Lower Back and Leg pain

Lower back and leg pain is the most common complaint heard in the chiropractic clinic.

1. Femoral nerve

There is a strong association between what you are feeling in the lower limb and what's happening in the lumbar spine, pelvis and hips; very painful radiating nerve pain emanating from the lumbar spine or the pelvis may cause pain, numbness, weakness and tingling in the feet and legs.

Diagram showing the femoral nerve, a common cause of lower back and leg pain.

From the mid to upper lumbar spine, a pinched femoral nerve may cause lumbago and or buttock and lower limb pain that radiates along the side, front or inner part of your thigh and down the inner lower leg. It can also cause pain in the groin and even the labia and scrotum.

Early in the condition, the leg may become super sensitive to a pin prick, for example. Later it becomes numb. If there is muscle weakness, it  usually affects the quadriceps muscle. The knee will feel like it's going to give on the stairs.

If the femoral nerve is involved then the knee jerk reflex may be disturbed, and weakness of the quadriceps muscle may develop, leading to a marked limp. 

You can test the quadriceps muscle by springing on your leg and comparing the strength of the thigh muscle of the naughty leg as compared with the other one.

If the muscle gives at the knee, allowing it to give, then the quadriceps thigh muscle is suspect and you should consider chiropractic help sooner rather than later. Before there are mutterings about lumbar spinal surgery.

Using a needle, lightly prick the side and front of the thigh, and inner lower leg, and compare with the other leg.

But once the muscles are affected the lower back and leg pain will usually be severe, often a deep gnawing, inescapable ache in the limb.

The involved muscles, particularly over the lateral thigh may become extremely sensitive to the touch, with a deep aching pain. Gentle massage down the side of the leg helps.

Meralgia paresthetica and Maigne's syndrome are two conditions causing pain and numbness on the side of the thigh, or groin or front of the leg. Both respond to chiropractic help but often the capsule in the groin must also be addressed.

The superior cluneal nerves are supplied by L1 to 3 too and may cause severe buttock pain.

2. Sciatic nerve

From the lower lumbar spine, a pinched sciatic nerve causes lower back and leg pain which extends usually down the back of the leg, reaching into the calf and foot.

A diagram of the sciatic nerve roots which are the most common source of neurlogical leg pain.

If the sciatic nerve (mainly L4, L5 and/or S1 nerve roots) is involved, then the Medial Hamstring reflex, or the Achilles reflex will diminish. Weakness of the lower leg muscles or great toe may occur. Can you stand on your toes? Raise the big toe? Stand on your heel? If not you should seek Chiropractic help immediately. You are on the verge of lumbar surgery.

Lower Back and Leg pain

Lower back and leg pain go hand and glove together; an irritated or pinched nerve causes tingling, numbness and a deep ache in the limb.

A diagram showing the sciatic and femoral nerve dermatome patterns.

FEMORAL NERVE : Roots L2, L3 & L4 (front and side of the thigh pain especially)

SCIATIC NERVE : Roots L4, L5 & S1 mainly (lower leg and foot pain especially)

Tingling in feet

Tingling in feet and legs, more usually in one limb only, is a common feature of this lower back and leg pain syndrome.

The disc joint (some authorities report that the L4 LUMBAR SPINE is particularly vulnerable), the facet joints, a restricted spinal canal (Lumbar Stenosis) and the Piriformis syndrome can all cause LOWER BACK AND LEG PAIN and tingling in the limbs. So can a host of neurological other conditions. It's best not to jump to conclusions.

Slump test for sciatica

A relatively simple tests for a pinched sciatic nerve can be done at home, if you are experiencing lower back and leg pain. Interpretation of the results of the Slump Test for sciatica can be a lot more difficult though; it's work for the experienced clinician.

Test the muscles in your leg

In just two minutes with the aid of a kitchen chair only, you will know if you have paresis in the leg.

To start with, can you raise your big toe off the ground?

The extensor hallucis extensor muscle, or EHL, is often affected by lower back and leg pain.


There's nothing simple about lower back and leg pain, but I think a series of chiropractic help adjustments is the way to go before having surgery; but then I'm biased, of course.

But seriously chiropractors everywhere have moderate success in the treatment of these chronic lumbar conditions; we don't cure it, any more than your doctor can cure your high blood pressure.

The closest you'll come to a cure is do do follow our lumbar exercise programme faithfully every single morning before getting out of bed; and deciding resolutely not to move deep freezes and grand pianos.

Being able to recognise these slipped disc symptoms should they appear is important.

A sketch showing how the intervertebral foramen and the nerve root may cause leg pain.

Lower back and leg pain requires first and foremost a careful examination in order to determine precisely where the nerve is being irritated. Is it in the upper, mid or lower lumbar spine? Which level exactly? Could it be a facet syndrome perhaps, or the sacro iliac joint? In the groin? Could it be something more serious, possibly from the prostate gland or a blocked artery? Or perhaps even hip arthritis?

Firstly the physical exam will enable your chiropractor to determine more or less where the problem is. But to be honest, sometimes it is extremely difficult to be absolutely sure which level of the lumbar spine is involved. Quite often more than one disc or facet joint is playing up, giving a distorted or confusing picture.

That's where an xray, and better still a scan can help your doctor narrow down precisely where the problem is.

That is very important, because if she or he considers only sacroiliac joint treatment when the problem is at the lumbar 4 lumbar 5 level, then you probably won't improve.

Vital are exercises and rehabilitation, or the problem is likely to return within a short period if you have had lower back and leg pain.

Even though the pain may reduce quite quickly with chiropractic care, if you have pain radiating down the leg from a slipped disc, then it is best to assume that it will be about two months before you be sure that all is healed.

Reduced sitting, and avoiding couches, deep comfortable chairs and car seats is important. Sitting increases the pressure in the disc and inhibits healing.

Alternating ice and heat is the best painkiller and simultaneously has an anti inflammatory effect.

For more about the lumbar slipped disk syndrome, and a case file, click on the link below.

Good lumbar surgery can produce wonders with a bad lower back and leg pain sciatica where there is significant weakness and numbness in the leg. Immediate relief of pain in the leg is the rule. But if the surgery doesn't go well, then a lifetime of backpain awaits the patient.

These are not chiropractic scare tactics. Complications of surgery and Failed Back Surgery are phenomenon the medical world has written prolifically about. They are not chiropractic phrases, but those used by medical researchers.

Can you wait? is the question. If you can, then consider the back surgeries alternatives first. The New England Journal of Medicine reports on research in which 281 candidates were randomly referred to surgery or alternative care. The surgical group did indeed have much faster relief of leg pain, 4 weeks vs 12 weeks but, and here is the interesting part, after one year, there was no difference between the two groups, and a blinded investigator could not tell the difference. Can you wait?

You can be sure that after a proper trial period of Chiropractic help your chiropractor will refer you to the appropriate surgeon should s/he not be winning, which is unlikely. We treat sciatica successfully on a daily basis.

One last tidbit. Research shows that if you FIRST consult a chiropractor you are less likely to end up under the knife than if you first consult your medical doctor. LOWER BACK SURGERY


Or in normal jargon, could you have a short leg? Leg length inequality research confirms that it causes not only hip and knee arthritis, but also lower lumbar back pain. It probably ultimately is also one of the causes of lumbar stenosis. Leg length inequality and low back pain are now confirmed to be strongly associated. Not responding to Chiropractic? Has your Chiropractor considered a short leg?

Here is a leg length inequality CaseFile that might interest you.


Google appears to frown on too many links, so phrases in bold, like these leg length pages above, need to be put into the Site Search function in the navigation bar on your left if you want more information.

Journal of Neurosurgery - spine.

Although 1.5 million lumbar MRI scans are carried out each year for sciatica, at a cost of $1.5 billion, only about 300 000 or 20 percent reveal a herniated lumbar disk amenable to surgery. About one third of the surgeries fail to relieve the sciatica. As a consequence, about 1.2 million or 80 percent receive no clear diagnosis and 100,000 Americans have lumbar spinal surgery that fails.

Every year.


Mr Kort ironically is very long. Over two metres tall. For nine months he had dreadful pain last year in the lower right leg. His doctor was convinced that it was a sacro iliac syndrome, but Gert wasn't getting better. In fact it was getting worse. He was limping badly and had to stop his favourite sport, volleyball.

We hit it off from the first consultation. He noticed my tie which has in very faint letters written across it the words Jesus Christ is Lord. Like me, Gert is a Christian.

Whilst he did have a fixation in the right sacroiliac joint, it was immediately clear that this was no sSI syndrome. All the orthopaedic tests were negative, and the test that gives me the shivers was strongly positive. Raising his left leg, produced pain in the right leg; the crossed sign. Otherwise, this was a typical case of lower back and leg pain that chiropractors see on a daily basis. He had a lumbar disc protrusion.

The long and the short of it is that he responded magnificently, if slowly. I made him take two weeks leave, with absolutely no sitting, and then part time for the next month. Within six weeks he was much improved and at twelve weeks had very little pain. He took a mattress to work, and lay down every half an hour for five minutes, and did the exercises I prescribed. More important the crossed sciatic sign became negative, slowly, and the strength returned to his calf muscle. He is again playing competitive volleyball.

The long summer layoff is a problem in Europe; everybody goes on holiday. Gert played plenty of beach volleyball on his vacation with no trouble. But at the first training camp some exercises, not active volleyball, did his back in. They made him do double leg raises, a definite no no exercise. He came in three weeks ago looking like the leaning tower of Pisa. He's fine again, and we are considering whether it's time at 45 to consider stopping competitive volleyball. Certainly there will be no more training camps!

Is this an unfair case to claim a chiropractic success for Chiropractic care of lower back and leg pain? Was it simply help from above? Probably!

Intermittent claudication 

Lower back and leg pain may also be caused by an artery in the groin blocked with cigarette ash and cholesterol! The leg pain typically gets worse with exercise. Leg pain.

Smoking is the biggest risk factor in lower back surgery, in fact in all surgery. Low back pain and smoking go hand in hand.

A venogram of the pelvis showing how a blocked artery can cause leg pain known as intermittent claudication.

The right bed

Just as important as any of the above is the right bed for your back. Memory Foam Mattresses is something you should consider.

Sacroiliac Joint

The sacroiliac joint is intimately tied up with both the L5-S1 joint, and the hip joint. Without correction of a SIJ fixation both lumbar and hip joint surgery often appear to have failed.

Exercise help

Research shows that those who exercise their lower backs, along with chiropractic help, do better than the latter alone. That in fact is my own personal experience with the health of my own lumbar spine, and nearly forty years in practice.

Four years ago I myself had a very serious lumbar herniation causing severe pain and paresis down the course of the femoral nerve. It was really a surgical case, with a so-called sequestration into the spinal canal; I was saved by superlative chiropractic treatment, a realisation I had to stop and exercise help.

Now I never miss the lower back exercises you can find in the navigation bar; but I do a lot more than that, and so should you. This Beginner Ab Workout is worth a consideration; take it easy, you're not going to the Olympics!


  1. Chiropractic Help
  2. Slipped disc symptoms
  3. Lower Back and Leg pain

Stones in my Clog

Stones in my Clog is a book by chiropractor Dr Barrie Lewis telling how he manages lower back and leg pain.

Mostly, folk know very little about what actually goes on in a Chiropractic Clinic. They may have heard... bones get cracked, ribs may be broken, risk of a stroke... find out what actually happens in Stones in my Clog.

Follow me, Bernard Preston DC, during my seven year sojourn in the Netherlands. A terrifically bumpy and very fulfilling ride! A very tough language is the start; Dutch is reputedly the third most difficult language in the world.

Read this tidbit about a cyclist who got severe pain in the thigh when cycling. Everyone thought it was a Femoral nerve lesion, but no...

Only $2.99 on your smartphone or Kindle...

Did you find this page useful? Then perhaps forward it to a suffering friend. Better still, Tweet or Face Book it.

Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I have left alone. After seven treatments his pain and stiffness is 50 percent better, and he is happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti-inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He is doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost pain-free. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he is well pleased; sixty-five percent better after three treatments.

5. Mr T is a wise man; he has taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily stroll has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift; he has a short leg.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. X-rays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65-year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88-year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done. 

10. Mr X is a 71-year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a few months ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It is a non-complicated upper cervical facet syndrome, and she is doing well.

12. Mr D is a 38-year old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he could not sleep on that shoulder.

13. Mr D, a 71-year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors should not be treating the elderly most medical sites state but that is so much bunkum.

Do you have a problem that is not getting better?

Are you looking for a different slant on your pain?

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Interesting questions from visitors

CLS writes:

Greetings, Dr B.

You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.

Your own unresolved problem. Pose a question

Knowing that up to 70 percent of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there is a fair chance I can add some insight to your unresolved problem. But at least 30% of the time, I may be quite wrong. Give plenty of detail if you want a sensible reply.

You visited this chiropractic help site no doubt because you have a problem that is not resolving and want to know more about what a DC does.

The quickest and most interesting way is to read one of my eBooks of anecdotes. Described by a reader as gems, both funny and healthful from the life and work of a chiropractor, you will love them. Priced right at $2.99, though Kindle fiddles the amount without telling me.

Interesting questions from readers