Our Philosophy on leg pain

When pain extends from the spine into the lower limb the patient wants to know what causes it and can it be fixed. Is it arthritis? Is it a muscle problem? Is it spinal?

It is usually possible to determine what causes it and how to fix it.

Strictly speaking, the leg is that part of the lower limb between the knee and the foot but popular usage has it as that part below the hip (the lower limb).

Sciatica is pain running from the buttock to the thigh, then to the leg and into the foot associated with numbness and pins and needles (paresthesia). The distribution of the pain tells us which nerve is being compressed - see picture.

Pain running down the front of the thigh to the knee or even into the shin (Medial tibia / leg bone) is called femoratica and involves nerves higher in the spine (the upper lumbar nerves, first, second, third and fourth lumbar nerves). More common in older patients, often severe, often due to a disc prolapse extending out to the side, but usually resolving within two months. Only occasionally do these recur.

When patients present with pain in the "leg” they know it hurts, not what causes it and it is our job to determine whether it is a spinal or non-spinal problem, such as a hip or knee joint problem or due to arterial disease or a muscle strain, and if it is a spinal problem is it due to compression of a nerve or is it referred from a disc or joint or other tissue.