Sciatica hip pain is due to injury, damage, irritation or compression of the Sciatic nerve which acts like a power cable relaying all information from your brain to your toes. A pinched nerve in your hip is a very distinctive pain, unlike anything you have ever experienced. It can only be described as unbearable and excruciating.

The sciatic nerve is the longest nerve in the body, originating from the lower back and sacrum, bundling together and running down to your toes, while branching off to supply power to the structures in the leg as it travels downwards. Any pain from the sciatic nerve experienced in the hip region is known as sciatica hip pain.

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What is the Sciatic nerve?

The Sciatic nerve is like a bundle of wires (nerve roots) that run out of the spinal cord at the Lumbar and Sacral vertebrae. The nerve originates in the lower spine as nerve roots exit the spinal cord (through gaps in the bones at the back of the spine), and extends all the way down the back of your leg to your toes.

The sciatic nerve is actually made up of five nerves. It is formed on the right and left hand side of the lower spine by the combination of the fourth and fifth lumbar nerves and the first three nerves in the sacral spine.

The five nerves group together on the front surface of the piriformis muscle (at the back of the buttock) and become one large nerve, the sciatic nerve. This nerve then travels down the back of each leg, branching out to provide motor and sensory functions to specific regions of your leg and foot.

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How does Sciatica happen?

Sciatica is a symptom of nerve pain which basically means there is injury, compression or irritation of the Sciatic branch of nerves.  This can cause Sciatic nerve pain to be felt down into the hip area.

The bundle of nerve wires that run out the lower spine and sacrum come together to form a cable about as thick as your thumb. They converge at the back of the buttock just above the Piriformis muscle and run between the two hamstring heads. These are the two most common places where the Sciatic nerve gets pinched.

Nerve Irritation

Nerve irritation is when these nerves in your hip are irritated by inflammation or friction. The friction between the structures in close proximity to the  nerve like  musclejoint and ligament irritates the power cables and causes swelling. This leads to a sharp, sudden burning or electrical type pain that radiates along the line of the Sciatic nerve. Initial discomfort or tightness usually progresses to pain, while experiencing weakness and more frequent sharp jolts of pain as it gets worse.  This type of sudden, sharp pain comes and goes, only to return with specific movements. Initially the nerve pain only comes on occasionally and relieves after a few minutes.

Pinched Nerve

When the Sciatic nerve is pinched in your hip the nerve is compressed to the point where impulses are disrupted. Abnormal stimulation of the Sciatic nerve causes ‘abnormal’ signals along the nerve path. When the nerve irritation progresses to compression you’ll feel more constant pain, pins & needles, numbness and loss of muscle power.

These are signs of serious nerve problems, and we advise you to contact us sooner rather than later.

What happens inside the nerve?

Nerves are made up of bundles of neurons carrying impulses, like messages, from the brain to the body and from the body to the brain. This neuron consists of a cell body, dendrites and an axon. The axons are mainly responsible for transferring the impulse from one neuron to the next. Myelinated axons have a fatty wrapping, or myelin sheath, which makes transmission of the message faster than axons without a myelin sheath.

If the neuron isn’t carrying a message it has a resting potential, meaning that it’s ready to transmit an impulse. During this resting potential there is a negative electrical charge inside the neuron and a positive electrical charge outside it, like a battery with positive and negative poles. The positive charge outside the cell is created by sodium ions.

Nerves fire an impulse

When something like heat, cold or pressure stimulates the nerve to a certain threshold it creates an action potential, so the nerve fires. Sodium channels open and the sodium ions can move from the outside to the inside of the neuron and this process is repeated as it jumps from one neuron to the next leading to the spinal cord and eventually to the brain. The brain will determine how you respond to the message. For instance, if you touch a very hot stove, the brain will interpret it as pain and make you pull away quickly to protect yourself. A normal temperature will be interpreted as heat, not pain, because the threshold is too low. This threshold is determined by the brain according to what it interprets as dangerous.

Neurons are very greedy when it comes to energy and oxygen, so the whole action potential mechanism is dependent on the blood supply of the nerve. Therefore, the blood supply to nerves is very specialized: into a coiled network around the nerve. Under normal circumstances this network means that nerves will have a blood supply during all movements and in all positions.

What happens when the nerve is injured?

When you have a pinched nerve, the nerve’s ability to handle different conditions, movements and positions will change. There will be pressure on the nerve’s blood supply and the neurons won’t get enough energy or oxygen. This causes swelling and inflammation of the nerve which causes a chemical irritation around the nerve and increases its sensitivity.

If sensitivity increases, the threshold where the nerve fires is lowered and what the brain interprets as pain changes. In this case something like normal pressure from sitting on a chair, a gentle stretch or mild heat will cause pain.

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Branches of the Sciatic nerve that can cause hip pain

There are branches of the Sciatic nerve which, when injured, can cause hip and buttock pain. The symptoms are similar to sciatica & hip pain, but the site where the nerve is pinched is different. Instead of pressure over the bulk of the nerve, smaller branches that split off the main Sciatic branch cause nerve pain to stay concentrated over your hip.

Nerve symptoms from entrapment of any of these t nerve branches can be confused with sciatica hip pain, but with neurological testing your physiotherapist can give you a more accurate diagnosis.

  • The superior gluteal nerve

    This nerve is formed by branches from L4, L5 and S1 and runs over the upper third of the buttock. A direct blow could injure this nerve or it could become pinched by the muscles at the back of the hip (piriformis, gluteus medius and gluteus minimus). This condition is also known as pseudo-sciatica, because the pain could be confused with symptoms caused by sciatica. If you injure this branch of the sciatic nerve you will have an aching pain over your buttock and weakness of the hip muscles, specifically moving the one leg away from the other (abduction).

  • The posterior cutaneous nerve of the thigh

    It arises from levels of S1, S2 and S3 of the lower back. Its cutaneous branch supplies sensation to the back of the thigh and the inferior cluneal nerve branch goes to the lower part of the buttocks. Injury to this nerve can also cause buttock pain and may be confused with sciatica hip pain. Your physiotherapist can differentiate between the different nerves causing your symptoms.

  • The middle- and superior cluneal nerves 

    These nerves supply the skin over the buttocks and can also cause buttock pain if entrapped.
    The superior cluneal nerve arises from the nerves of L1, L2 and L3 and go to the skin of the upper two thirds of the buttocks.
    The middle cluneal nerve comes from the nerves of S1, S2 and S3. This nerve supplies the skin over the coccyx and the inner part of the buttock.

Places where the Sciatic nerve gets Pinched

It is important to note that the point of compression will cause pain radiating up the nerve, but it is more common to find the pain travelling down the nerve.

Piriformis muscle

  • This muscle sits right in the middle of your buttock and runs horizontally from the sacrum to attach onto the thigh bone (femur).  It turns your hip outward.
  • The sciatic nerve runs underneath the piriformis muscle. Piriformis syndrome develops when muscle spasms develop in the piriformis muscle thereby compressing the sciatic nerve.
  • Tightness, stiffness or shortening of the piriformis muscle can cause a pinched nerve in your hip which results in Sciatic hip pain.
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Hamstring muscles

  • This muscle runs vertically downwards and extends the hip (moves it to the back). The Sciatic nerve runs between the inside and outside hamstring heads from the sitting bone (Ischium) to the back of the knee.
  • Tightness, stiffness or shortening of the Hamstrings can put pressure on the nerve that runs deep to it.
  • Repetitive hamstring contractions like leg curls may trigger an irritation on the Sciatic nerve and cause nerve pain in your hip.
  • We also find that abnormal scar tissue (wound tissue) that is formed after a hamstring tear may restrict the normal sliding of the nerve, and may produce a sharp pain over your hip and down your thigh.

Lower back

Along the spinal cord there are many structures that can move into the space where the nerve runs. Some conditions put direct pressure onto the nerve, others restrict its normal sliding movement, which then causes an irritation resulting in hip and leg pain.

A few causes of Sciatica radiating from the lower spine into the hip:

  • A slipped disc (Lumbar Disc bulge or prolapse)
  • Lower back muscle spasm (Prevents the normal movement of the nerve)
  • Intervertebral Disc Degeneration (Loss of disc height leads to less space for the nerve to run out the spine)
  • Narrowing of the intervertebral foramen (the holes where the nerves exit the spinal cord)
  • Osteophytes (abnormal bone growth that moves into the path of the nerve)
  • Spondylolysthesis (Shift of a vertebrae on top of one another due to hairline fractures)
  • Spondylosis
  • Spinal stenosis (Narrowing of space around the spinal cord)
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Direct trauma can trigger Sciatica nerve & hip pain

Neuropraxia is when the protecting cover of the nerve gets damaged when it is stretched along its length, but the sensitive nerve fibers inside are still intact. Like the plastic surrounding a power cable that gets stripped away exposing the wires on the inside. Most trauma to nerves cause neuropraxia.

Car accidents are one of the main culprits due to the high impact pressure on your hip causing a collection of problems at multiple areas.

A sudden over-stretch of the nerve like falling into a split or kicking can also cause a neuropraxia. This can cause sciatic nerve pain in your hip.

Slipping and falling onto your buttocks can trigger the nerve injury. Even more so when you fall on the edge of a step while walking down. Usually your hip muscles go into spasm which in turn compresses the Sciatic nerve in your hip causing a sharp or burning hip pain.

Sitting on a chair on the edge of your seat for hours, may trigger nerve symptoms down your leg. Ever sat in an awkward position for a while, only to feel your leg go ‘numb’…

Sciatic nerve pain feels very different to other types of pain. Nerve pain is a very distinctive pain, unlike anything you have ever experienced. It can only be described as unbearable and excruciating.

It’s described as feeling like a knife stabbing you in your buttock, like an electrical shock or a burning pain like warm coals in your hip. The nerve pain usually radiates downwards from your hip into the thigh, and in more severe cases it can travel to your knee, back of your calf and to the sole of your foot.

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Symptoms of Sciatica & Hip pain

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Self-test

Lying on your back lift up the affected leg about 30 cm off the floor, keeping your knee straight and then flex your foot (“toes to nose”).  Hold this position and lift your head off the floor.  If this makes your buttock pain worse the test is positive for sciatica, and you may have a pinched nerve in your hip.

Sit on a table or counter, so that your feet don’t touch the floor. Hunch your shoulders and place both hands behind your back on the table. Now lower your head towards your lap.  Holding this position, straighten the knee of your painful leg while flexing the foot (“toes to nose”).  If your buttock pain gets worse with this movement, lift your head.  If your pain lessens/goes away the test is positive for sciatica.

Our physiotherapist will need to investigate your Sciatic nerve to determine if the nerve is pinched in your lower back or your hip.

Standing with your feet shoulder whit apart, straighten your lower back and tilt forward from your hips. Don’t allow your upper body to collapse forward. Keeping your knees straight, you’ll feel a pull over the back of your thigh.

If you feel a sharp pain around your hip, as you lean forward you may have a pinched Sciatic nerve in your hip.

Stand facing a step, put your unaffected foot on the step, while keeping your toes facing upward. Straighten your knee and turn your hip inwards so that your toes face inwards. Then lean forward from your hip and see how far you can reach down.

Repeat the test on the other leg and compare how far you were able to lean down. A sharp pain in you hip and buttock may be a sign of a pinched nerve.

How bad is my Sciatica pain in my hip?

Buttock pain
  • Nerve Irritation – this causes tingling and stiffness or cramping in your hip. It usually comes and goes and is aggravated by specific activities like prolonged sitting or stretching.
  • Nerve compression – causes a sharp, burning sensation or an “electrical shock” kind of pain in your buttock. The pain is more severe than with a nerve irritation and if the compression gets worse it could lead to nerve entrapment.
  • Nerve entrapment – you will have a sharp or burning hip pain and the surrounding muscles will be in spasm. You will also have a constant tingling and/or numbness in your buttock and weakness of some of the muscles in your leg.  In this case you should get medical attention as soon as possible as it could lead to permanent nerve damage.
  • Repeated injuries to the nerve results in swelling, changes in blood flow and damage to the outer layers of the nerve. The function of this outer layer (myelin sheath) is transmitting messages back to the spinal cord and ultimately to the brain. In severe cases there will be degeneration and formation of scar tissue in parts of the nerve which may not fully recover, even after surgery to release the nerve.
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Diagnosis of nerve pain

Our physiotherapists are experts at detecting nerve injury, irritation or compression because we spend many hours a day working on it. Allow us to say “we just have the feeling for it”.

We will test the movement or your nerve (neurodynamics) by evaluating how your nerve reacts under tension and if it is able to slide like it should. Our Physios palpate (“feel”) along your nerve’s pathway to test each of the possible points where your nerve can be pinched. We perform a series of tests to get a clear picture of what we are dealing with. This allows us to treat you optimally, give you the right exercises and the right advice for your problem.  We don’t just want you to get better – we want you to stay better.

Sciatica is caused by compression or irritation of the nerves coming from different areas op the spine – L4, L5, S1, S2 and S3. Each level will have different symptoms and your physiotherapist knows how to test each specific level.

  • Dermatomes

Each nerve that leaves the spine supplies sensation to specific areas of your body; these areas are called dermatomes. By finding the area of sensation that is affected, we can accurately determine at which level the nerve irritation or compression is. Sensations we will test are pressure (light touch and deep pressure) and temperature (hot and cold) on each level.

The L4 dermatome supplies the back of  the thigh and down to the inside of your foot, L5 supplies the top of your foot to your big toe, S1 supplies the outer part of your foot up to the middle part of your buttock and S2-3 supplies the inner part of your buttock.

  • Reflexes

Nerve compression can also affect the deep tendon reflexes and we can assess this with reflex testing.  We will test the knee jerk reflex (at your patellar tendon) as part of testing the L3-4 level and the ankle jerk reflex (at your Achilles tendon) as part of S1-2 testing. If the reflex is absent or decreased compared to the other side, this indicates a problem with the nerve carrying the message to the spinal cord.

  • Muscle power

In worse cases of nerve compression you will experience weakness in your leg. We will test the muscle power of the muscles supplied by the different levels of the sciatic nerve. To test L4 we will test lifting your foot, L5 lifting your big toe, S1 standing on your toes and S2 bending your knee.

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Sonar (Diagnostic Ultrasound)

The soft tissue (muscles, ligaments and bleeding) around the nerve can been seen with diagnostic ultrasound. The sonographer can also see swelling or bleeding and where the nerve is thickened or thinner than normal.

X-Rays

In some cases we may refer you for an X-ray to exclude any other problems. Remember that X-rays only show bones and will therefore not show us what is happening with your nerves. X-rays will only be indicated if we suspect a fracture, avulsion fractures or stress fractures.

MRI

An MRI is a very expensive test, but worth every cent in this case if indicated. We can see all the different structures in your hip (muscles, ligament, disc, tendons and nerves). It may become necessary if your pain doesn’t respond to conservative treatment or if we establish that there are multiple problems causing your pain. This is when it becomes important to distinguish between each problem area’s impact and severity.

“Why is my sciatica pain in my hip not going away?”

A direct blow to the buttock can cause bleeding in the area, disruption of blood supply to your nerve and an increase in pressure around your Sciatic nerve. This causes nerve irritation.  This nerve pain in your hip or leg gradually eases as the area heals.  However, the injury can cause muscle weakness & scarring near the nerve, which affects the normal movement of the nerve (neurodynamics). Scar tissue restricts the nerve to move. This means that the pain and discomfort doesn’t go away completely.

If you rest you will find that there are times when you don’t have pain, but as soon as you return to training or sit for a long period of time the pain comes back. Rest will cause further weakness of already weakened muscles, so just resting will not solve the problem.  When you avoid activity,no pain, but as soon as you start your normal movements again your pain returns. Proper rehabilitation involves exercises to improve the strength of the muscles around the hip and restoring the normal movement of the nerve.

Nerve conduction is the impulse, or message, being carried through the nerve to the spinal cord and brain. The impulse takes time to travel to the spinal cord which is known as latency. If you have a nerve injury this latency could be increased, so if you do something that aggravates your symptoms like sitting in a hunched position for hours you may not feel the pain in the moment, but that afternoon. It makes it difficult to judge what really makes the pain worse. Was it the training, sitting or lying that made it worse. but after a while you will feel the pain again.

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What NOT to do

  • Anti-inflammatory medications are not recommended in the first 24 hours if your pain is due to direct trauma, as this could increase the bleeding and delay healing.

  • Stretch through your pain.

  • Walk with a crutch

  • Walk, run, jog through the pain.

  • Strength training through the pain.

  • Constantly rubbing the painful area can further irritate the nerves supplying the skin.

  • Foam rolling will also further irritate the nerves supplying the skin.

  • Leave it untreated, if you are uncertain of the diagnosis, rather call us and be safe.

What you should do

  • Make an appointment to confirm the diagnosis and determine the severity of your problem.

  • Call us if you recognize any of the symptoms of sciatica hip pain – it is important that you receive a professional opinion as soon as possible.

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Making the injury worse

  • Climbing stairs.

  • Running uphill.

  • Stair running drills.

  • Sprint running drills

  • Single leg jumps.

  • Driving.

  • Sitting at your computer for prolonged periods of time.

  • Walking through the pain.

  • Jumps.

  • Sitting cross legged.

  • Sitting on the floor with your legs straight.

  • Standing in a hunched over position.

  • Cycling.

A Big Problem we see with Sciatica & nerve pain

We often find that patients with a pinched nerve in their hip want to “stretch it out”.  The nerve irritation causes muscle spasm and stiffness in the area and patients feel that stretching will relieve their pain.  However, the nerve is already sensitive and extra tension will only make it worse.

If your pain is so severe that you cannot step on your leg you may end up using crutches for pain relief. A couple of days on crutches can be useful during treatment, but we see problems that arise from using crutches for weeks or months without getting treatment for the cause of the pain. When using crutches for an extended period of time, the muscles in the affected leg will get weaker because they are not being used properly. Some patients also develop compensatory back pain due to bad posture from walking with crutches. The other hip can also develop pain due to this bad posture, as there is extra tension on the muscles on that side to compensate for the weakness on the painful side.

Another problem we see is that patients wait until the pain is quite severe before making an appointment.  By this time the pain has caused muscle weakness in the area and they have picked up bad habits like sitting with all of their weight on the other buttock to avoid the pain. We have seen patients who have suffered from sciatica hip pain for months before making an appointment, so if your pain doesn’t improve in 3 or 4 days you should get a professional opinion. This is not a condition that just heals on its own.

Physiotherapy treatment for sciatica & hip pain

Physiotherapy for sciatica hip pain will depend on your symptoms and goals of treatment.

If you have an acute injury, for instance after a fall on your buttocks, we would use electrotherapy modalities like ultrasound and laser to help with swelling and support the healing process.  We might also use acupuncture or dry needling and soft tissue massage to relieve muscle spasm in the painful area.  Strapping with kinesiology tape or rigid taping is useful for pain relief and when we start with strengthening exercises.

If your injury had a more gradual onset we will need to eliminate aggravating factors first. This could be anything from changing how you sit when you work on your computer to the position you sleep in.

How often you come for treatment will depend on how your pain started. If you had an acute injury we will need to see you twice a week for pain relief and once a week after that for rehabilitation. You will need 4 to 6 treatments over a period of 6-8 weeks.

For sciatica hip pain that developed over a period of time we will also see you twice a week, initially, but your rehabilitation might take up to 12 weeks. When your pain settles we will see you once a week. As pain the goals of treatment move towards rehabilitation, rather than pain relief, we will see you every second week to check on your progress and change your exercises.

Nerve conduction

The speed & intensity that an impulse can travel along your nerves are called conduction. When nerve’s impulses are interrupted from nerve injury, we must ensure your nerves can relay a message across your body. Like a cellphone with bad signal. Our treatment works on the pinched Sciatic nerve to restore its conduction.

Motor unit recruitment

When a muscle should contract the brain sends a message to a motor unit in the muscle. When the impulse reaches the motor unit, other motor units automatically fire, leading to a stronger muscle contraction. This is called motor unit recruitment. If you have pain, the motor recruitment is decreased, so you have a weaker muscle contraction. In our treatment we will use motor control exercises to restore the normal muscle contraction. This is especially important to make sure that your movements are synchronized and that muscles fire in the order that they should to prevent compensation later on.

Nerve glide

Another important part of your treatment will be to ensure unobstructed glide of the nerve during movement. The sciatic nerve leaves the spinal cord through an opening and passes through different muscles as it runs down the leg. Each of these areas could possibly pinch the nerve and we will treat the whole nerve to make sure it can move the way it should.

During our assessment we will identify where the nerve is pinched and this will determine our treatment techniques. We may use spinal mobilisations to improve vertebral joint movement, massage and dry needling to treat muscles that irritate the nerve and electrotherapy to support the healing process.

Full range of movement

Before the end of your rehabilitation we will make sure you have full range of movement under muscle tension. This means that we will add exercises that put the nerve under tension to make sure your pain doesn’t flare up again. For instance cycling uphill or doing weighted deadlifts.

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Sciatic Nerve & Hip Pain

1st Phase: Protection & initial Healing (week 1)

The main goal of this phase is to stop irritation and damage to the nerve tissue. We will guide you on what to do and what not to do, like stooping over a kitchen counter. The biggest part of your treatment during this phase will be education – teaching you what is happening, why it’s happening and what we’re going to do about it.

The inflamed tissue around the nerve can be managed using a combination of muscle relaxant medications and anti-inflammatories while the nerve’s sensitivity can be suppressed using Central Nervous system suppressors. We will also use laser to speed up the healing process and strapping to support the area.

3rd Phase: Localize the area of nerve irritation

Our goal is to pinpoint the exact part of the nerve causing your pain and focus our attention on treating the structures surrounding it. We aim to get rid of the pain that radiates down your leg.

In this phase you will find that the referred pain radiating to the bottom of your foot will go away and your pain only travels as far down as your thigh. Treatment will involve dry needling and massage to treat the muscles of your hip and joint mobilisation to your lower back to improve movement between the vertebrae.

5nd Phase: Motor unit recruitment

An impulse from the brain ends at the motor unit on a muscle – like where a power cable is attached to a lamp. The motor unit will fire and cause the muscle to contract when it receives the message from the brain. Under normal circumstances this will lead to the firing of other motor units in the surrounding muscle fibers.

Nerve injuries cause inhibition of this mechanism, so the resulting muscle contraction isn’t as strong as it should be. This will cause compensation by other muscles around the hip to make up for the weakness. It also leads asymmetry of your movements or that movements occur in the wrong order compared to the other hip.

We will use specific motor control exercises to correct the motor recruitment. Initially you will do easier exercises only involving one specific movement in an easy position, like lying on your back, to retrain your brain. As your treatment progresses we will add more complex exercises in more unstable position, like standing on one leg, to correct motor recruitment in any and all conditions.

7th Phase: Full range of motion with load

Normal nerves glide during body movements and can tolerate tension or compression caused by joints moving and muscles contracting. When a muscle is loaded it increases the tension in that muscle even more and will cause irritation of an injured nerve.

We will use exercises that put the nerve under tension – like cycling or deep squats – and then add load like resistance or weights. The extra load will add even more tension or compression to the nerve. After this phase of rehabilitation the nerve should not flare up during or after these kinds of exercises.

2nd Phase: Regain Normal Nerve movement

This involves nerve mobilization techniques to restore the movement of the nerve during everyday activities like walking or getting up from a chair. Early in the rehabilitation we will teach you nerve gliding movements to do as home exercises. All the nerves in the body are connected, so if the exercises are too painful we can also use gliding movements of the opposite side. As soon as the pain improves we will change to exercises to the affected side.

We use massage, stretches and neurodynamic mobilizations to achieve this range of movement. This will also prevent recurrence of the problem.

4nd Phase: Desensitizing free nerve endings

Free nerve endings send messages to the brain if a certain input (sensation) is too strong and could potentially cause damage. When the message reaches the brain, it will be interpreted as pain.

With a nerve injury you will notice that sensations that shouldn’t be painful cause pain, like gentle pressure or cold. We call this sensitization.

The goal of this phase is to improve the sensitivity of the painful area. Treatment will focus on gradual increase in pressure, heat and cold to basically retrain the nerve endings. At the end of this phase you will be able to tolerate normal sensations on the previously painful area.

6th Phase: Restore nerve glide through full range movement

The hip is a ball-and-socket joint which means that it has a lot of movement. If you go down into a deep squat or bend down to touch your toes the hip goes into flexion (bending). When you stand up from a chair the hip goes into extension (straightens). Under normal circumstances the nerve can glide to tolerate all these movements, therefore movements of the hip are not painful.

The sciatic nerve runs down the back of the hip and thigh and all the movements of the hip will affect the nerve. Bending forwards puts tension on the nerve, like pulling on a piece of string and if the nerve is pinched your movement will be limited. Leaning backwards will compress, or squeeze, the nerve in your back and if the nerve is irritated or pinched this will cause pain.

This phase of rehabilitation will focus on restoring this glide of the nerve during all the movements of the hip. We will use nerve tensioning exercises, muscle stretches and complex movements like burpees to make sure the nerve can tolerate changes of position through all hip movements.

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How long does Sciatica nerve pain take to heal?

A pinched nerve in your hip be either acute or chronic.

  • Acute sciatica hip pain takes about 4-6 weeks to heal.  The initial severe pain improves within the first week, but the condition can take up to 6 weeks to to go away. However, without treatment and rehabilitation the hip and leg pain will take longer to improve and return again.
  • Chronic sciatica hip pain develops gradually and, without treatment, the condition could persist for months or even years. An acute episode becomes chronic if the Sciatic nerve pain around your hip doesn’t dissipate within 2 months. The longer you wait, the longer the healing time. If you do not receive treatment for the pinched nerve, you’ll need surgery to prevent permanent nerve damage.

Other medical treatments for sciatica pain in your hip

  • Your doctor can prescribe pain medication, muscle relaxants and anti-inflammatories to help with pain relief. Medication will not solve the problem, but it is a useful adjunct to therapy.
  • neurosurgeon can inject cortisone and a numbing agent into the spine to relieve nerve pain.
  • Crutches may be useful for a few days if you have severe pain with walking.
  • biokineticist can help with final rehabilitation and strengthening once a physiotherapist has treated your pain.
  • Topical rub combined with gentle massage may give temporary pain relief in the area.
  • Insoles in your shoes can also be a useful adjuct to therapy if you have a leg length difference or overpronation (flat feet).
  • An adjustment from a Chiropractor may help with pain relief, but rehabilitation would still be crucial to prevent recurrence of the problem. If the adjustment helps with the cause of sciatica the muscle weakness and nerve damage must still be addressed.

Surgery for Sciatica hip pain

If a pinched nerve in your hip is left untreated or if conservative treatment fails you may need surgery to prevent permanent nerve damage. This is a last resort for sciatica hip pain.

The surgery performed will depend on the cause of your pain:

  • A discectomy will be performed if the nerve pain in your hip is caused by a slipped disc.
  • You may need spinal decompression and fusion surgery if your pain is due to spondylolisthesis.
  • A laminectomy will be performed if your symptoms are caused by spinal stenosis or narrowing of the intervertebral canal.
  • If the piriformis muscle is the cause of your symptoms a surgeon will cut through the piriformis muscle to relieve pressure on the nerve.

Also known as:

  • Pinched nerve in hip
  • Hip nerve pain
  • Burning hip pain
  • Buttock pain

Other Causes of Sciatica & Hip pain

Hip joint pain – If you have a problem with your hip joint, your pain is a deeper, dull ache.

Labrum tear – Usually with groin pain and sometimes hear a clicking sound with hip movement.

Osteoarthritis of the Hip joint – One of the main characteristics is marked stiffness in the mornings or after sustained positions. The stiffness goes away with movement.

Referred pain from your lower back – A dull ache in your buttocks that is difficult to pinpoint. The ache gets worse with specific movements of your lower back like leaning backwards.

Femur Fracture – Sudden pain after an incident, like a car accident, and you wouldn’t be able to take weight on the leg. You

Gluteus muscle strain – A deep, dull ache that comes and goes and is relieved by movement.

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