Have you ever felt that deep electric shock-like leg pain? Would it surprise you to learn it is coming from your back?
At the point where the spinal cord exits from the back, it forms little spaghetti like structures, called nerve roots. When nerve roots are irritated, they can cause a radiating pain down the back of your leg along the path they travel.
But why do nerve roots become irritated in your back?
There are three main reasons why:
Mechanical Disc Bulge
Discs work to absorb shock and provide cushioning between vertebrae. When you bend or extend through your back it is normal for the disc to shift forward and backwards.
Sometimes with prolonged bending or heavy lifting, the disc can bulge out. Because nerve roots are next to discs, this bulging can take up the space needed for the nerve roots. Therefore a disc bulge which will naturally irritate nerves.
The good news is mechanical bulges can settle without surgical intervention through specific physiotherapy treatment and posture modification.
Inflammation
Injury in surrounding structures, such as a lumbar joint sprain, triggers an inflammatory response. Inflammatory cells gather at the site of injury to begin healing and repair.
Nerve roots that are close to the site of injury can be irritated by these inflammatory cells which will then be felt as leg pain.
Physiotherapy can help by providing manual therapy and advice to settle inflammation.
Neural Tension
Your nervous system is effectively one complete structure starting at your brain → spinal cord down your back → nerve roots out of your spine → down your legs.
As the nerves cross many joints in the body they need to slide, bend and elongate as the body moves. However, prolonged and repeated elongation can cause neural irritation.
The picture below shows a ‘slump position’ that causes peak neural tension.
There are many positions in our day to day life that cause neural tension.
Looking down at phone
Kicking a football
Sitting with your feet up
Slouching
Your Physiotherapist will go through positions in your day to day life that could be causing neural tension, and work through solutions to minimise this neural irritation and settle down your pain.
Your physiotherapist will also show you techniques to improve your nerve mobility and prevent a reoccurrence.
In Summary
The cause of the pain in your bum or down the back of the thigh has had many syndromes to describe it. These can range from piriformis syndrome, pinched nerve, sciatica or even SIJ. Thankfully, Physiotherapy has become significantly more sophisticated and we now understand better the importance of neural elongation along its pathway through the body.
The nerve doesn’t get pinched or caught, rather it can be irritated and sensitised from the three reasons outlined. Physiotherapy will identify why the nerve is irritated, settle the pain and give you tools to learn how to manage the nerve irritation independently – so you can say goodbye to the electric leg pain.
