One of the hardest parts of my job as a Physical Therapists is also the coolest. I have to figure out why you have pain, and I also have to know how to treat it. It’s actually the reason why I decided to go to PT school way back in the day (I feel so old when I think about when that was). There are multiple injuries that present the same way in the clinic. One of the most common injuries that I have to tease out is pain in the back of the thigh. People always think its a hamstring strain, but sometimes it can be sciatica. How do you know what it is, and how do you treat it?
The symptoms of a hamstring strain and sciatica are very similar. Pain in the back of the thigh that can worsen with activity, and also worsen when you stretch the hamstring. The treatment to fix a hamstring strain is very different than how you would treat sciatic symptoms though. Furthermore, if you treat sciatica with a treatment plan for a hamstring strain, it will probably make your sciatica worse. So how do you figure out what is causing the pain in the back of your thigh? Read on my friends.
The easiest way to discern between sciatica and a hamstring strain is to use what’s called a slump test. Sit at the edge of a bed with your legs dangling off the floor. Slouch down (this is literally the only time a PT will tell you to slouch) bringing your chin to your chest, raise the foot of the leg that is injured and kick your leg up straight. This should reproduce your pain whether you have a hamstring strain or sciatica. Now comes the cool part. Perform that same move again until you feel the pain in the back of your leg and staying slouched, with your leg out straight, point your foot away from you and look up. If that helps with the pain in the back of the leg, it's not your hamstring, it's your sciatic nerve that is causing your pain.
Now let’s just assume you perform the test and you now know you have sciatica. What do you do about it? Most people when they have pain in the back of the leg will stretch it. When it comes to sciatica that is the worst thing you can do. It only irritates the sciatic nerve. Instead, lie your back kick the opposite leg up in the air keeping it straight. This will add mobility into your nervous system and start to alleviate the sciatic symptoms you have been dealing with. Isn’t PT cool? I think so.
Hopefully this helps you with the leg pain that you have been dealing with. If you have any questions or comments please contact me. If you did the test and it turns out you have a hamstring strain, the treatment for that can be a little more complicated.
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