Lower back pain with pain in thighs

Low back pain with referred pain can vary widely with regards to severity and quality. It tends to be achy, dull and migratory (moves around). It tends to come and go and often varies in intensity. It can result from the identical injury or problem that causes simple axial back pain and is often no more serious.

Area of Pain Distribution

Referred pain is usually felt in the low back area and tends to radiate into the groin, buttock and upper thigh. The pain often moves around, and rarely radiates below the knee. This type of low back pain is not as common as axial low back pain or radicular pain sciatica.

See What You Need to Know About Sciatica

Referred pain is analogous to the pain that radiates down the left arm during a heart attack. It is the result of the extensive network of interconnecting sensory nerves that supply many of the tissues of the low back, pelvis and thigh.

An injury to any of these structures can cause pain to radiate – or be “referred” - to any of the other structures. It is important to understand that this type of pain is not due to “pinched nerves”.

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Diagnosis of Referred Low Back Pain

Unfortunately, the brain cannot determine the specific source of the pain. A careful history and physical exam by an experienced spine specialist can usually distinguish this type of pain from radicular pain, or pain that radiates down the leg along the specific course of a compressed spinal nerve. The distinction between referred pain and radicular pain is critical because the treatment of the two types of pain varies considerably.

Treatment of Referred Low Back Pain

In This Article:

• Understanding Low Back Pain (Lumbago)
• Diagnosing the Cause of Lower Back Pain
• Axial Back Pain: Most Common Low Back Pain
• Low Back Pain with Referred Pain
• Lumbar Radiculopathy
• Video: What is Lumbago?

In general, referred pain is treated with the same types of nonsurgical care as axial back pain and will frequently diminish as the low back problem resolves. Once the possibility of a serious underlying medical condition as the cause of a patient’s low back pain is ruled out, treatment of referred low back pain is non-surgical and may include one or a combination of the following:

• A short period of rest (e.g. one or two days)
• Physical therapy, active exercise and stretching
• Ice packs and/or hot pads
• Appropriate medications for pain relief

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If the above treatments do not successfully reduce the patient’s pain to a manageable level, then additional non-surgical treatments may be tried. Laminectomy and discectomy surgery (back surgery aimed at decompressing the spinal nerve sac or individual spinal nerve roots) are often unsuccessful in treating referred pain. For cases of chronic severe low back pain, with or without referred leg pain, further testing and evaluation with discography (injection of the discs to determine if they are the pain generators) may be considered depending upon the treatment options being considered by the treating spinal specialist.

Low back pain that radiates down your thighs or legs can have several different causes. It often starts without warning and can limit your ability to perform simple tasks, like sitting, rising from a chair, bending, or walking upright.

Low back and thigh pain can affect one or both sides. It may stop above the knee or go all the way to your foot. You may suspect sciatica, a well-known cause of pain in the back and thigh, but it may be one of several other problems.

This article examines the causes, symptoms, and treatments of lower back and thigh pain.

Anatomy of Your Spine

The lumbar spine, also known as the low back, is composed of 5 bones called vertebrae that are stacked one upon another. Between the bones are soft, spongy discs. Your spinal cord runs down the center and nerves split off from it and exit between vertebrae.

Many nerves originate in the low back and travel down through the buttocks or legs. Some types of low back pain involve those nerves and cause pain along their entire length.

Hip joints—which include muscles, tendons, and ligaments—attach to the lumbar spine, giving it both mobility and stability.

By monitoring where you feel the pain and understanding how your pain changes, you can help your healthcare provider or physical therapist diagnose and find the best treatments for you.

Central Low Back Pain

Here are the most common symptoms of problems coming from the low back:

Central low back pain is usually caused by small disk bulges or muscular strain in the low back. This type of low back pain usually responds to gentle stretches and postural correction.

Central Low Back Pain With Pain Down Both Legs

This is very typical of a condition called spinal stenosis. This condition occurs when the spinal canal is too narrow and the nerves that travel down the legs are compressed.

The common presentation of stenosis is low back and leg pain that worsens with walking and is often relieved with sitting or bending forward at the waist. Research shows that physical therapy can effectively treat spinal stenosis and should be considered before any surgical intervention.

One-Sided Lower Back Pain Only Above the Thigh

This pain presentation is usually due to muscular strain and should readily respond to postural correction and gentle stretching. A small bulging disc may also cause this type of back pain.

Degenerative arthritis may cause bony overgrowth around a joint in your spine, which may also pinch a spinal nerve, leading to pain in your back or buttock.

Lower Right Back Pain: Causes and Treatment

One-Sided Lower Back Pain With Thigh Pain

Usually, pain that travels down the thigh is due to a pinched nerve. Nerves can be pinched by either a bulging or herniated disc, an arthritic facet joint, or an overgrowth of bony material, such as a bone spur. Pain may or may not be accompanied by numbness or tingling in the thigh, and muscle weakness may also be present.

One-Sided Lower Back Pain With Pain In the Lower Leg or Foot

Pain that travels from the low back to the lower leg is called sciatica. Many consider this to be the most severe presentation of low back pain. The pain may or may not be accompanied by numbness or tingling. This is usually caused by a pinched nerve from a lumbar disc, an arthritic joint, or a bone spur.

Emergency Symptoms

If you have pain with the sudden loss of strength or loss of bowel or bladder control, call 911 or get to an emergency room right away.

A Word From Verywell

Sometimes, episodes of low back pain are short-lived and go away without treatment. Once you begin to have low back pain, you may have more episodes and it can worsen due to factors such as posture and degenerative spine disease. It is important to maintain a strong and mobile spine to help prevent worsening low back pain. Basic exercises performed once or twice per day are a good way to keep your spine healthy.

By understanding where your pain is felt and what is possibly causing your pain, you can help your healthcare provider or physical therapist prescribe the best treatment for you.

Physical Therapy as Treatment for Lower Back Pain

Frequently Asked Questions

• What does it mean when only one side of your lower back hurts?

  Pain on only one side of your lower back can be caused by soft tissue injuries, bone problems, or a problem with an internal organ. Common causes of pain on one side only include:

  • Arthritis
  • Bone spurs in the spine
  • Injury to muscles, discs, or joints
  • Problem with kidneys, pancreas, colon, or uterus
  • Spinal stenosis 
    

• Can lower back pain radiate into the thigh?

  Yes, lower back pain that radiates to the thigh, buttocks, or hip is often caused by sciatica, an inflammation of the sciatic nerve. The sciatic nerve runs from the lower spine through the hips and buttocks and down the leg.

• What causes lower back pain and front thigh pain?

  Lower back pain that travels down the front of the thigh is usually caused by a pinched nerve. This can be caused by a bulging or herniated disc, an arthritic facet joint, or a bone spur.
  

• How do I get rid of sciatic pain in my thigh?

  For short-term sciatic pain relief try ice, moist heat, topical pain-relieving creams, and over-the-counter NSAIDs. Talk to your healthcare provider about treatment options for longer-term solutions, including physical therapy and chiropractic.

  What causes pain from lower back to front of thigh?

  Lower back pain that travels down the front of the thigh is usually caused by a pinched nerve. This can be caused by a bulging or herniated disc, an arthritic facet joint, or a bone spur.

  How do you get rid of lower back and thigh pain?

  Alternating heat and ice therapy can provide immediate relief of sciatic nerve pain. Ice can help reduce inflammation, while heat encourages blood flow to the painful area (which speeds healing). Heat and ice may also help ease painful muscle spasms that often accompany sciatica.

  What does it mean when your lower back and legs hurt?

  Lower back and leg pain are common symptoms that often result from sprains and strains or poor posture. However, severe or recurring pain may indicate an underlying medical condition, such as arthritis or fibromyalgia.

  What disc causes thigh pain?

  Herniated disks usually affect one side of the body. Arm or leg pain. If your herniated disk is in your lower back, besides pain in your lower back, you'll typically feel pain in your buttocks, thigh and calf. You might have pain in part of the foot as well.