There are many possible contributors to hip pain — and sciatica, which actually comes from the Greek word for hip, ranks high on the list. Though you may feel sciatica pain in your hip, the problem originates with nerves in your back. 

Sciatica usually only affects one side of the lower body, and although the pain and discomfort typically resolve on their own over a few weeks, sciatic pain and symptoms can be challenging and affect your daily routine and activities. “Patients sometimes say it hurts if they sit, stand, or walk for too long,” says Caitlin Shaw, PT, DPT, a physical therapist at Hinge Health Health. “It can even affect sleeping for some people because we can’t really control what we do, or how we move, in our sleep.” 

Although a lot of different factors can affect sciatic symptoms, there are many simple measures you can take that can help. Here, learn how to prevent and treat hip pain related to sciatica — especially with exercises from our Hinge Health physical therapists.

What Is Sciatica?

Sciatica occurs when your sciatic nerve becomes pinched, irritated, or inflamed. The largest and longest nerve in the body, the sciatic nerve is actually made up of five nerve roots located in the base of your spine. They come together to form a right and left sciatic nerve that runs from your lower back through your hips and buttocks and down the back of your leg into your foot and toes.

You can get symptoms of sciatica, including pain, weakness, numbness, or a pins and needles sensation, anywhere along the neural pathway — from the lower back through the hips, buttocks, or down your legs. Hip pain related to sciatica can occur in the anterior (front) hip, lateral (side) hip, or posterior hip (aka the butt). It can appear suddenly or slowly and can vary from mild to severe. 

Sciatica and Hip Pain: A Hinge Health Perspective

As you may already know, hip pain from sciatica can really impact your day-to-day routine. It can affect your work, family time and activities, and some of your favorite hobbies. For some people, the pain is unlike anything they’ve experienced in the past. The good news is: It can — and usually does — get better within days to weeks. If you’re struggling, know that there are a lot of things you can do to help speed your recovery. And the solution often starts with moving more. 

Easing up on activity for a day or two when the pain is hard to bear is okay, but taking action with therapeutic exercises is the key to improving your symptoms. As our Hinge Health care team says, movement is medicine. 

How Sciatica Causes Hip Pain

In some cases, sciatica-based hip pain stems from a herniated disc. This is when one of your spinal discs — the “shock absorbers” that separate and cushion your vertebrae (spinal bones) — pushes through its outer ring. If inflammation around the disc irritates the nerves, it can cause symptoms such as back pain and hip pain. It’s worth noting that discs are designed to bulge so we can move. A herniated disc is only a problem if it catches a nerve root and causes symptoms. 

Other potential causes of sciatic hip pain include: 

• Spinal Stenosis. It’s normal for the spine and the discs between vertebrae to change over time. This isn’t necessarily a bad thing, though it can cause the space around the spine to narrow for some people. This tightened space can cause the nerve roots that contribute to the sciatic nerve to become irritated.

• Prolonged sitting. Most people experience symptoms when they stay in the same position for too long, whether that’s sitting, standing, crouching, kneeling, or lying down. Sitting tends to be a problem for more people because many of us have to sit for long periods of time — say, for work. This can increase the pressure placed on your spinal discs and contribute to hip pain. It can also cause muscles around your hip to tighten, which may put extra pressure on the sciatic nerve. 

• Wearing tight pants or underwear. This is one many people don’t think about, but squeezing into clothing that’s too small or restrictive can increase pressure along the sciatic nerve, says Dr. Shaw. “This isn’t going to cause sciatica, but it could further irritate an already irritated nerve.” 

• Wearing high heels. High heels can cause your hips to tilt unevenly. This isn’t a problem for many people, but if you’re prone to sciatic hip pain, it can be a factor in your pain. Opt, instead, for flat shoes with good support to help with shock absorption (even if you sit for much of the day). If you have flat feet, you could try shoe inserts and arch supports (orthotics). 

• Issues with the piriformis muscle. Some people refer to this as piriformis syndrome, but there's actually some debate about whether this is different from sciatica. The sciatic nerve runs under the piriformis muscle, a flat, narrow muscle in the buttocks. If your piriformis muscle spasms or becomes tight and compresses an area of the nearby sciatic nerve, it may cause a burning or shooting pain in the back of the hip that may travel down the leg. This can be caused by repetitive movements, such as long-distance running, and sitting for long periods of time. (In these cases, your body may be sending a message that it needs more variety in movement.) 

How to Relieve Hip Pain From Sciatica

Most symptoms of sciatica go away within a few weeks, but these treatment options can help speed your recovery: 

• Ice and heat therapy. Alternate between ice and heat packs, based on what feels best for you. Most people prefer to use ice for the first few days of a pain flare, then switch to a hot pack or heating pad. “Ice decreases inflammation around the nerve and can help with symptoms,” explains Dr. Shaw. The heat helps relax the area and decrease muscle spasms.

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

• Physical therapy. A physical therapist will teach you exercise movements that decrease sciatic hip pain by reducing pressure on the sciatic nerve. You’ll also learn targeted moves to strengthen your lower back and surrounding muscles and improve muscle flexibility. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

When to see a Doctor

Most people with sciatic hip pain do not need to see a doctor to get symptom relief. You should, however, call your healthcare provider if:

• Your pain gets worse after a few weeks of trying at-home treatments 

• You lose feeling in your affected leg or notice weakness in your leg

• You have difficulty controlling your bladder or bowels

One of the most important treatments for sciatic hip pain is exercise. It’s important to keep active when you have sciatica, even if you’re unable to do as much as usual. Movement builds strength in the areas around your sciatic nerve, making you more resilient to injuries and pain flares in the future. Here are a few top exercise recommendations by Hinge Health physical therapists for sciatic hip pain. 

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.

PT Tip: Don’t Forget Your Feet

Flat feet or excessive pronation — when your feet hit the ground and roll inward — can create more internal rotation on your upper leg that, in turn, puts extra stress on your piriformis muscle, Dr. Shaw explains. “If that’s you, consider shoe inserts to help support the arches of your feet.” This may help alleviate sciatic hip pain. Just know that if you do have flat feet, you’re far from doomed. Plenty of people with flat feet never experience sciatic pain, and many people with pain have perfectly arched feet. Flat feet or excessive pronation may be contributing factors to your pain, but they’re not the only reason for it, and there are many ways to manage and prevent pain. 

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. Sciatica. (2020, March 5). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/12792-sciatica

2. Help, My Hip Hurts! And Other Signs of Sciatica. (n.d.). Steel City Spine Orthopedic Center. https://www.steelcityspine.com/blog/help-my-hip-hurts-and-other-signs-of-sciatica

3. Sciatic Nerve. (2021, June 15). Cleveland Clinic. https://my.clevelandclinic.org/health/body/21618-sciatic-nerve#:~:text=Your%20sciatic%20nerve%20is%20a,and%20sensory%20(sensation)%20fibers.

4. Sciatica. (n.d.). University of Utah Health. https://healthcare.utah.edu/spine/conditions/sciatica#:~:text=Schedule%20an%20Appointment%20with%20Our%20Sciatica%20Specialists&text=You%20can%20schedule%20an%20appointment,provider%20to%20see%20a%20specialist.

5. Atlas, S. J. (2022, March 15). Taming the pain of sciatica: For most people, time heals and less is more. Harvard Health. https://www.health.harvard.edu/blog/taming-pain-sciatica-people-time-heals-less-2017071212048