Chronic lower back pain is problematic enough on its own, but when it begins to radiate through the hips and down both legs, it can become debilitating.
The searing, shooting sensations impair mobility and prevent you from carrying out your normal daily activities. Just trying to stand or walk around can be agonizing.
Whether it comes on gradually or hits you all at once, lower back pain radiating bilaterally down both legs signals a problem with one or more nerves being compressed, inflamed, or damaged.
What is the cause of lower back pain that radiates down both legs?
Lower back pain that travels through the hips and down the legs, especially on both sides, is commonly caused by compression, irritation, or damage to one of the lumbar nerve roots exiting the spinal column. The most frequent underlying diagnoses include:
Sciatica
This large nerve branch originates in the lower back and extends down the back of each leg to the feet. Any type of nerve root impingement in the lumbar spine can directly affect the sciatic nerve, triggering pain to radiate along its path down the legs.
Radiculopathy
General nerve root compression in the lumbar spine is referred to as lumbar radiculopathy.
Conditions like herniated discs and spinal stenosis put pressure on the nerve roots as they exit the spinal column through the vertebral foramen. This can happen on one side, or commonly affect bilateral nerve roots leading to pain radiating down both legs.
Degenerative Disc Disease
Degenerative disc disease is a gradual wearing down of the intervertebral discs between spinal vertebrae. It is a natural part of the aging process, but can be accelerated by injury or poor posture. As discs degenerate, they lose structural integrity and elasticity.
Spinal Stenosis
Lumbar spinal stenosis is an abnormal narrowing of the spinal canal or intervertebral foramen where nerve roots exit. This puts direct pressure on the nerve roots and compresses them, leading to sciatica-like pain, numbness, and tingling down the legs.
Stenosis can be caused by discs bulging into the canal, overgrowth of bone spurs, arthritis, or even tumors pressing against the nerves. \
Spondylolisthesis
When one vertebra slips out of alignment and shifts forward over the bone below it, this is called spondylolisthesis. This pinches the nerve roots exiting the spine and refers to pain down the legs.
Other Causes
While nerve compression is the most frequent cause of radiating back pain, other conditions can also be at play.
Pregnancy often causes sciatica and low back pain radiating down the legs due to the baby putting pressure on nerves and the extra weight straining muscles. Trauma from accidents can damage nerves. Spinal tumors or infections affecting the nerve roots may require prompt medical attention.
What exercises can help with lower back pain radiating down both legs?
Gentle exercises can help alleviate nerve compression contributing to radiating back pain down the legs. However, check with your doctor before starting any new exercise regimen.
Recommended examples include:
Walking
Low-impact cardio exercise like walking helps pump fresh blood and nutrients to the nerves to aid healing. Start with short walks and gradually increase distance as tolerated.
Swimming
The buoyancy of water prevents any jarring movements to the spine. The resistance provides a gentle strengthening workout.
Yoga
Gentle yoga poses like a child’s pose stretch the lower back muscles. Avoid any positions that aggravate radiating leg pain. Listen to your body.
Stretches
Hamstring, hip flexor, and piriformis stretches increase range of motion in areas connected to the lower back. This takes pressure off pinched nerves.
Pelvic Tilts
Tilting the pelvis forwards and backwards strengthens core muscles that support the low back and improves posture.
Avoid High Impact Exercise
Jogging, jumping, and heavy weight lifting can further compress nerves. Wait until acute flare-ups subside before resuming intense training.
Physical Therapy
Work with a physical therapist to develop a personalized exercise program that meets your needs and abilities. They can guide modifications to avoid exacerbating nerve compression.
How can you treat lower back pain that shoots down both legs?
Conservative treatments focused on alleviating inflammation and muscle spasms can help soothe radiating back pain. Medical management options include:
Medications
Over-the-counter NSAIDs like ibuprofen, naproxen or aspirin reduce inflammation and nerve irritation. Muscle relaxants like cyclobenzaprine relieve spasms.
Hot/Cold Therapy
Alternating hot packs and cold packs can relieve pain and swelling of compressed nerves and tense muscles.
Physical Therapy
Manual manipulation, massage, ultrasound therapy, electrical stimulation like TENS units can relax muscles and mobilize nerves.
Spinal Injections
Epidural steroid injections deliver anti-inflammatory corticosteroids near irritated nerve roots.
Lifestyle Modifications
Surgery
For severe herniated discs, decompression surgery may remove pieces impinging on nerves. Spinal fusion stabilizes and supports the vertebrae.
Does severe lower back pain radiating down legs indicate a serious condition?
Severe low back pain radiating persistently into legs may signal serious nerve compression requiring prompt medical evaluation, especially if worsening or accompanied by numbness, weakness, loss of bowel/bladder control, or saddle anesthesia in groin/inner thighs.
Can COVID-19 cause lower back pain that radiates down both legs?
For some, back pain and sciatica persist as part of long COVID syndrome. Theories explaining this include inflammation triggering nerve/tissue irritation, overextending back muscles while prone during hospitalization, potential nerve damage from the virus, losing conditioning from inactivity, and stress disrupting pain signaling. Though not fully understood yet, radiating back and leg pain should be evaluated by a doctor.
What are some stretches for lower back pain that radiates down both legs?
Specific stretches can provide relief when back pain radiates down the legs by gently extending the muscles and mobilizing pinched nerves. Always move carefully within your limits to avoid exacerbating symptoms. Helpful stretches include:
| Stretch | Description |
| Knee to Chest | Lying on your back, hug one knee at a time to your chest. This pulls the lower spine in the opposite direction to take pressure off nerve roots. |
| Figure Four | Cross one ankle over the thigh of the opposite leg. Grasp behind the thigh and gently rotate the hip to stretch the glutes and piriformis. Switch legs. |
| Child’s Pose | Kneel with hips over ankles then sink your torso down between thighs with arms extended. Let your back muscles gently lengthen and relax. |
| Seated Piriformis Stretch | Sit with one leg crossed over the other knee. Lean forward applying light pressure to the bent leg to rotate the hips and stretch the piriformis muscle near the sciatic nerve. |
| Pelvic Tilts | Lie on your back with knees bent. Tighten your core and tilt your pelvis up then down to gently mobilize the low back. |
Why does my lower back pain radiate down both legs when lying down?
The discs between vertebrae are composed of a soft jelly-like middle encased by a tougher exterior. When lying down, gravity pulls water into the discs causing them to expand and put pressure on the nerve roots exiting the spine. This can intensify radiating leg pain from sciatica or pinched nerves when lying down.
Try lying on your side in a fetal position with a pillow between your knees to take pressure off the nerves. Sleeping on too soft or firm a mattress can also aggravate back and leg pain symptoms.
Nerve compression likely already exists, and lying flat simply makes the impingement more pronounced.
Why do I have pain in my lower back that radiates down both legs before my period?
Hormonal fluctuations during the menstrual cycle can worsen low back and leg pain. The hormone relaxin loosens ligaments in preparation for childbirth but can overextend the joints.
Progesterone relaxes muscles, which decreases stability in the pelvis and lower spine.
Sciatica and radiating leg pain may increase around your period due to heightened inflammation or fluid changes irritating the nerves. Menstrual cramps also make existing nerve sensitivity worse.
Is it possible to have lower back pain that radiates down both legs but not be sciatica?
Yes, bilateral radiating leg pain can have other causes beyond sciatica. Compression of nerves in the lumbar plexus along the front of the thighs can refer pain down the legs. Sacroiliac joint dysfunction often radiates pain into the buttocks and backs of the thighs.
You Don’t Have to Suffer From Radiating Lower Back Pain
For years, Kaly has empowered people to take control of their radiating back pain. We know how it is to live with chronic back pain, so we know how frustrating and limiting it can be. This inspires our unwavering commitment to helping you thrive again.
We provide the most up-to-date, evidence-based information and advice to properly diagnose and treat the root causes of radiating lower back pain, whether it’s due to sciatica, a herniated disc, spinal stenosis, or other issues. Our thorough, customized programs provided by our doctors can help you find real, lasting pain relief.