Lots of things could cause pain down the back of the leg: hips, facet joints, discs, lumps and bumps, endometrial plaques, vascular disease—even, sometimes, on very rare occasions, our friend the piriformis. True lumbar radicular pain, caused by an injury to a lumbar nerve root, is just one among many.
1. backside hurts
There is generally pain in the gluteal area
2. It’s worse in the leg, and worst below the knee
Sometimes the lower back pain is not to painful
3. It’s really, really painful
“The Worse pain I have ever had”
4. And it’s not just the pain
People can report buzzing , tingling and numbness
5. Their strength and sensation are down (but not out)
If your patient has pain down the back of their leg that seems to be coming from their spine, and your neuro exam shows they’ve lost strength, sensation or reflex integrity, that points towards a conduction block in a nerve root.
6. They hate stretching their nerves out
If you stretch and it makes your leg pain worse than it is probably sciatica.