Pain that begins in the right hip and travels down the leg is a common symptom. This sensation, often described as a deep ache, burning, or sharp jolt, indicates irritation of a major nerve or surrounding soft tissues in the lower back, hip, or pelvis. Pinpointing the exact source of this radiating pain is the first step toward effective relief, as the cause may originate far from where the discomfort is felt. The pain traveling from the hip area to the thigh, calf, or foot suggests a mechanical problem affecting the nervous system or a localized inflammatory process.
Understanding the Sciatic Nerve Pathway
The anatomical pathway of the sciatic nerve explains why hip discomfort can extend far down the leg. The sciatic nerve is the largest single nerve in the human body, formed by the convergence of nerve roots originating from the lower lumbar spine (L4, L5) and the sacral spine (S1, S2, S3). This nerve travels deep within the buttock, passes down the back of the thigh, and splits near the knee into the tibial and peroneal nerves, which continue to the foot.
Any compression or irritation along this route can cause symptoms to radiate along its entire length. When the nerve root is compressed near the spine, this is known as radiculopathy. When the nerve itself is affected anywhere along its path, it is commonly called sciatica. The radiating pain typically affects only one side of the body, which helps clinicians trace the location of the irritation. Symptoms often include sharp, electric-like pain, numbness, tingling, or muscle weakness in the foot or ankle.
Spinal Conditions Causing Nerve Compression
The most frequent source of radiating hip and leg pain is a structural issue within the lower spine that directly impinges upon the sciatic nerve roots. These conditions cause pain that originates centrally but is experienced peripherally in the hip and leg. Even minor pressure on the highly sensitive nerve roots can produce intense symptoms that travel along the nerve’s distribution.
Herniated or Bulging Disc
A herniated or bulging disc is a primary culprit, often accounting for the majority of sciatica cases. Intervertebral discs act as shock absorbers between the vertebrae. When the tough outer ring tears, the soft inner material can push outward, compressing a nerve root as it exits the spinal column, commonly at the L4-L5 or L5-S1 levels. This mechanical pressure, combined with inflammatory chemicals, results in intense, shooting pain that radiates down the leg.
Spinal Stenosis
Spinal stenosis describes the narrowing of the spinal canal or the small openings (foramina) through which the nerve roots exit. This narrowing is often a degenerative process caused by age-related changes, such as the thickening of ligaments or the formation of bone spurs. Standing upright or walking for prolonged periods typically exacerbates symptoms, as these positions further reduce the limited space and increase pressure on the nerve roots.
Spondylolisthesis
Spondylolisthesis involves a vertebra slipping forward over the vertebra directly beneath it, typically in the lower lumbar spine. This misalignment reduces the space available for the nerve roots, causing mechanical compression and subsequent radiating pain. The slippage can also contribute to foraminal stenosis, where the nerve exit path is narrowed, leading to symptoms that mimic sciatica.
Localized Hip and Pelvic Issues
Not all radiating pain stems from the spine; several conditions localized to the hip and pelvis can mimic spinal nerve compression. These issues involve soft tissues or joints in the hip region that cause pain to refer down the leg.
Trochanteric Bursitis
Trochanteric bursitis, often categorized as greater trochanteric pain syndrome, involves inflammation of the bursa located over the greater trochanter on the side of the hip. This inflammation causes localized tenderness at the outer hip and can result in pain that radiates down the lateral side of the thigh. The pain is typically worse when lying on the affected side or during activities like walking or climbing stairs, but generally does not extend past the knee.
Piriformis Syndrome
Piriformis syndrome occurs when the piriformis muscle, situated deep in the buttock, tightens or spasms and irritates the sciatic nerve. Because this muscle is located near the hip and directly over the nerve, its irritation can produce pain, tingling, and numbness that closely resembles true sciatica originating from the spine. Symptoms are often aggravated by prolonged sitting, especially if the muscle is compressed against the nerve.
Sacroiliac (SI) Joint Dysfunction
Sacroiliac (SI) joint dysfunction involves the joint connecting the sacrum to the ilium (the hip bone). Dysfunction can arise from either too much or too little movement in this joint. When irritated, the SI joint can cause pain localized to the buttock and hip area that may refer down the back of the leg. This pain most commonly remains above the knee and is felt as a deep, achy sensation in the buttock or groin area.
When to Seek Medical Attention
While many causes of hip and leg pain improve with conservative measures, certain symptoms warrant immediate medical evaluation. The sudden onset of severe pain, especially following a fall or injury, should prompt urgent consultation to rule out a fracture or serious soft-tissue damage. Pain that is unrelieved by rest, is rapidly worsening, or interferes significantly with sleep also requires professional assessment.
Specific “red flag” symptoms indicate a potentially severe condition that requires emergency care to prevent permanent neurological damage. These include new or sudden weakness in the leg or foot, such as foot drop, or the sudden inability to control bowel or bladder function alongside leg pain. If self-care measures, such as rest and over-the-counter pain relievers, fail to provide relief after one to two weeks, consult a healthcare provider for an accurate diagnosis.