Lower back pain radiates to the leg and buttock

Back pain is a fairly common phenomenon, which is largely due to the peculiarities of the modern lifestyle, low level of mobility, etc. People often face such a problem as lower back pain, which radiates to the leg and buttock. This, called lumboischialgia in medicine, significantly reduces the quality of life and interferes with the performance of both professional and household duties, and at the same time can be a sign of various diseases. Therefore, it is important to find the true cause of pain and undergo complex treatment, with which a chiropractor, vertebrologist, rehabilitation specialist and neurologist is ready to help each patient.

Causes of lower back pain radiating to the leg and buttock

There are quite a large number of diseases that can manifest themselves as lower back pain, radiating to the left or right leg and buttock. Mainly, they are associated with the occurrence of disorders in the spine, in which the spinal cord may suffer, as well as blood circulation.

Lower back pain radiates to the leg and buttock when the sacral and lumbar nerve plexus are affected. This is typical for:

• osteochondrosis of the lumbosacral discs;
• protrusions and intervertebral disc herniations of the lumbosacral region;
• spondylolisthesis;
• sciatica and piriformis syndrome;
• curvature of the spine;
• formation of tumors of a benign or malignant nature.

Often pain in the lower back, leg and buttock first appears during pregnancy, which is associated with changes in hormonal levels, as well as a shift in the center of gravity. This is difficult for the spine to bear, and if there are already pathological changes in it, this leads to their rapid progression and the development of pain. Due to the fact that during pregnancy the load on a woman’s body doubles, it is very important to put the spine in order. Our clinic has developed and prepared a special program of comprehensive examination and treatment for pregnant women and those planning pregnancy.

It is impossible to independently determine the cause of pain in the lower back, buttock, and thigh. Indeed, in some cases, similar symptoms are accompanied by pathologies of internal organs. For example, even deep hemorrhoids can provoke dull pain in the lower back, which will radiate to the leg and buttock. Therefore, if you experience discomfort in the back with irradiation to the buttock, thigh, lower leg, etc., you should immediately make an appointment with a doctor. Our clinic has developed an integrated approach to solving this problem - experienced chiropractors, neurologists, rehabilitation specialists, endocrinologists will conduct an examination and prescribe the necessary treatment. It is necessary to understand that spine treatment is the work of a whole team of specialists.

Osteochondrosis of the lumbosacral spine, protrusion and hernia

Most often, lower back pain radiates to the buttocks and legs in people whose work involves prolonged sitting or, conversely, high physical activity, in particular office workers, construction workers, loaders, and installers. Since during the day in all these cases a high load is created on the muscles of the lower back, this leads to disruption of the nutrition of the intervertebral discs, which occurs according to the diffuse type, i.e. the discs do not have their own blood vessels. As a result, they are destroyed and degenerative-dystrophic changes begin in them, that is, osteochondrosis of the lumbosacral spine develops.

Often the first symptom is the occurrence of pain of varying intensity in the lower back, which subsequently, as the disease progresses, begins to radiate to the leg and buttock. This may be accompanied by a feeling of numbness and weakness in the leg muscles on the affected side. If comprehensive treatment of the disease is not started at this stage, osteochondrosis will eventually lead to the formation of protrusion, and then herniation of the intervertebral disc.

This is due to the fact that the fibers of the fibrous ring lose their elasticity and gradually collapse. As a result, the disc protrudes, but its outer shell still retains its integrity, i.e., a protrusion is formed. Subsequently, further destruction of the fibers of the fibrous ring occurs and ultimately its rupture. The nucleus pulposus (the internal contents of the disc) is able to go beyond its limits and enter the spinal canal. This results in compression of numerous nerves, nerve roots and spinal cord located within the spinal canal.

It is also possible that the quality of blood supply to the spinal cord may decrease. If an intervertebral hernia compresses the spinal cord, this can cause plexopathy, paresis, and paralysis of the legs.

Poor circulation in the lumbar spine leads to decreased nutrition in the lower extremities and pelvic organs. In the absence of appropriate treatment, a number of diseases can develop - sexual dysfunction, amenorrhea, dysmenorrhea, thrombophlebitis, etc.

However, although degenerative-dystrophic processes in the intervertebral discs of the lumbar spine are the most common cause of lower back pain, radiating to the leg and buttock, it is not the only one.

Spondylolisthesis

Spondylolisthesis is a pathological process in the spine in which the vertebral bodies “slip” relative to each other. As a result, they are displaced from the anatomically correct position to varying degrees and can lead to compression of not only blood vessels, nerves, but also the spinal cord, which is fraught with the occurrence of not only paresthesia (sensitivity disturbances), but also paralysis.

Sciatica and piriformis syndrome

Sciatica is a pinched nerve of the sciatic nerve that begins in the area of ​​the so-called cauda equina and passes through the piriformis muscle. It can be compressed by a deformed intervertebral disc, scar tissue, displaced vertebrae, spasmed muscles, etc. This leads to the development of an inflammatory process, which is characterized by acute, shooting pain, spreading along the buttock, back of the thigh up to the popliteal fossa.

With piriformis muscle syndrome, similar sensations occur, but with this tunnel pathology, there is a sharp increase in pain when trying to move the straight leg to the side from a standing position. This is a dangerous disorder, since it is fraught with partial or complete atrophy of the nerve in the absence of competent, complete treatment.

Rachiocampsis

Spinal curvature is a common pathology, most often first occurring in childhood. The most common is scoliosis, i.e., deformation of the spinal column in the lateral plane, but aggravation of lumbar lordosis, i.e., strengthening of the natural curvature of the spine in the lumbar region, can also provoke the appearance of lower back pain radiating to the buttock and leg. In both cases, there is a high probability of pinched nerves, as well as the development of osteochondrosis with all the ensuing consequences. Therefore, lower back pain occurs, which tends to get worse over time.

Formation of tumors in the lumbosacral region

Malignant tumors of the spine are a fairly rare phenomenon, however, their formation in tissues in the lumbar region, including metastasis of tumors in other organs, is fraught with the occurrence of acute pain in the lower back, radiating to the leg and buttock. Benign tumors of the spine are more common, in particular hemangiomas - vascular formations. Since they can not only independently lead to compression of tissues and nerves, but also destroy the vertebrae, provoke an inflammatory process and other changes, their growth is often accompanied by severe pain in the lumbar region.

Causes of shooting pain in the legs

Now let's talk about the potential causes of shooting pain in the legs. Immediately after the appearance of such a symptom, the risk of traumatic damage to bones and soft tissues should be eliminated. If you have slipped on ice, fallen, squatted poorly, lifted heavy objects, been attacked by another person, or been involved in an accident, then immediately contact a traumatologist.

Shooting pain can be a sign of traumatic injuries such as:

• fracture of the femoral neck, tibia, fibula, femur or pelvis;
• crack of similar bones;
• sprain of the ligament and tendon apparatus;
• microscopic or complete ruptures of the ligamentous and tendon apparatus;
• dislocations in the projection of the hip or knee joint;
• formation of hematomas, rupture of the joint capsule;
• damage to the joint capsule (bursa).

To diagnose injuries, the first step is to take an x-ray. It eliminates damage to the integrity of bone tissue. To diagnose soft tissue ruptures, a puncture is performed. If blood is detected, an MRI is prescribed. If it is necessary to surgically restore the integrity of damaged tissues, therapeutic and diagnostic arthroscopy is recommended. It allows you to examine and restore the integrity of damaged tissues.

Other potential causes of shooting pain in the legs may include the following pathologies and conditions:

• degenerative dystrophic damage to the cartilage tissue of the intervertebral discs in the lumbosacral spine (osteochondrosis);
• its complications, such as protrusion and extrusion, intervertebral hernia and its sequestration;
• instability of the position of the vertebral bodies and their periodic displacement in different planes, which provokes pinching of the radicular nerves and their branches;
• spinal canal stenosis;
• osteophytes on the edges of the vertebral bodies;
• destruction of intervertebral (facet and facet) joints;
• poor posture and curvature of the spinal column;
• twisting and distortion of the pelvic bones, including compensatory in thoracic scoliosis;
• short limb syndrome, including against the background of severe destruction of large joints of the leg;
• cauda equina and piriformis syndrome;
• tunnel syndrome in the area of ​​the bifurcation of the sciatic nerve in the popliteal fossa;
• myositis of different muscle groups;
• cicatricial deformation of the ligament and tendon fibers, which has a compressive effect on the nerve fiber responsible for the innervation of the lower extremities.

Note! Shooting pains in the lower extremity may be due to problems with the blood vessels. These are obliterating endarteritis, varicose veins of the lower extremities, atherosclerosis, diabetic angiopathy, vasculitis, etc. These problems indicate serious pathological changes in the human body. You need to contact a specialized specialist as soon as possible. This is especially true for men aged 40–45 years. They are at high risk of developing coronary heart disease. And at the initial stage it manifests itself as shooting pains in the legs when walking. You should make an appointment with a cardiologist and undergo a full examination.

Another serious cause of shooting in the leg is neuropathy. It may be diabetic or toxic. If a patient smokes, drinks alcoholic beverages, works in an environmentally unfavorable environment, or likes to use medications without a doctor’s prescription, then he is highly likely to develop toxic neuropathy. In this case, it is very important to start treatment in a timely manner and eliminate further exposure to the pathogenic factor. Those. you need to give up bad habits, not use medications and lead a healthy lifestyle. And see a neurologist as soon as possible.

Diagnosis of the causes of lumboischialgia

When pain in the lower back radiates to the leg and buttock, you need to consult a chiropractor or neurologist. Our center’s specialists use an integrated approach to diagnosis and treatment, so they can quickly make the correct diagnosis. Diagnosis begins with a survey of the patient, during which the nature of the complaints, as well as the characteristics of work and rest, are clarified. The doctor must carefully examine the patient, palpating the spine, as well as conducting special functional and neurological tests. This allows you to get a complete picture of the patient’s condition, detect signs of neurological deficit and assess the extent of damage.

In order to establish the exact cause of lower back pain radiating to the leg and buttocks, instrumental diagnostic methods are prescribed. They almost always start with assessing the condition of the bones, intervertebral discs, ligaments and muscles of the spine. For this purpose the following are assigned:

• X-ray;
• CT;
• MRI.

The most complete and accurate picture of the state of the soft tissue structures of the spine is provided by magnetic resonance imaging. The method involves conducting a study of the body using powerful magnetic fields that do not have a negative effect on the human body. Therefore, it has practically no contraindications, with the exception of the presence of metal foreign bodies or implants in the body. If there are any, the patient is referred to a CT scan or x-ray. But only MRI allows one to determine the size of protrusions and intervertebral hernias with millimeter accuracy and detect the slightest degenerative-dystrophic changes in the discs, as well as signs of compression of nerve structures.

In our clinic you can also learn in more detail about the composition of your body and the state of the vascular system, which is involved in the blood supply to internal organs, musculoskeletal muscles, and the brain. Our experienced doctors will explain the data obtained to you in detail. Bioimpendansometry calculates the ratio of fat, muscle, bone and skeletal mass, total fluid in the body, and basal metabolic rate. The intensity of recommended physical activity depends on the state of muscle mass. Metabolic processes, in turn, affect the body's ability to recover. Based on the indicators of active cell mass, one can judge the level of physical activity and nutritional balance. This simple and quick test helps us identify disturbances in the endocrine system and take the necessary measures. In addition, it is also very important for us to know the condition of blood vessels for the prevention of diseases such as heart attacks, hypertension, heart failure, diabetes and much more. Angioscan allows you to determine such important indicators as the biological age of blood vessels, their stiffness, stress index (which indicates heart rate), and blood oxygen saturation. Such screening will be useful for men and women over 30, athletes, those undergoing long-term and severe treatment, as well as everyone who monitors their health.

In this case, body composition analysis gives us information that adipose tissue predominates in the body, and the bone-muscle component is in relative deficiency. These data will help the rehabilitation doctor competently draw up a physical activity plan, taking into account the individual characteristics of the patient.

If during the examinations no abnormalities in the condition of the spine are found, the patient is referred for consultation to a proctologist, gynecologist or urologist, since pain in the lower back radiating to the leg and buttock can be accompanied by proctitis, paraproctitis, prostatitis, adnexitis, uterine prolapse, prostate adenoma and other similar diseases.

What else to pay attention to

As mentioned above, shooting pain in the leg when walking can be a sign of not only neurological, but also vascular, traumatic and degenerative health problems. How can you independently distinguish one from the other - what should you pay close attention to when assessing your condition?

We encourage you to monitor for additional signs. Nerve fiber damage is characterized by the appearance of concomitant neurological symptoms. They include:

1. the spread of pain strictly along the course of the affected nerve (for example, with compression of the sciatic nerve, discomfort spreads to the back of the thigh and the lateral surfaces of the lower leg);
2. paresthesia - a sensation of crawling goosebumps, tingling in the foci for the innervation of which the affected nerve is responsible;
3. decreased skin sensitivity, feeling of numbness;
4. decreased muscle fiber strength, rapid leg fatigue during habitual physical activity.

Upon examination, the neurologist in such cases reveals a decrease in tendon reflexes. He may also perform some diagnostic functional tests to more accurately localize nerve fiber damage.

With vascular pathologies, you can see the expansion of the venous bed. With obliterating endarteritis, so-called intermittent claudication is present. It manifests itself in the fact that after walking a certain distance, the patient feels a sharp shooting pain, which forces him to stop. After a short rest, he can continue on his way until the next attack.

In case of injuries, external manifestations are present, such as bruises, violation of the integrity of the skin, bruises, hematomas. Palpation of the affected area in such cases is sharply painful.

In inflammatory processes against the background of tissue degeneration, redness of the outer skin occurs. The affected area is swollen, painful to the touch, hot and dry.

Do not self-diagnose. We recommend using all these additional signs solely to determine more precisely the profile of the doctor with whom you should make an appointment. If you can’t decide, then visit an orthopedist. This doctor will help you understand the existing problem and tell you how best to conduct the examination and which other doctor you should contact for help.

What to do for lower back pain radiating to the leg and buttock

First of all, if pain occurs in the lower back, buttock, or thigh, you should ensure complete rest. Gradually, the pain should subside due to muscle relaxation. You should also definitely make an appointment with a chiropractor - a neurologist, but before examining a specialist, it is important not to take any medications, since painkillers will blur the clinical picture and make it difficult to diagnose the disease.

It is important not to self-medicate when pain occurs and not to rely on ointments, creams or gels containing diclofenac sodium and other NSAIDs, since they have practically no therapeutic effect, but only dull the symptoms of the disease.

Treatment of low back pain radiating to the leg and buttock

After determining the cause of pain, treatment tactics are individually developed for each patient. Initially, patients are prescribed complex conservative therapy. Although sometimes patients develop severely advanced diseases, which can only be treated surgically.

Conservative treatment of lower back pain radiating to the leg and buttock is developed taking into account the detected pathological changes. Therefore, in each individual case it will have its own distinctive features. The main components of treatment are:

• drug therapy;
• osteopathy;
• manual therapy;
• massage;
• physiotherapy (phonophoresis, carboxytherapy, ozone therapy, pressotherapy, RF currents);
• individual sessions with a rehabilitation doctor.

Also, the chiropractor will definitely recommend making certain adjustments to the lifestyle, since low physical activity, excess weight and an unbalanced diet work against the patient. Therefore, it is advisable to take measures to normalize body weight and move more, which is especially important in relation to representatives of “sedentary” professions. At the same time, lifting weights and grueling workouts in the gym should be left in the past.

When treating spinal pathologies, it is important to eat properly so that the body receives all the substances it needs from food. This will ensure an improvement in the processes of tissue restoration and regeneration, and will also lead to a general improvement in well-being.

In some cases, patients are offered to purchase a special orthopedic corset. It will help relieve the back muscles and reduce the load on the spine, which will help reduce the severity of pain. But the size and degree of rigidity of such products are selected for each person individually based on the diagnosis. In our center you can select and purchase a corset that suits you.

Drug therapy

All patients are prescribed a whole range of medications that will help improve their well-being and will affect the cause of pain. Their list, as well as the method of administration, are also selected individually, taking into account not only the diagnosis, but also existing concomitant diseases, since certain drugs cannot be taken in the presence of pathologies of the gastrointestinal tract, etc.

Thus, the basis of drug treatment for spinal diseases that provoke the appearance of lower back pain radiating to the buttock and leg are:

• NSAIDs are a huge group of drugs that have anti-inflammatory and analgesic properties and are available in almost all possible dosage forms (tablets, solutions for intramuscular and intravenous administration, rectal suppositories, ointments, gels, creams, etc.;
• corticosteroids are powerful anti-inflammatory drugs, which are used when NSAIDs are insufficiently effective (often prescribed in short courses);
• muscle relaxants - drugs that quickly eliminate muscle spasms, which leads to a decrease in the severity of lower back pain;
• chondroprotectors are medications designed to accelerate the regeneration processes of intervertebral discs, but are effective only in the initial stages of the development of osteochondrosis. To prevent diseases of the musculoskeletal system, we recommend the most effective drug Mermaids Marine Collagen to our patients;
• B vitamins - medications that help improve the conduction of nerve impulses from the spinal cord to the corresponding organs and parts of the body;
• Vitamin D is a remedy responsible for the condition of bone tissue, as well as for higher brain functions, such as memory, memory, attention, and speech.

For very severe pain that cannot be relieved with analgesics or NSAIDs, blockades can be performed. They are a medical procedure in which an anesthetic solution containing a corticosteroid is injected directly into the area where the compressed nerve passes. Thanks to this, it is possible to quickly eliminate even very severe pain, but the procedure has contraindications and can only be performed by qualified medical professionals who are thoroughly proficient in the technique of placing blockades, in a medical institution. When performing a blockade, there is a risk of nerve damage, especially when a drug solution is administered by a specialist without appropriate training, which is fraught with serious complications.

Manual therapy

Manual therapy is one of the most effective methods of combating pain in the lower back, including those that tend to radiate to the leg and buttock. With its help, it is possible to achieve a significant improvement in well-being, not temporary, but permanent. We do not have general standards of treatment; we apply an individual approach to each patient. The use of techniques of manipulation, mobilization, post-isometric relaxation, as well as Gritsenko’s original technique makes it possible to effectively influence the causes of pain and restore the normal anatomy of the spine, which has a beneficial effect on the condition of the whole organism.

Manual therapy and therapeutic massage are not the same thing. Manual therapy involves influencing the spine and has a much wider range of therapeutic possibilities, while therapeutic massage can only improve blood circulation in the soft tissues and affect muscle tone.

Thanks to manual therapy it is possible to:

• increase the distance between the vertebrae, thereby reducing pressure on the intervertebral discs and eliminating factors predisposing to the formation or increase in protrusions and intervertebral hernias;
• normalize the position of the vertebrae and eliminate curvature of the spine;
• eliminate the pressure of vertebral structures on the nerve roots, spinal cord and thereby achieve the elimination of acute pain, including that radiating to the leg and buttock;
• normalize muscle tone, eliminate spasms and tone overly relaxed ones, eliminate the risk of developing atrophy;
• increase range of motion;
• significantly improve the quality of blood circulation and tissue nutrition;
• activate the body's natural recovery processes.

This is far from the full range of possibilities of manual therapy, since the method involves deep work on the spine. This has a comprehensive healing effect on the body and causes a progressive improvement in well-being. A decrease in pain intensity is observed after the first session, and then the condition improves more and more. Ultimately, patients note not only the elimination of lower back pain radiating to the leg and buttock, but also a noticeable increase in immunity.

The duration of manual therapy and the frequency of sessions is selected individually for each patient.

Physiotherapy

Physiotherapy procedures are used to obtain anti-inflammatory, analgesic, antispasmodic effects, improve microcirculation and potentiate other methods of treatment. As a rule, patients are prescribed courses consisting of 8-15 sessions, conducted at different intervals. It could be:

• electrophoresis;
• laser therapy;
• ultrasound therapy;
• UHF.

Exercise therapy

When dealing with lower back pain radiating to the leg and buttock, the possibilities of physical therapy cannot be neglected. A set of exercises is developed separately for each patient. This takes into account the diagnosis, the patient’s age, his level of physical fitness, the presence of concomitant diseases and other factors. This allows the rehabilitation doctor to select the optimal level of load and the most effective and safe exercises that will bring maximum benefit.

So that the patient can thoroughly master the technique of performing each exercise, the first classes are recommended to be carried out under the supervision of a specialist. If necessary, he will be able to adjust the load and replace the exercises with easier ones to perform. Only after 100% mastery of all exercises is it possible to continue training at home. But it is important to do exercise therapy every day, while avoiding haste and sudden movements. Only in this case will physical therapy be beneficial, strengthen the muscles of the lower back and legs, and also help improve blood circulation and nutrition of tissues in the affected area.

Thus, it is impossible to be negligent in treating lower back pain that radiates to the leg and buttock. This can provoke irreversible changes, including paralysis and disability, which are not always possible to eliminate even with surgery. Therefore, we recommend that you seek medical help at the first signs of discomfort.

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