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Get to the Root of Leg Numbness or Tingling

Do you have tingling and numbness that goes in your buttock, leg, or even down to your toes? There are quite a few potential causes of this, including a pinched nerve in your back, an inflamed nerve from a sacroiliac joint dysfunction, or even a pinched or entrapped nerve somewhere else in your leg. Regardless of the cause, tingling or numbness should be evaluated by a specialist to ensure there is no permanent damage!

Pinched Nerve in the Back

One of the most common causes of tingling and numbness {even weakness and pain} into the leg is a pinched nerve in the back. Grandma may call this sciatica but we now call it lumbar radiculopathy and is frequently associated with a burning and stinging pain which radiates into the leg. Depending on which nerve is pinched will depend on where the tingling and numbness goes.

For example, a disc herniation at the bottom disc level {L5/S1} often irritates the S1 nerve which causes pain or numbness into the buttocks, back of the leg and calf, and can even go to the bottom or outside of the foot. A different nerve can be pinched that may result in a different location like a disc herniation just one level up from that {L4/5}. A herniation here can irritate the L5 nerve and result in radiating pain around to the front fo the calf and right down to the big toe.

Pain from a pinched nerve may appear:

  • When sitting
  • When leg is straightened out in front
  • When your hip is flexed when
  • Sometimes when you cough or sneeze {Valsalva maneuver}
Sacroiliitis

Sacroiliitis is the result of an inflamed sacroiliac joint {SI joint} and can often lead to leg pain, tingling, and numbness. Instability to the SI joint in addition to increased inflammation could lead to symptoms very similar to that of a disc herniation. Often times once the SI joint is treated the leg pain will resolve.

Pinched Nerve Outside of Back

Other causes of leg pain can occur due to pinching outside of the spine. For example, irritated nerves as they pass around the knee joint can cause tingling and numbness in the lower part of the leg. Hernias, such as a femoral hernia in the groin area, can also cause numbness or tingling to the front of the thigh down toward the knee. Even hip arthritis can cause leg pain that extends from the groin down to the knee.

Much of the time, differentiating causes of leg pain, tingling, or numbness can be made by just hearing the story of where the pain is in the leg.  Physical exam, checking reflexes, nerve stretching, and joint range of motion can also help with the diagnosis.  Frequently x-rays and MRIs will be needed to help further differential diagnosis. Once we have a good diagnosis, then the appropriate non-operative, as well as possibly surgical treatment can be considered.  The good news is that over 90% of patients with these problems can be treated non-operatively!

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