Individuals experiencing lower back pain and front thigh pain may be wondering how discomfort in the back and hips are connected. Because the lower back pain may start first, many people don’t realize that the two issues are related.
Back aches and thigh pain may subside on its own in a short period of time or persist for several weeks. The discomfort can also disrupt the ability to do simple movements such as walking upright, bending, sitting, or standing up from a seated position.
Determining what part of the back or spine is injured and then receiving proper treatment is the key to finding relief. The spinal column or spine encloses the spinal cord, nerves, and spinal fluid that helps cushion the spinal cord from a forceful impact or injury.
The spine also consists of numerous vertebrae (spinal bones), discs positioned between vertebrae, and facet joints that connect vertebrae from top to bottom in a chain-like manner. In addition, there are various muscles, tendons, and ligaments in the back that provide extra stability.
Any type of spinal or back injury that irritates one or more of these structures can lead to lower back pain that may radiate to other parts of the body. In order to properly identify the cause of lower back and front thigh pain, it is best to visit a physical therapist who can pinpoint the underlying problem and offer a beneficial treatment plan.
Symptoms Linked to Lower Back and Front Thigh Pain
There are many spinal nerves that innervate the lower back. Spinal nerves that originate in this region extend to other parts of the body including the abdomen, pelvis, hips, buttocks, thighs, and legs. Therefore, lower back pain may radiate to many different areas and this can make an accurate diagnosis difficult. It can also make it harder to determine what type of treatment will offer the most favorable outcomes.
Closely monitoring where you feel pain or where it’s spreading is important. This information helps a healthcare professional such as physical therapist isolate the cause, understand how the pain is changing, and develop an effective treatment strategy. Persistent back aches and referred pain in other areas usually arise due to a specific underlying issue. Physical therapists can typically pinpoint the main problem through a description of the symptoms.
Read on to learn more about referred pain that is linked to back aches.
Back Pain and Front Thigh Pain
Lower back pain on one side that begins to radiate down the front of the thighs, but does not spread to the knees, may be due to an issue called radiculopathy (a pinched nerve root). Spinal nerve roots can become pinched by bulging or herniated discs, the overgrowth of a bony structure (e.g., bone spur), or an arthritic facet joint.
For some people, lower back pain is accompanied by tingling or numbness in the front of the thighs, and muscle weakness may also develop in both regions. The pinched nerve may be located anywhere along the cervical, thoracic, or lumbar spine, which refers to the neck, upper-middle, and lower region of body (trunk), respectively.
Lumbar radiculopathies, or pinched nerves in the lower back, are the most common causes of back aches and thigh pain. This occurs because there is a large network of nerves in the lower back that overlap spinal nerves that innervate the frontal thigh muscles.
As a result, even minor injuries in the lumbar region typically lead to the presentation of radiating back pain that extends to the front of the thighs. The pain may also progress into the knee, and potentially radiate to the middle portion of lower leg, and eventually into the foot.
During an examination, an individual may display weakness during knee extensions, hip flexion, or hip adduction. In some cases, there is a loss of sensation in the front of the thighs along with the pain. Activities that can intensify lower back and front thigh pain include sneezing, coughing, and straightening the legs.
Thigh pain that accompanies lower back pain may be followed by leg pain. Discomfort that develops in both legs may be related to issues other than radiculopathy.
Back Aches and Pain in Both Legs
Central lower back pain that gradually spreads down both legs is often a symptom of latent conditions such as spinal stenosis or degenerative disc disease. Stenosis refers to the abnormal narrowing of one or more structures in the spinal area. There are two main forms of stenosis — foraminal stenosis (lateral stenosis) and central canal stenosis.
Foraminal stenosis is characterized by nerve compression that arises due to the narrowing of a structure called the neuroforamen – an opening in the spinal column through which spinal nerves exit. When foraminal stenosis develops, it means spinal nerves have less space and may become pinched, irritated, inflamed, or dysfunctional.
This form of stenosis can arise in any of the foramina along the spine, but it is frequently detected in the lumbar spine. Foraminal stenosis can also develop in the cervical spine (neck region), but is rarely observed the thoracic (middle) spine.
Central canal stenosis occurs when the narrowing of the spinal canal compresses the spinal cord and nerve bundles. The spinal canal is a hollow, protective passage that encases the spinal cord and numerous nerve roots. Similar to foraminal stenosis, central canal stenosis reduces space around the spinal cord, leading to both nerve root and spinal cord compression.
This causes pain and dysfunction in various regions of the body below the level of spinal compression. Canal stenosis most frequently develops in the cervical or lumbar spine. Some people also suffer from pain due to both foraminal and central stenosis.
Both forms of stenosis are associated with lower back pain as well as pain in one or both legs. The pain typically worsens with movement and is temporarily relieved when an individual is sitting or bending forward. Discomfort usually worsens while standing or walking because being in an upright position decreases spinal space and increases pressure on the spinal cord and nerve roots.
Another condition that may cause back aches and pain in both legs is degenerative disc disease — a common health problem that may develop due to the aging process. It occurs when the protective, shock-absorbing spinal discs located between each vertebra in the spine begin to gradually break down (degenerate) or shrink over time.
As the degeneration progresses, the lost disc tissue decreases the space between vertebrae and allows them to rub together. When vertebrae rub together, pain and stiffness can be felt in different areas of the back. The loss of space between the vertebrae can lead to spinal nerve compression as well.
Frequently reported symptoms of degenerative disc disease include lower back pain that may radiate down through the buttocks, the thighs, and both legs. The pain usually worsens when standing, lifting, twisting, or bending. Weakness in the legs and feet may also develop.
People who are suffering from back pain that extends to the legs should speak with a physical therapist who can determine if a health problem such as stenosis or degenerative disc disease is the reason for the pain.
Weakness and Legs Giving Way With Back Pain
Sudden back pain or weakness that causes the legs to give way can be a sign of a serious underlying problem and should be evaluated right away by a healthcare professional such as a physical therapist. Common issues that may result in the legs giving way with back pain include:
- A herniated disc
- Peripheral neuropathy
A herniated disc develops when the gel-like fluid inside of spinal discs that cushion the vertebrae protrudes through a tear in the protective outer layer, causing pain. This complication may be due to an injury or degenerative changes that develop with age.
If the herniated disc begins to compress a nerve that is nearby, it can lead to back pain, numbness, burning, or tingling down the legs, muscle weakness, pain that worsens when sitting or standing, or weakness that causes the legs to give way.
Sciatica is characterized by lower back pain that is caused by a pinched (compressed) nerve in the lumbar spine. The pain radiates along the sciatic nerve, which is one of the main nerves that runs down the lower back, the hips, buttocks, and the legs.
When sciatic pain develops, it typically affects one side, but both sides of the body may be impacted. The pain may extend to both legs as well. The pain that sciatica causes can feel like a constant, dull ache or a sharp burning sensation that worsens during inactivity (e.g., sitting).
Mild sciatica usually resolves on its own through beneficial strategies such as resting, exercising, and taking pain medication for minor discomfort. Severe sciatic pain may be accompanied by numbness or weakness, the legs giving way, or difficulty controlling the bladder and bowels. These symptoms require immediate medical attention as delayed treatment can lead to paralysis of the legs.
Peripheral neuropathy refers to damage to one or more nerves in the peripheral nervous system (PNS). The PNS encompasses the nerves that innervate central nervous system (CNS) components and branch out to other parts of the body. This type of nerve damage may develop due to an infection, injury, or other conditions such as hypothyroidism (an underactive thyroid) and diabetes.
The first signs of peripheral neuropathy are tingling and numbness in the hands and feet. However, the abnormal sensations may spread to different regions. Additional symptoms include stabbing or shooting pain, muscle weakness, legs giving way, and difficulty walking.
Treatment for conditions such as a herniated disc, sciatica, or peripheral neuropathy depends on the severity of the spinal or nerve damage. A spine specialist such as physical therapist can diagnosis the issue that is present and begin treating the underlying condition to target the lower back pain.
How to Treat Lower Back and Front Thigh Pain
The first line of treatment for most mild to moderate cases of lower back pain is over the counter pain medication such as ibuprofen (Motrin, Advil), naproxen (Aleve) and acetaminophen (Tylenol). These medications temporarily ease discomfort that is associated with a pinched nerve, a herniated disc, nerve damage, or other spine-related issues. However, they are only recommended for short-term use.
Steroid injections, which involve injecting a corticosteroid into the region where a pinched or inflamed nerve root is located, can also offer relief for extended periods (e.g., weeks or months). The injections do not promote healing, but can help decrease inflammation that is associated with the pain.
Individuals may also be given prescriptions for stronger medications for severe pain including opioids such as oxycodone (Roxicodone, Oxycontin) and hydrocodone (Vicodin, Norco). Opioids are narcotics and pose a high risk of addiction and dependence, especially when they are taken long-term. As this type of medication may become habit forming, it is best to speak with a healthcare professional to determine whether alternative pain management approaches may be a better option.
In addition to using pain relievers temporarily, physical therapy is a beneficial treatment approach for lower back pain and referred pain (e.g., front of the thighs). A physical therapist can help people who are suffering from constant pain avoid becoming inactive by teaching them useful exercises that help provide relief.
Therapeutic strategies aim to build up endurance and strength, enhance the stability and flexibility of the spine, and improve balance. Meeting with a physical therapist at the first sign of an ongoing back issue may help shorten the recovery period.
Mild lower back pain that is linked to a minor issue is typically isolated to the lower back and usually resolves in a short amount of time. However, lower back pain that persists, increases in severity, or begins to spread to other areas such as the front of the thighs indicates a more serious health problem. Furthermore, chronic pain with movement can disrupt daily activities or cause loss of time from work.
If lower back pain continues to worsen while sitting down, standing up, walking, and bending or the legs give way, it is best to speak with a physical therapist at FYZICAL. Our therapists offer innovative pain management approaches and therapeutic exercises that promote spinal injury recovery, realignment, postural correction, stronger back muscles, and enhanced flexibility that help alleviate frustrating symptoms. At FYZICAL, individuals also learn beneficial exercises they can perform safely at home or work.
A physician should perform an initial examination of the spine before providing a diagnosis and referral for physical therapy. Targeting lower back pain early on can help prevent it from radiating to other parts of the body or progressing into a more serious issue.
FYZICAL offers a wide variety of physical therapy services by qualified providers across the U.S. Our highly skilled therapy providers are 100% focused on your optimal health so you can Love Your Life®!