well as other health care providers who have seen the patient prior to arriving at NSPC are unsure of which body area is causing the pain. The pain may be originating from the lower part of the spine (lumbar spine), the sacroiliac joint (SI joint), the hip joint, the pelvic muscles/tendons, or a combination of all four. This diagnostic dilemma is common, and the providers at NSPC are eager to solve it.

Understanding the different pain sources may be subtle. It requires a careful medical history, physical examination, and often imaging of the hips, pelvis, and/or the lumbar spine (xray, CT, and/or MRI). Interestingly, an abnormality in the hip, SI joint, or lumbar spine can cause very similar pain patterns, despite being separate areas of the body. For example, pain running down the front or the back of the leg is usually caused by a problem in the lumbar spine, but this distribution of pain can also be caused by a hip issue. Imaging and other diagnostic studies are often used to clarify the main problem and other contributing factors.

The NSPC pain specialist can help answer the mystery.

In addition to medications and physical therapy, he or she may recommend a steroid injection, nerve block, or regenerative treatment. The response to the injection is often THE key piece of information towards understanding the central problem. Often, one injection could be enough to diagnose and treat the issue. At times, if some pain persists or returns, then either a repeat injection or a different type of procedure may be implemented to further clarify the diagnosis and help in choosing the least invasive option for treatment. The ultimate goal is long-term relief from the pain and return to full function.