If you have pain in your buttock or the back of your thigh, it can be hard to tell if sciatica or hamstring pain might be causing it. Both may start suddenly or build over time and both can make it uncomfortable for you to sit, walk, bend or exercise.
The pattern of pain, triggers and other symptoms can help point you in the right direction. Patrick Graham, ANP-BC, a sports medicine specialist with Banner - University Medicine, explained more about the differences between sciatica and hamstring pain.
What sciatica usually feels like
Sciatica happens when a nerve gets irritated. With sciatic nerve pain, symptoms may start in the lower back, buttock or hip and travel down the back of the thigh, sometimes into the calf or foot. It may feel sharp, burning, electric or shooting and you may also have numbness, tingling or weakness.
It’s common to notice symptoms only on one side of your body. Sitting, coughing, sneezing or moving your back a certain way may make sciatica symptoms worse.
What hamstring pain usually feels like
Hamstring pain stems from an issue with your muscle. You usually feel pain behind your thigh or near your buttock. It may feel like a pull, cramp, tear or sharp pain that starts after sprinting, jumping, stretching, lifting or a sudden movement. It could also come on gradually and feel worse when you’re sitting or running.
- The area may feel sore to the touch
- You may have bruising, swelling or weakness
- Pain may be worse when you bend forward, climb stairs, run or straighten your leg
Sciatica vs. hamstring pain: Key differences
More like sciatica:
- Starts in the lower back, buttock or hip
- Shooting leg pain that travels down past the hip and thigh
- Burning, electric, pins-and-needles or nerve-like pain
- Numbness, tingling or weakness
- May reach the calf or foot
- Worse with sitting, coughing, sneezing or moving your back
- Often one-sided
More like hamstring pain:
- Stays mostly in the back of the thigh
- Starts after a pull, sprint, stretch or workout
- Tender to touch in one spot
- Bruising or swelling
- Worse with running, stairs or bending forward
- Feels muscular, tight or sore
- May improve when you take a break from the activity that caused it
Other problems that can mimic sciatica or hamstring pain
Not every type of thigh or buttock pain is caused by sciatica or a hamstring problem. These conditions could also cause symptoms:
- Piriformis syndrome or deep glute pain
- Hip problems
- Sacroiliac joint pain
- Lumbar disc problems
- Tendon irritation
- Muscle strain
- Peripheral artery disease, if pain happens with walking and improves with rest
- Blood clot, if you have sudden swelling, warmth or calf pain
What you can try at home for mild symptoms
These tips may help relieve symptoms of sciatica or a hamstring injury:
- Rest from activities that make your pain worse but try not to stay inactive for long periods
- Try ice for a new hamstring strain or soreness
- Try heat for tight muscles if it feels helpful
- Gentle walking may help if you can tolerate it
- Stretching may help but avoid aggressive stretching if your pain is sharp or getting worse
- Over-the-counter (OTC) pain relievers may help if it’s safe for you to take them
- A compression sleeve may help with a hamstring injury
- Do not push through numbness, weakness or worsening pain
When to see a provider
Contact your health care provider if you have:
- Symptoms that interfere with your work, sleep or exercise
- Pain that lasts more than a couple of weeks or keeps coming back
- Pain that is severe or getting worse
- Pain that travels below your knee
- Numbness, tingling or weakness
- Trouble walking or standing
- Heard or felt a pop in your thigh
- Bruising, swelling or a visible deformity
- Pain after a fall or injury
“Ignoring symptoms or waiting too long can make it harder for you to recover,” Graham said.
When leg pain is urgent
Seek urgent or emergency care for:
- New loss of bladder or bowel control, which is a medical emergency
- Numbness in the groin or saddle area
- Significant swelling or bruising
- Severe or sudden leg weakness
- Fever with severe back or leg pain
- Major injury or fall
- A swollen, red, warm or painful calf
- Chest pain or trouble breathing
- Sudden severe pain with a cold, pale or blue leg or foot
How a provider may diagnose the cause
When you see a provider for sciatica or hamstring pain, they may:
- Ask about where the pain starts and travels
- Ask what triggered it
- Check your strength, reflexes, sensation and movement
- Check your hamstring tenderness, flexibility and strength
- Look at the back, hip and leg
“For sciatica, the root cause is often the spine,” Graham said.
You may not need imaging right away but if your symptoms are severe, persistent or concerning, your provider may order an X-ray, MRI, ultrasound or other tests.
Depending on your diagnosis, treatment may involve physical therapy, activity changes, medications, injections or referral to an orthopedic, spine care or sports medicine specialist.
The bottom line
Sciatica and hamstring pain can both cause pain in the back of your thigh. Sciatica is more likely when the pain starts in your back or buttock and shoots down the leg with numbness, tingling or weakness. Hamstring pain is more likely when the pain stays in the back of your thigh and begins after running, stretching or a sudden pull.
If pain in the back of your leg is not improving or you are not sure whether it is sciatica or a hamstring problem, contact a Banner Health provider who can check your symptoms and help you find the right treatment.
FAQs on sciatica and hamstring pain
Can sciatica feel like hamstring pain?
Yes. Sciatica can cause pain in the back of the thigh, which may feel like hamstring pain. Numbness, tingling or pain traveling below the knee may point more toward sciatica.
How do I know if I pulled my hamstring?
A pulled hamstring often starts during running, stretching or sudden movement and causes pain in the back of the thigh. Bruising, swelling or tenderness may happen.
Does hamstring pain cause numbness or tingling?
Hamstring injuries usually do not cause numbness or tingling. Those symptoms may point to nerve irritation, such as sciatica.
Should I stretch sciatica or hamstring pain?
Gentle stretching may help some people, but aggressive stretching can make symptoms worse. Stop if pain increases and ask a provider or physical therapist for guidance.
Why does the back of my thigh hurt when I sit?
Pain when sitting can come from sciatica, hamstring tendon irritation, hip issues or other causes. A provider can help identify the source.
When should I worry about pain down the back of my leg?
Get care if pain is severe, worsening, travels below the knee, causes numbness or weakness or follows an injury. Seek emergency care for bladder or bowel changes, groin numbness or severe weakness.
