If your knee starts to bother you out of the blue, you might wonder, “What did I do to my knee?” Did I twist it during that golf game? Maybe I did something during a tennis match? Did I overdo it with cleaning and chores this weekend?”

Sometimes, though, an uptick in knee pain doesn’t have anything to do with the knee joint itself. In some cases, the pain may stem from issues with your sciatic nerve, which extends from your lower back to your feet and toes. Sciatica refers to pain that travels anywhere along the path of this nerve, which is the longest and largest in the body. 

“Sciatica doesn’t commonly affect the knee, but that nerve is long and it touches a lot of areas, including the knee. So it’s possible,” says Keesha Vaughn, PT, DPT, a physical therapist at Hinge Health. Knee pain that is related to sciatica often occurs with low back pain, too.

Sciatica can cause a wide range of symptoms and levels of discomfort, but there’s a lot you can do to improve pain related to sciatica. Gentle at-home stretches and exercises can be key to improving your symptoms. While taking it easy for a couple of days when the pain is acute is okay, long periods of inactivity will actually make your symptoms worse. As our Hinge Health care team says, movement is medicine. 

Here, learn more about how sciatica can sometimes affect the knee and what you can do to feel better, especially with exercises from our Hinge Health physical therapists.

What Is Sciatica?

Sciatica is a catch-all term for irritation of the sciatic nerve, which is made up of a bundle of nerve roots that join together just outside the base of your spine to form a right and left sciatic nerve. On each side of your body, the sciatic nerve then travels from your low back, through your glute (butt), and then branches off the nerve traveling down the back of your thigh, behind the knee, into the calf, and finally ending in your foot and toes. Along this pathway, the nerves control movements and sensations of the leg. 

So can sciatica cause knee pain? If something is irritating the nerve in your low back, glute, or back of your thigh, you may feel some sensations of pain in the knee. Knee pain that results from sciatica can be a symptom of an underlying condition. The most common include:

• A herniated disc in your low back that irritates the sciatic nerve due to excessive inflammation (sometimes called a pinched nerve)

• Arthritis-related changes in the spine, also known as spondylosis

• Tight glute muscles or hamstrings (the three muscles that run down the back of the thigh) 

What Does Sciatica Feel Like in the Knee?

“It really runs the gamut,” says Dr. Vaughn. Common symptoms of sciatica affecting the knee include:

• Knee pain accompanied by low back pain or pain from lower back to knee. Sometimes this discomfort can feel like a shooting, burning, or radiating pain. You might also feel numbness or tingling.

• Tightness or cramping of the hamstring in the back of your thigh or glute.

• Weakness of the knee, including feelings of the knee buckling or giving out.

How to Manage Sciatica That Affects the Knee

Sciatica occurs more commonly with age as a result of natural changes to your anatomy. But there are adjustments you can make in your daily routine that can help reduce your risk:

• Move more. Movement helps with sciatica in a number of different ways, including by strengthening your core. “The stronger your core, the more supported your low back, and therefore your sciatic nerve, will be,” says Dr. Vaughn. There’s no one-size-fits-all when it comes to exercise, so the key is to find strategies and movements that work best for you. This could include a lunchtime walk with coworkers, strength training at home or a gym, or Pilates classes. The other key is to find an exercise that you like to do. The more you enjoy movement, the more consistent you’ll be. And consistency is ultimately the key to long-term prevention and management of symptoms. 

• Take breaks from sitting. Your body craves movement. That’s why staying in the same position for too long can cause pain. While it’s important to take breaks from standing, lying down, and all other positions, people more often get stuck sitting for long stretches. “I recommend giving your back a break from sitting whenever you can,” says Dr. Vaughn. “You can stand, take a short walk around the room, or do some gentle stretching.”

• Tune into your lifting technique. Contrary to what many people think, there’s actually no right or wrong way to lift something. You may, however, benefit from modifying your lifting technique if you’re experiencing a pain flare. When you pick something up, experiment with your approach by holding the load as close to your body as possible, at the level of your belly button, and use your legs to lift, pushing through your feet. See how that feels. If it feels better, you can continue with that approach until the worst of your pain has passed. “And if you can, break up a heavy load into smaller chunks,” advises Dr. Vaughn. 

Treatments for Sciatica That Affects the Knee 

What else helps knee pain from sciatica? Sciatica will usually improve with non-invasive treatments, which may include: 

• Physical therapy. “Physical therapy tailors a program that meets you where you’re at,” says Dr. Vaughn. “It helps you recover by building strength and flexibility, to the point where you can start doing stuff on your own more and being more functional.” You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

• Over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be helpful for knee pain. It’s important to make sure that you are safely able to take these medications, based on your medical history.

• Ice or heat. Go with your preference on this one. “With low back pain and sciatica, neither ice nor heat is going to get deep enough into the tissues to make a real physiological difference, so what’s more important is whatever you prefer and feel comfortable with,” says Dr. Vaughn. 

• Integrate movement snacks into your day. Think five to 10-minute walks. “You want to keep the muscles active so that you have the ability to continue moving and staying active,” says Dr. Vaughn. 

When to See a Doctor

Listen to your body. If your pain isn’t improving after a few weeks with at-home care and exercises, or it’s getting worse, you might want to talk to your healthcare provider. You’ll also want to seek guidance from your doctor if you experience:

• Changes in bowel or bladder function

• Progressive numbness or tingling in the groin, legs, or feet

• Worsening weakness of the extremities

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Most of the time, sciatica pain is temporary and can be improved with light movement. These are some exercises recommended by Hinge Health physical therapists that you can try at home. 

PT Tip: Your Next Position Is Your Best Position

“Don’t get hung up on having and maintaining ‘perfect posture’ and alignment,” says Dr. Vaughn. Instead, if you’re experiencing sciatica symptoms, simply focus on changing positions often throughout the day.

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

1. How to Know If Your Knee Pain Comes From Your Spine. (2022, June 20). The Spine and Rehab Group. https://www.thespineandrehabgroup.com/knee-pain-cause-spine

2. Lifting heavy boxes may have triggered sciatica. (2023, February 15). UCLA Health. https://www.uclahealth.org/news/lifting-heavy-boxes-may-have-triggered-sciatica#:~:text=The%20heavy%20lifting%20that%20you,presses%20on%20the%20sciatic%20nerve.

3. Fairag, M., Kurdi, R., ALkathiry, A., Sr, N. A., Alshehri, R. S., Alturkistany, F. O., Almutairi, A., Mansory, M. A., Alhamed, M. A., Alzahrani, A. S., Sr, A. M. A., Fairag, M., Kurdi, R., Alkathiry, A., Alghamdi, N., Alshehri, R., Alturkistany, F. O., Almutairi, A., Mansory, M., & Alhamed, M. (2022). Risk Factors, Prevention, and Primary and Secondary Management of Sciatica: An Updated Overview. Cureus Journal of Medical Science, 14(11). doi:10.7759/cureus.31405