The Surprising Connection between Knee and Back Pain

Posted in Knee , Back Pain   |   By

Erin Barsness

January 03, 2020

Nearly one-third of all Americans suffer from knee pain at one point. In addition, as many as 84% will experience back pain during their lifetime. If you suffer from knee pain, there's a good chance that back problems may be causing it. We'll take a look at the surprising connection between knee pain and back pain below.

Helpful tips for knee and back pain

Signs your Back Problem is Causing Knee Pain

If your knee pain stems from a back problem, it may be obvious because you might experience discomfort in both areas at the same time. That's not true in all cases though, as some people will notice pain in the knees but not in the back. You may also have back and knee pain intermittently, and never be bothered by both at the same time.

When back pain is the cause of knee problems, you might also have:

  • Muscle tightness in the hamstrings, quadriceps, or hips.
  • Weak hips.
  • Achy feelings or stiffness in the hips.
  • Foot pain.
  • Pain in the upper thigh.

Sciatic Nerve Anatomy

Your sciatic nerve originates in your spine, and consists of five separate nerves. Each of these five nerves passes through your vertebrae before coming together at your buttocks. From there, the sciatic nerve travels down the back of each leg and to your knee, where it is responsible for sensory and motor functions.

The five nerves that make up the sciatic are each named for the vertebrae over it. Specifically, the sciatic consists of the S1, S2, and S3 nerves in your tailbone, along with the L4 and L5 nerves of the lower back. If any of the corresponding vertebrae are pressing down on these nerves, it can result in pain and inflammation in the knees.

Effects of Sciatic Inflammation

Sciatic nerve malfunction can cause more than just a painful shooting sensation down the back of the leg. It can also result in:

  • Knee, hip, or lower back pain
  • Muscle spasms in the back and legs
  • A burning sensation in the back of the legs
  • A loss of bladder or bowel control

You may experience any of these symptoms in conjunction with weak or wobbly knees that feel as though they are giving out. Sciatic problems normally cause issues with only one knee, However, you may occasionally experience pain in both knees as well.

Self-Care for Knee-Related Sciatic Pain

Obesity increases your risk of sciatic problems. By losing weight, you can avoid the type of undue pressure on your spinal column that might lead to sciatic irritation.

Prolonged sitting can leave you more vulnerable to sciatic flare-ups. So if you work at a sedentary job, make it a habit to get up and move more often so that you will not become stiff.

Certain stretches can relieve tension in the hamstrings, making it less likely that you will experience pain down the back of one of your legs. Anti-inflammatory medication and hot/cold therapy can reduce swelling and reduce the frequency and intensity of flare-ups.

Conservative Medical Treatment for Sciatic Nerve Issues

Chiropractors are aware of the different effects vertebrae in the nerves can have on bodily function. Accordingly, they often use a nerve function chart when performing adjustments that will take the pressure off certain body parts. For discomfort and numbness in the legs, which includes knee pain, they often focus on the L1 through L5 vertebrae specifically.

Acupuncturists often target the sciatic nerve along the lower back and back of the leg to increase blood flow and release endorphins, which are nature's painkillers. Acupuncture itself does not cure the underlying back problem, and should therefore be used as a pain control method only. It can however be used specifically for knee pain, with research showing it more effective than anti-inflammatory medications such as ibuprofen.

The Connection between Bunions, Back Pain, and Knee Pain

A study published in Arthritis Care and Research revealed that people with bunions are more likely to experience back or knee pain. This is more than a coincidence, as there is actually a connection between the three conditions.

The "L" and "S" nerves in your spine also govern the muscles that support your feet. Specifically, the S1 nerve powers muscles along the outside of your foot, while the L5 nerve controls those along the inside of your foot.

When one of these nerves becomes irritated, the affected muscle may weaken or atrophy. This often causes the foot to over-pronate or turn inward more than usual. This additional pressure on your feet can increase your risk of bunions.

Over-pronation may also result in misalignment or instability that would then cause weakness in the knees. If you have bunions, this could also affect your gait, in which case you may place additional stress on your knees by trying to balance yourself.

Treating Bunions and Knee Pain

If back problems are causing your bunions and/or knee pain, you may not experience any discomfort in your spine. That's why many focus only on treating their foot problems, and never address the underlying cause. Surgery is sometimes needed to eliminate bunions; however, unless you tackle the reason you have them in the first place, it's highly likely they'll return.

If you have bunions and knee pain, it's important to wear a good, comfortable pair of shoes, preferably orthotics. You may also wish to modify your gait in order to take pressure off of your knees. A study performed by the Arthritis Foundation showed that those who place their toes slightly outward can reduce the amount of pain felt on the inside of the knee joint.

Consider exercises to improve your posture and alleviate pressure in your lower back. Chiropractic treatment and massage may also prove helpful in reducing tension that may lead to bunions and/or knee pain. If you do these things, you should experience less discomfort, and will reduce the risk of your bunions returning or getting worse.

Function of the Psoas Muscles

The sciatic nerve is not the only part of your back that can result in knee pain. Your lower back also contains what is known as the psoas. Psoas is Greek for "muscle of loin", and actually consists of three different muscles:

  • Psoas major. The largest of the three muscles, psoas major extends from the sides of vertebrae T12 through L4, covering your pubic bone before attaching to the iliacus.
  • Psoas minor. Somewhat smaller than the psoas major, this muscle attaches to the T12 and L1 vertebrae in the lower back. It sits just in front of the psoas major.
  • Running from the pelvic bone to the femur, the iliacus is responsible for the movement of your pelvis and femur.

Tightness in any of these muscles can result in a stiff pelvis, hips, or lower back. The resulting tension can place unnecessary strain on your knees, resulting in pain that makes it difficult to move.

Strengthening the Psoas to Reduce Knee Pain

Some evidence suggests that regularly stretching before a workout (or any other physical activity involving the low back and hips) can provide greater flexibility for the psoas muscles. This in turn means less tension on areas of the body that would then trickle down to the knees.

Certain yoga poses are known to activate the psoas as well. Try adding Warrior Pose, Utthita Parsvakonasna (extended side angle pose), and Paripurna Navasana (boat pose or full boat pose) to your workout to help you alleviate back and knee pain.

Any time you are exercising, it's important to avoid placing any undue stress on the knees. The use of a knee brace can prove very helpful when it comes to stabilizing the knee and preventing further injury.

The Effects of Posture

Good posture keeps your back, hips, knees, and feet in perfect alignment. If you have poor posture, you are more likely to feel pressure in your lower back; however, the stability of your legs, knees, and feet might be affected as well.

To ensure good posture, you should:

  • Choose a comfortable chair that properly supports your back while sitting.
  • Stand up straight when walking, keeping your shoulders back and your head and eyes forward.
  • Avoid carrying heavy bags that might cause your shoulders to become misaligned.
  • Wear shoes with the proper support. Avoid wearing high-heeled shoes on a regular basis. If you do wear them, choose a lower, square-shaped heel rather than a tall, skinny stiletto.
  • Keep your core engaged while standing or walking. Doing so will help to strengthen and stabilize the lower spine and keep undue pressure off of your hips and knees.
  • Always lift with the legs by squatting rather than stooping or bending over.

Preventing Back and Knee Pain

The cause of your knee pain may not always be what you think. As such, you should always consider the health of your back any time you suffer from knee pain. Choosing the right brace for knee or back pain is equally important, and can often times prevent your problem from getting worse. To find the right one for your condition, we invite you to browse through our website and then contact us if you have any further questions.

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