Knee aches can be the result of many different injuries or issues. Almost as bad as the pain itself can be trying to figure out where the pain came from and what to do about it. Did you accidentally twist your knee while out for a run or while chasing your kids? Did you forget to stretch before you played that pick-up game of basketball? If your knee pain has been affecting you for any amount of time, you’ve probably already wondered, “Is there a walk-in chiropractor near me?”
And the answer as to why your knee is in pain might surprise you. If you haven’t had any sort of injury, there’s a chance that your knee pain may be due to sciatica. If you’re not familiar with sciatica, it is nerve pain caused by compression of your sciatic nerve, which is the largest nerve in your body. Sciatica pain typically starts in your lower back or bottom and can radiate down your leg.
What Does Sciatica Knee Pain Feel Like?
If your knee pain is originating in your sciatic nerve, you’ll likely experience some specific knee pains that you might not experience with other acute or injury-related knee pain. These symptoms include:
- A dull ache, sharp pain, or warm sensation in your knee- this can occur in the front, on the sides, or behind the knee
- Weakness or inability to bear weight on your leg or knee
- Weakness of the knee that causes your knee to buckle or give out
- Decreased ability to extend your knee
If your knee pain is due to sciatica, you’ll likely also be experiencing additional symptoms outside of just knee pain. Typical sciatica symptoms include:
- Burning sensation or shooting pain that originates in the lower back or bottom. This pain can often radiate down the leg, all the way to the feet. This pain can occur in either the front or the back of the leg. Sciatica typically only affects one leg, so you’ll likely experience these symptoms in the same leg as your knee pain.
- Tingling, weakness, or numbness in the back of your leg.
- Pain when changing positions or postures. You might notice that your pain worsens when you stand up or sit down or when you change your posture. Often people experience increased pain when bending the spine forward. Usually, this pain is relieved by walks or a heat compress near your sciatic nerve in your pelvis.
Not all radiating pain is due to sciatica, but sciatica can account for this type of pain. Only pain originating in the sciatic nerve can be sciatica.
The Sciatic Nerve and Different Types of Sciatica
As we mentioned, the sciatic nerve is the largest nerve in your body. It is actually made up of 5 nerve roots that meet and are housed in the lumbar and sacral spine area. You have two sciatic nerves- one on each side of your body. The five nerve roots that flow into your sciatic nerve come from your back and lower back. Before they fuse into one nerve, they are smaller and correspond to separate spinal segments from the L4 to S3 vertebrae. Once they form to make the larger sciatic nerve, this nerve runs all the way down your leg. Behind your knee, the sciatic nerve branches to form two other nerves, running down the front of your leg and your foot.
When it comes to knee pain related to sciatica, there are a few common causes relating to how the sciatic nerve plays into this pain.
If you know you have sciatica and you are experiencing knee pain as well, there’s a chance that you might be experiencing compression of your L4 nerve root, also called radiculopathy.
Another common cause of knee pain related to sciatica is tight hamstrings. Your hamstrings are a group of muscles concentrated in the back of your thigh. If you have tight hamstrings, this decreases the stability of your lower back, and the stress and change caused by this decreased stability can cause stiffness, pain, and radiating pain into your leg.
What Causes Sciatica?
There are several different causes of sciatica, but most research indicates that the majority of sciatica cases are caused by a herniated disc in your lumbar region. When this occurs, it can compress one or more of the spinal roots that make up the sciatic nerve. This can cause direct compression of your sciatic nerve or when the inner material of your disc leaks out and creates friction against the sciatic nerve. Alternatively, an acidic chemical that leaks from the disc can irritate and inflame the region around your sciatic nerve.
While this typically accounts for most sciatica, there are a few other causes to be aware of:
- Spinal Stenosis- Spinal stenosis refers to a decrease of space in the spinal canal, and for this to cause sciatica, it would have to occur specifically in the lumbar area. This is fairly common in older adults over 60.
- Degeneration – Within the lumbar spine, as tissues degenerate, they can compress or cause irritation and inflammation of the sciatic nerve.
- Spondylolisthesis – This condition occurs because of a stress fracture that causes one vertebra to slip onto another.
If you suspect you are suffering from knee pain as a result of sciatica, it’s important to consult with a doctor to help you diagnose and propose an effective treatment plan. Typically if a doctor suspects sciatica, they will want to review your medical history and conduct a physical exam to see if they can determine a pattern of sciatica.
While going over your medical history, your doctor will want to make sure you cover:
- When and where you first started feeling pain
- What kind of pain you’re experiencing (sharp, dull, ache, etc.)
- The onset of any other symptoms you may have
- Whether or not you were in an accident or experienced any physical trauma
- If you’ve had cramps or spasms in your leg or around your pelvic area
- If you’ve had any weakness in your leg or decreased ability to use your leg
During a physical exam, you can expect your doctor to look for:
- Pain concentrated in your lower back, bottom, thigh or leg
- The nerve response when you straighten your leg
- The nerve response to pressing on your toes, calf, or leg
If your doctor suspects you have sciatica, they may request other diagnostic tests in order to confirm their suspicions. These typically would include:
- Magnetic Resonance Imaging (or MRI) – An MRI gives your doctor visibility into the sciatic nerve and surrounding areas, including tissues and joints. If there were any bone issues, inflammation, tumors, or herniated discs, they would show up on an MRI.
- Discogram – In a discogram, dye is inserted into the spinal tissue via an injection in order to highlight any abnormalities in the vertebrae.
There are many ways to get relief from sciatica. In order for the treatment plan to remain simple and low-key, sciatica must be detected early. Treatment can include surgical and non-surgical options. In most cases, doctors will exhaust all non-surgical options before proceeding to anything involving surgery. Sometimes doctors will utilize more than one treatment method at a time.
If you have acute sciatica, the good news is that you will usually feel relief after about 4 to 6 weeks. For those with pain lasting beyond eight weeks, you most likely have chronic sciatica, which can take longer to heal from as treatments vary more greatly.
Many treatment options for sciatica are available at AICA Atlanta.
As experts in physical therapy at AICA Atlanta, we recommend a combination of stretching, conditioning, and strength training to treat sciatica. The goals of physical therapy to treat sciatica are to strengthen the muscles that surround the spine and pelvis, increase core strength, and stretch tight or inflexible muscles.
Sometimes, the pain from sciatica requires over-the-counter or prescription medication to manage pain prior to starting any sort of physical therapy. Nonsteroidal anti-inflammatory drugs like ibuprofen may be suggested by your doctor, but they may prescribe other medications like steroids, antidepressants, or even opioids in some cases.
Chiropractic care is administered by a professional who knows how to physically adjust your spine to relieve pain. Chiropractic care may help address root cause issues of pain, and itself should not be painful.
Steroid injections may be used to treat pain by controlling the inflammation around the sciatic nerve. The goal of steroid injections is to manage pain to the point that patients can actively participate in chiropractic care or physical therapy.
Surgery is an option when pain is persistent or progressive after many non-surgical options have been exhausted. It is rarely something that is considered as an initial option for pain relief. Depending on the cause of sciatica, different surgeries address different root causes. Surgery is always voluntary unless you’re experiencing a medical emergency.