Musculoskeletal Problems and Leg Pain

Pain that originates from muscles and/or joints of the pelvis or hip can travel down into the leg and may also affect the foot. The hip joint, sacroiliac joint, and the piriformis muscle are common structures that may cause leg pain. Pain from these structures can mimic radiculopathy or nerve pain. ¹ Grimm BD, Blessinger BJ, Darden BV, Brigham CD, Kneisl JS, Laxer EB. Mimickers of Lumbar Radiculopathy. Journal of the American Academy of Orthopaedic Surgeons. 2015;23(1):7-17. doi:10.5435/jaaos-23-01-7

Hip osteoarthritis

Wear-and-tear of the hip joint (osteoarthritis) commonly causes:

• Deep aching pain in the hip and groin region that radiates to the front of the thigh and the knee, sometimes including areas below the knee ² Wilson JJ, Furukawa M. Evaluation of the patient with hip pain. Am Fam Physician. 2014;89(1):27-34. ^{, 3} Lam S, Amies V. Hip arthritis presenting as knee pain. BMJ Case Rep. 2015;2015:bcr2014208625. Published 2015 Feb 19. doi:10.1136/bcr-2014-208625
• Locking, sticking, or grinding sound (also called crepitus) that occurs during hip movements ⁴ Lespasio MJ, Sultan AA, Piuzzi NS, et al. Hip Osteoarthritis: A Primer. Perm J. 2018;22:17–084. Published 2018 Jan 3. doi:10.7812/TPP/17-084

The pain is usually worse in the morning, after prolonged sitting or resting, or after performing physical activities.

Read more about Hip Osteoarthritis on Arthritis-health.com

Sacroiliac (SI) joint dysfunction

The SI joint in the pelvis may cause pain due to abnormal motion or malalignment. ⁵ Raj MA, Varacallo M. Sacroiliac (SI) Joint Pain. [Updated 2019 May 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470299/ Typical symptoms include ⁶ Ou-Yang DC, York PJ, Kleck CJ, Patel VV. Diagnosis and Management of Sacroiliac Joint Dysfunction. The Journal of Bone and Joint Surgery. 2017;99(23):2027-2036. doi:10.2106/jbjs.17.00245 :

• Pain that originates in the lower back and buttock area and is referred to the back and side of the thigh.
• Effect of posture, such as standing from a seated position and/or sitting on a hard surface typically increases the pain.

SI joint pain may be relieved while lying down or walking.

Watch Sacroiliac Joint Dysfunction Video

Piriformis Syndrome

The piriformis muscle located deep in the buttock may sometimes compress the sciatic nerve as the nerve leaves the pelvis, causing piriformis syndrome. Commonly, the following symptoms occur ⁷ Hicks BL, Varacallo M. Piriformis Syndrome. [Updated 2018 Nov 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.Available from: https://www.ncbi.nlm.nih.gov/books/NBK448172/ :

• Shooting, burning pain that travels down the back of the leg
• Tingling the back of the leg
• Numbness in the buttock and hip

Piriformis syndrome pain may increase or flare-up while getting out of bed or while sitting for prolonged periods of time.

See What Is Piriformis Syndrome?

Leg pain can also occur due to a variety of other factors, such as pulled muscle issues, trauma, aging, strain, dehydration, or from being sedentary with minimal hip and leg movements. An accurate diagnosis of the underlying cause can help formulate an effective treatment for the specific condition.

See Accurately Diagnosing Leg Pain