Can Sciatica Cause Knee Pain?

If you’re experiencing knee pain that won’t go away despite rest, ice, and typical treatments for a sore or achy knee, your spine might be the real culprit. Many patients are surprised to learn that their persistent knee joint discomfort is actually caused by sciatica, a condition that often originates in the lower back but can send sharp pain radiating down to the knee. As many as 40% of Americans will experience sciatica at some point in their lives, and it is one of the most common causes of nerve-related pain.

Yes, sciatica can absolutely cause knee pain. The sciatic nerve is formed by nerve roots in the lower spine and begins in the pelvis, then runs through the buttocks and down each leg, passing near the knee. When the nerve roots become compressed or irritated in your spine, it can send pain signals anywhere along its path, including your knee. This is referred pain, meaning you feel pain in your knee even though the source of the problem is in your lower back. Understanding if your nerve roots in the spine or the sciatic nerve itself are compressed, is crucial in diagnosis. 

This explains why many sciatica patients experience knee weakness, a dull ache around the knee, or even knee buckling without any actual injury to the knee joints themselves.

When something compresses the nerve roots in your lower spine, it disrupts the normal function of the entire sciatic nerve path, creating symptoms that radiate down your affected leg.

The sciatic nerve forms from five nerve roots that exit your spinal canal in the lower back. These roots merge to create a thick nerve that travels down the back of your thigh and branches into smaller nerves including the peroneal nerve, which wraps around your knee. This is why nerve compression in your spine can directly affect how your knee feels and functions.

When a herniated disc or bone spur compresses the nerve roots in your lower back, it creates inflammation and disrupts normal nerve signaling. Your brain can interpret these disrupted signals as coming from your knee because the same nerve pathway serves both areas. The compression can also interfere with your muscles’ ability to properly support your knee, leading to muscle weakness and instability.

Sciatica-related knee pain typically affects the outer side or back of the knee. Most patients report a dull ache behind the knee, burning or tingling along the outer knee, or sharp pain that shoots through the back of the leg. With sciatica, the discomfort feels like it’s traveling through your knee rather than originating there.

You can look out for several signs that suggest your knee pain may stem from your spine. First, sciatica-related knee pain typically accompanies other symptoms, such as lower back discomfort, buttock pain, or tingling that travels down your leg. Second, the pain often improves when you lie down and worsens with prolonged sitting.

If rest, ice, and nonprescription medication haven’t helped your knee after a few weeks, your spine deserves closer examination. An accurate diagnosis to identify any nerve compression will require a thorough neurological examination and imaging studies of your lower back.

Multiple spinal conditions can compress the nerve roots that form the sciatic nerve and lead to knee pain.

Yes, a herniated disc is one of the most common causes of sciatica that leads to knee pain. When the soft inner material of a spinal disc pushes through its tough outer layer, it can press against the nerve roots that form your sciatic nerve, creating inflammation and disrupting nerve signaling down to your knee. Other spinal conditions include spinal stenosis (narrowing of the spinal canal), spondylolisthesis, and bone spurs, all of which we treat with neurosurgical expertise at Goodman Campbell. 

Tight hamstrings can contribute to sciatica and knee pain, but they’re rarely the primary cause. When hamstring muscles become excessively tight, they can alter the alignment of your spinal joints, potentially increasing pressure on your sciatic nerve. However, hamstring tightness itself is often a symptom of sciatic nerve irritation rather than the cause.

Effective treatment must address the nerve root compression in your spine rather than focusing solely on your knee. Initial approaches may include pain medications, as recommended by your healthcare provider. A physical therapist can teach you exercises that reduce pain by improving spinal alignment, and proper posture training helps relieve pressure on the affected nerve root.

Many patients improve with these conservative medical treatments over several weeks. However, if your pain worsens or doesn’t improve, surgical intervention may be necessary. 

At Goodman Campbell, our neurosurgeons collaborate with interventional pain management specialists to treat both simple and complex spine conditions. Our extensive training on the entire nervous system gives us deep insight into how nerve compression affects your entire leg function.

You should seek evaluation from a specialist at Goodman Campbell if your knee pain is accompanied by symptoms suggesting a neurologic or spine-related cause, such as lower back pain, pain that radiates down the leg, numbness, tingling, or weakness — or if symptoms persist despite conservative treatment. Following a thorough evaluation, our spine care team might recommend physical therapy, interventional pain management treatments, or surgery — but only if conservative measures haven’t produced satisfactory results. 

If you experience progressive muscle weakness, knee buckling that creates a risk of falling, or numbness that spreads down your leg, you may have significant nerve compression that requires more immediate expert assessment. Goodman Campbell is ready to help no matter where you are in your journey to find relief, but if you experience chronic pain related to your back for more than 6–8 weeks without improvement, it’s time for specialized pain management through neurosurgical evaluation.

As a global leader in brain and spine care, Goodman Campbell offers you direct access to one of the most accomplished neurosurgery teams in the world, right here in Indiana. Call Goodman Campbell today to schedule a comprehensive evaluation and discover the neurosurgical expertise to help you heal and restore your quality of life.