Pain That Radiates From Your Hip Down to Your Knee

Pain running from the hip down to the knee is hard to name from the outside, because several structures produce almost the same map on the leg. The detail that sorts them out is not how bad the pain is. It is where the pain stops.

What the stopping point tells you

Pain in a leg arrives one of two ways: a joint, tendon or muscle referring pain into the leg, or an irritated nerve carrying pain along its own path.

Referred pain is dull, deep and hard to point to with one finger. It fills a region rather than drawing a line, it usually fades out somewhere in the thigh or at the knee, and it rarely brings numbness with it.

Nerve pain follows a narrower line. People call it electric, burning or shooting, and it tends to keep going past the knee into the calf, the shin or the foot. Pins and needles, a patch of numbness, or a leg that feels weak point the same direction.

So pain that stops above the knee is more often referred joint or muscle pain, and pain that carries past the knee, especially with numbness or tingling, is more likely nerve involvement. It is not an absolute rule, but it is the first question worth asking.

The usual sources of hip to knee pain

The hip joint itself. Joint pain is felt in the groin or the front of the thigh more often than on the outside, it is worse putting weight through the leg, and it flares getting out of a low car seat or pulling on a sock. It refers down the thigh and sometimes as far as the knee. A few people feel it only at the knee.

The gluteal tendons on the outside of the hip. Pain sits right over the bony point on the side of the hip, it hurts to lie on that side at night, and it flares on stairs and hills. The ache spreads down the outer thigh and stops around the knee.

The IT band. A band of tightness or burning along the outside of the thigh ending near the outer knee, often after a jump in walking, running or hill work. The gluteal tendon and the IT band are frequently irritated together.

A lumbar facet joint. A stiff joint in the low back refers a dull, diffuse ache into the buttock and the back of the thigh. It is worse standing or leaning back, it rarely reaches past the knee, and it brings no numbness.

When the pain goes past the knee

Pain reaching the calf, the shin or the foot, particularly with pins and needles or a patch of numbness, points at an irritated nerve root in the low back rather than anything at the hip. That is sciatica, and our sciatica page covers it. Buttock pain that acts like sciatica but starts at the hip rather than the spine is covered on piriformis syndrome.

How the exam sorts it out

Most of this is settled with a history and a hands-on exam, not imaging. At Tradewinds Chiropractic & Wellness in Estate Thomas, the exam loads the hip through its range, presses over the gluteal tendon attachment, tests the sacroiliac joints and the lumbar spine, and checks reflexes, strength and sensation by nerve root so nerve involvement is confirmed rather than assumed. Digital x-rays are taken on site when the findings suggest arthritis or a structural problem.

Dr. Keys is the Chair of the Virgin Islands Board of Chiropractic Examiners, a member of the Virgin Islands Chiropractic Society, and the International Chiropractors Association representative for the U.S. Virgin Islands.

Treatment follows what the exam finds, which is why the source matters more than the label you arrived with. If the answer is the hip joint or the tendons beside it, hip pain covers the treatment. If it is the low back, see lower back pain. Everything used is listed on our services page.

When you should see someone else

Some of this does not belong in a chiropractic office. Call 911 or go to the nearest emergency room for:

• Calf swelling with warmth, redness or tenderness, especially after a long flight or bed rest. That can be a clot. It is a medical emergency, not a chiropractic problem
• A fall after which you cannot put weight on the leg, or a leg that looks shortened or turned outward. That can be a hip fracture, and in older adults it follows falls that seemed minor
• New loss of bowel or bladder control, or trouble starting to urinate
• Numbness in the groin, the inner thighs or the area you sit on
• Leg weakness that is getting worse, such as a foot that slaps or drags when you walk

See a physician if the pain comes with fever, unexplained weight loss, a history of cancer, or night pain that does not ease in any position. We refer to an orthopedist when the hip joint is clearly the source and the pain limits your walking and sleeping despite good conservative care.

Getting seen

Tradewinds Chiropractic & Wellness is in the VI Medical Foundation Building, Suite 202, 9150 Estate Thomas, St. Thomas, USVI 00802, just east of Charlotte Amalie. Hours are Mon, Wed, Thu: 10:00 am to 1:00 pm and 3:00 pm to 7:00 pm. Tue, Fri: 7:00 am to 2:00 pm. Closed Sat and Sun.

Call (340) 690-4994 or email info@tradewindschiropractic.com. We take walk-ins and same-day appointments. We have more than 180 five-star Google reviews. New patient forms are on the forms page to print and fill in.

Questions patients ask

What causes pain from my hip down to my knee?

Most often it is referred pain from one of four places: the hip joint itself, the gluteal tendons on the outside of the hip, the IT band down the outer thigh, or a joint in the low back. All four can send a dull ache into the thigh that fades at or above the knee. The exam separates them by where the pain is reproduced, not by where you feel it.

Is hip pain that travels to my knee sciatica?

Usually not, if the pain stops at the knee. Sciatica typically carries past the knee into the calf or foot and brings numbness, tingling or weakness with it. Pain that ends at the knee with no numbness is more often a joint or tendon referring pain. Some people have both, which is why the exam checks reflexes, strength and sensation either way.

What is the aching from my hip to my knee on the outside of my leg?

Outer thigh pain that starts over the bony point on the side of the hip and runs toward the outer knee is usually the gluteal tendons, the IT band, or both. The giveaway for the tendons is that it hurts to lie on that side at night and it flares on stairs and hills. It is treated as a tendon problem, with loading and strengthening rather than rest.

Do I need an x-ray or an MRI for pain from my hip to my knee?

Usually neither at the first visit. A history and hands-on exam answer most of it. Digital x-rays are taken on site when the findings point to arthritis or a structural problem, and imaging of the low back is considered when nerve findings are present or the pain is not improving as expected.