Shooting pain that starts in the hip and runs down the leg is often labeled as sciatica. Technically, sciatica is a specific type of nerve pain. While sciatica is a frequent culprit in radiating leg pain, other potential pain sources include problems originating in muscles, joints or bursae. Identifying patterns in the pain and related symptoms can help determine the source of the pain and set the course for recovery.
Sciatica is a nerve pain caused by compression or inflammation of a nerve in the lower back or buttock region. Pain is usually quite sharp in the buttock area and often runs down the leg all the way to the foot. The pain increases when tension is placed on the sciatic nerve. Radiating pain that is dramatically increased when lying face up and raising a straight leg suggests sciatica. Nerve compression or inflammation may also cause numbness or weakness in the involved leg. When radiating pain is increases by leg raising and is coupled with numbness or weakness, a sciatic nerve problem is the likely culprit according to a clinical review published in the "British Medical Journal" in June, 2007.
A strain or cramp in a hamstring muscle can certainly be painful. Usually a hamstring injury occurs suddenly during an activity like high speed running. (ref. 2) The focal point of the pain is often where the hamstring attaches to the pelvis. This portion of the pelvis is sometimes called the "sit bone" because of its location at the lower margin of the buttock. The pain will radiate along the course of the hamstring muscle in the back of the thigh. There is usually no pain below the knee and no numbness.
Inflammation or arthritis of the hip joint often manifest as pain in the groin that radiates down the front and inner portion of the thigh. A study published in January, 2008 in the journal "Pain Medicine" specifically assessed pain referral patterns from the hip joint. Authors of the study found that over 50 percent of the time, the pain is felt in the groin and front of the thigh. Over 70 percent of the subjects had pain in the buttock and in just over 20 percent, the pain ran past the level of the knee into the lower leg. Logically, pain coming from the hip joint is increased when the joint is placed in a position of stress. Sitting cross-legged on the floor, for example, is likely to be uncomfortable or even impossible for a person with significant hip joint arthritis or inflammation.
The trochanteric bursa lies over a bony knob along the outside of the hip. This knob serves as an attachment point for several powerful muscles that move and stabilize the hip. Bursitis, or inflammation of this bursa, can cause sharp pain. When the bursa is very inflamed, there is often tightness and tenderness traveling along the course of the iliotibial band, a dense, fibrous connective tissue band that runs along the outside of the thigh to a point just below the knee. The most sharply tender area will be at the point of the hip on its outside edge. Lesser tenderness runs down along the outside edge of the thigh. (Ref. 4) This pain may interfere with sleep, especially when lying on the tender side. Standing up after prolonged sitting may be painful. Squatting, stair climbing and prolonged walking may also increase this pain. (Ref. 4)
- British Medical Journal: Diagnosis and Treatment of Sciatica; 2007
- Journal of Orthopedic and Sports Physical Therapy: Hamstring Strain Injuries: Recommendations for Diagnosis, Rehabilitation and Injury Prevention; 2010
- Pain Medicine: Hip Joint Pain Referral Patterns: A Descriptive Study; 2008
- American Academy of Orthopaedic Surgeons: Hip Bursitis