Sciatica is a common diagnosis of pain in the lower back, hip, and legs. Sciatica is usually caused by a herniated disc in the lower back, but it could also be related to other conditions, such as sacroiliac joint dysfunction or piriformis syndrome. Since sciatica is a common cause of radiating pain, it is easy for other conditions that cause such pain to be misdiagnosed as sciatica. Misdiagnosis means mistreatment.

As a patient or medical professional, it is important to be aware of all possible causes of pain to ensure proper diagnosis and treatment. The following conditions can mimic aspects of sciatica.

hip bursitis

Bursa is a sac of fluid that allows two parts of the body to move smoothly over each other. A tendon runs along the outside of the upper femur, and a bursa rests between them to prevent friction. Inflamed hip bursa causes hip bursitis. The tendon moves through the bursa and hip with each movement of the leg; if the bursa is inflamed, this movement will cause pain. This pain can radiate throughout the pelvis, affecting the lower back, buttocks, and groin.

Hip bursitis is only common in athletic people who run a lot and those who have had hip surgery. It can also appear in people who have fallen hard on the hip. Many of its symptoms are similar to those of sciatica and it can be misdiagnosed as such. People with hip bursitis often have visible swelling at the bursa site and pain when this area is affected; this is not a symptom of sciatica and can be used to distinguish between the two conditions.

Femoral nerve entrapment

The femoral nerve leaves the spinal column at the second, third, and fourth lumbar vertebrae and runs down the front of the thigh. This nerve provides sensory and motor functions to the groin and the front of the thigh.

On its course from the lower back to the leg, the femoral nerve passes through the psoas muscle. This muscle runs from the top of the thigh bone to the lumbar spine and assists in movements that bring the lower and upper body closer together. If the psoas muscle is tight and inflamed, it can compress the femoral nerve, causing referred pain throughout the groin and down the leg.

The femoral nerve can also be compressed in the groin crease due to static “frog-legged position,” such as when riding a horse. It can be compressed using tight belts or by impact. Radiating pain caused by compression of the femoral nerve can be mistaken for a symptom of sciatica. Pain radiating from the femoral nerve is likely to be in the front of the thigh, while sciatica pain tends to be more concentrated in the back of the thigh. This can help decipher the true cause.

trigger points

Trigger points are knots that form in the connective tissue of muscles. They are made up of tissue in isolated spasms and usually occur from overuse of a muscle over time. Trigger points can refer pain to other parts of the body. When these knots form in the muscles of the lower back or buttocks, they can refer pain along the same path as the sciatic nerve. Check out Neuromuscular Therapist Christina Abbott’s blog at http://abbottcenter.com/bostonpaintherapy/?p=3447 for more on this.

Hip bursitis, femoral nerve entrapment, and trigger points in the core muscles can cause symptoms similar to those of sciatica. Avoiding common misdiagnoses will help ensure that you receive the proper treatment for the cause of your pain.