Hip joint pain can develop for a number of reasons, and the first step to long-term pain relief is determining the underlying cause of the hip pain. From disc issues to scoliosis, the sciatic nerve can become irritated and painful for a number of reasons.
Hip pain and sciatica are connected. The sciatic nerve starts in the lower back and passes through the hip area, and if the sciatic nerve is inflamed, impinged, and/or irritated, it can cause pain felt anywhere along its pathway.
As the largest nerve in the body, sciatic nerve irritation can cause a number of symptoms.
While sciatica is commonly regarded as a condition, the term sciatica isn't a diagnosis; it references sciatic nerve irritation that causes noticeable symptoms like pain and discomfort, but the cause isn’t indicated.
The sciatic nerve is a bundle of two sciatic nerves and is a mixed nerve containing both motor and sensory fibers; it starts in the lumbar spine (lower back), and travels posteriorly down the back of the hip, buttock, leg, and into the foot.
As a mixed nerve, if it's irritated, it can affect both sensation and movement.The sciatic nerve enables motor and sensory function in the leg and foot; it controls muscles used in movement and transmitting sensory information such as touch, temperature, and pain.
The sciatic nerve enables knee flexion (bending motion of the knee joint) and hip abduction (sideways leg movement away from the body) via the hamstring muscles and abductor magnus muscles.
The nerve divides and branches off to control muscles in the lower leg and foot; it shapes the foot's ability to point toes downward and/or up, and it provides sensory input for the thigh, leg, and foot.
Because the sciatic nerve branches off throughout the lower body where it exits the spine, nerve irritation mainly causes symptoms felt throughout the lower body.
Nerve irritation can involve the nerve being impinged (pinched nerve) and/or compressed (exposed to excessive pressure).
Hip pain involving the sciatic nerve can include sharp, aching, or burning sensations and can include sensations of numbness, tingling and/or weakness in the leg.
In most cases of sciatic nerve pain, because the nerve branches off down each side of the body, depending on the cause, it's more common for only one side of the body to be affected, most often the left side, but it can involve both the left and right side.
Sciatic nerve pain can also move and often involves flare ups: periods during which symptoms escalate, but then abate.
In severe cases, pain can be chronic and debilitating, and the longer it's left untreated, the more likely it is to cause unhealthy movement patterns, potentially causing a number of additional issues.
The first step to addressing sciatic nerve pain is determining the underlying cause of the sciatic nerve irritation and customizing a treatment plan accordingly.
The sciatic nerve can become irritated for a number of reasons; the most common include disc issues, stenosis, bone spurs, and/or the presence of an underlying spinal condition like scoliosis.
The main structures of the spine include its vertebrae (bones), intervertebral discs, and supportive ligaments.
A disc sits between each pair of adjacent vertebrae and the spine's overall health is shaped by the health of its discs, so if a disc starts to degenerate, it can disrupt spinal function in a number of ways.
Degenerative disc disease contributes to the development of a number of spinal conditions/issues.
The discs provide the spine with structure, prevent friction during movement, facilitate spinal flexibility, and act as the spine's shock absorbers; if a single disc starts to degenerate and change shape, it can affect the spine in a number of ways.
Because the discs don't have their own vascular supply, it can be difficult to reverse damage; the discs are generally the first structures of the spine to degenerate, and this can involve disc desiccation, a bulging, and/or herniated disc.
Degenerative disc disease is a common cause of sciatica pain.
If a disc in the lumbar spine is degenerating and changing shape, it can impact its surroundings, adding compression, and if the sciatic nerve is compressed inside the spinal cord, or at its root, where it exits the spine and branches into the lower body, it can cause sciatic pain, including hip pain.
A bulging disc can become a herniated disc if the disc's inner nucleus pushes through a tear in its outer annulus, projecting into the space surrounding the disc.
The lumbar spine has to support the weight of the upper body, including the spinal sections above, and it feels the effects of mechanical stress during movement; the lumbar spine itself is the most vulnerable to injury and is the most common location for back pain.
Spinal stenosis can also cause sciatica issues and related hip pain by causing a loss of space within the spinal canal, and if this develops in the lumbar spine, it puts pressure on the spinal nerves, and can impinge the sciatic nerve, causing back pain, radiating pain, searing pain, hip and leg pain.
Spinal stenosis is also most commonly diagnosed in the lower back.
A compressed nerve can cause symptoms felt far from the source of irritation, so a sciatica problem can be difficult to diagnose.
Bone spurs can also lead to hip pain if they develop in the lumbar spine.
Bone spurs are bony over growths that develop on the edges of bones and/or where bones meet, in the joints.
A bone spur can take up space in and around the spine, and if the sciatic nerve is affected, certain movements in particular can cause hip pain; hard working hips support body weight, movement, and anchor the trunk and legs.
If a bone spur in the lower back is compressing the sciatic nerve, it can cause related hip pain.
There are a number of spinal conditions that can contribute to hip pain; scoliosis causes an unnatural lateral spinal curve with rotation, and with current estimates at close to seven million people diagnosed with scoliosis in the United States alone, awareness is necessary.
Scoliosis introduces uneven forces to the spine, its surroundings (muscles and nerves), and the entire body, and once skeletal maturity is reached, scoliosis becomes compressive.
If the lumbar spine has an unnatural bend and twist, this can irritate the sciatic nerve, causing lower back pain, hip pain, and leg pain.
Scoliosis also causes postural changes such as uneven shoulders and hips, so scoliosis-related hip pain can be caused by compression, sore muscles, muscle weakness, muscular imbalance, and/or unhealthy movement patterns.
The connection between hip pain and sciatica is based on the sciatic nerve’s close proximity to the pelvis and hips.
The sciatic nerve branches off from the lumbar spine and passes through the hip, buttock, leg, and into the foot.
Sciatic pain can be mild and intermittent with flare ups, or it can be severe, chronic, and debilitating.
When it comes to treating sciatica pain, the first step is determining the underlying cause of the sciatic nerve's irritation and customizing a treatment plan accordingly based on severity, symptoms, and causation.
If the cause is a disc issue, treatment has to focus on restoring disc health and function so the damaged disc is no longer pressing on the sciatic nerve.
If there is a structural issue within the spine causing nerve compression such as spinal stenosis, bone spurs, and/or scoliosis, the structural issues need to be addressed to take pressure off the sciatic nerve.
Here at the CLEAR Scoliosis Institute, patients experiencing sciatica pain are given a comprehensive physical examination and, in many cases, include X-ray imaging for a complete understanding of what's happening in and around the spine.
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