When someone comes to me for back pain, one of the first things I ask is whether that pain stays in the back or if it’s traveling down the leg. That detail changes everything.
There’s a study that followed over 1,581 back pain patients who saw a primary care doctor. Here’s what they found: 41% had pain in the low back only.
25% had pain that moved above the knee, and 34% had pain that traveled below the knee, and the patients in that last group, the ones with pain below the knee, were in the toughest spot.
They were more likely to miss work, more likely to be unemployed, and more likely to need ongoing care from multiple providers. Their quality of life scores dropped the most.
So when a Denver Chiropractor like myself sees leg pain, I don’t brush it off. That tells me something very clearly: when leg pain is present, it’s not just a nuisance, it’s a sign that something deeper is going on, usually involving the nerves.
Common Causes of Leg Pain
Leg pain isn’t always coming from the leg itself. In many cases, it starts higher up in the spine, pelvis, or hips and works its way down through the nerves, muscles, and joints. Below are the most common causes I see at our Wheat Ridge, CO clinic.
Sciatica
Sciatica is probably the most well-known cause of leg pain. It’s usually caused by a herniated or bulging disc pressing on the sciatic nerve, causing irritations. You might feel it as a sharp, burning, or electric sensation that shoots from your lower back or buttocks all the way down into the calf or foot.
Piriformis Syndrome
The piriformis is a small muscle located in the buttock, underneath the gluteus maximus. It connects the sacrum (the base of your spine) to the top of the femur (thigh bone), and it plays a role in rotating the hip. Often it mimics sciatica symptoms but unlike true sciatica, piriformis syndrome is a muscle entrapment problem.
Runner’s Knee
Runner’s Knee, or Patellofemoral Pain Syndrome, happens when the patella doesn’t track properly along the femur, often due to muscle imbalances, additional factors like weakness in the inner quad and tightness in the outer quad can pull the kneecap off track.
Jumper’s Knee
Jumper’s Knee, medically known as patellar tendinopathy, is caused by impact. While Runner’s Knee involves the cartilage behind the kneecap, Jumper’s Knee is all about the tendon just below it.
This tendon connects your kneecap to your shin and takes on heavy loads during explosive movements like jumping, cutting, or quick deceleration.
Over time, too much stress breaks down the tendon’s structure. Tiny tears form. Collagen fibers lose their strength. And what starts as mild soreness can turn into sharp, activity-limiting pain.
Hamstring or Calf Strains
Strains are small tears in muscle fibers, and they usually happen when a muscle is stretched too intensely. In the hamstrings, which run from the ischial tuberosity (sitting bones) down to the back of the knee, this often occurs during sprinting or sudden starts.
In the calves, we’re usually looking at the gastrocnemius or soleus muscles, pain here tends to be more local with tightness, soreness and even bruising in the back of the thigh or calf.
Shin Splints
Medial tibial stress syndrome, or shin splints, is pain along the inner edge of the tibia (shin bone). It’s usually caused by overuse of the muscles that attach to the tibia, especially the tibialis posterior and soleus.
Iliotibial (IT) Band Syndrome
The IT band is a thick band of connective tissue that runs from the outer hip down to the lateral knee. When it gets tight or the hip and pelvis becomes unstable, it can rub against the lateral femoral epicondyle (outer thigh bone) and cause sharp, burning pain.
Sacroiliac (SI) Joint Dysfunction
The SI joints sit between the sacrum and the ilium (the big bones of the pelvis). They’re designed for shock absorption, not for a lot of movement. But when they get misaligned or inflamed, they can create symptoms often mistaken for sciatica.
Knee Misalignments
When the knee joint isn’t tracking properly often due to tight quadriceps, weak hamstrings, or pelvic imbalance it can cause stress at the patella (kneecap) or within the joint itself. Pain might show up even by just going on short walk.
Leg Length Discrepancy
Sometimes one leg feels longer than the other. Other times, one leg is longer due to bone structure or pelvic rotation. Even a small difference of just a few millimeters can lead to compensations throughout the body: uneven hips, tilted spine, or pain in the knee, hip, or lower back.
How We Diagnose the Source of Your Leg Pain
Getting lasting relief from leg pain starts with knowing exactly what’s causing it. And I don’t mean where it hurts, I mean what’s actually wrong with the structure that’s sending that pain signal. Here’s what that process looks like when you walk into the Disc Chiropractic:
Step 1: Consultation That Actually Connects the Dots
We sit down and talk really talk. I want to hear how your leg pain started, what makes it worse, what makes it better, and how it’s showing up in your daily life. Maybe it’s shooting down your calf when you drive. Maybe your workouts are suffering. Maybe it’s been keeping you up at night.
We’ll also look at your posture, workstation habits, prior injuries, and the way you carry stress. All of these things matter more than most people realize. They help us build the map.
Step 2: Orthopedic and Neurological Testing
This is where we get into the mechanics. I’ll test your:
- Range of motion
- Reflexes and strength differences between limbs
- Signs of nerve compression (like sciatic irritation or foot drop)
- Joint integrity at the hips, knees, ankles, and spine
- Muscular compensation patterns—who’s working overtime, who’s asleep at the wheel
When your leg pain is coming from a spinal misalignment, nerve entrapment, or postural dysfunction, these tests will show it. Fast.
Step 3: Digital X-Rays or MRI (If Needed)
We have digital X-rays right here in the office, and we only take them if I suspect a structural issue that needs a closer look at things like degenerative joint changes or pelvic tilt.
If I suspect deeper soft tissue or nerve involvement—like a disc herniation pressing on a lumbar nerve root—I’ll refer you out for an MRI. Not everyone needs imaging, but when they do, we don’t wait around. We want answers, not assumptions.
Step 4: Gonstead Chiropractic Analysis
This is where the difference in our care really shows up. As a Gonstead chiropractor, I don’t adjust everything—I adjust what needs to be adjusted, and nothing more. That takes skill, precision, and a deep understanding of how the spine, pelvis, and lower extremities work together.
Here’s what I look for:
- Postural distortion: Are your hips even? Is your gait off?
- Motion palpation: Which vertebrae are moving? Which are stuck?
- Instrumentation and X-ray analysis: Are there measurable signs of nerve interference or segmental dysfunction?
How We Treat Leg Pain at The Disc Chiropractic
We look at how your hips load, how your knees track, how your feet strike the ground, and how the muscles in your legs are firing—or not. Then we correct what’s off. That’s how real results happen. Here’s how we do it:
Spinal Decompression Therapy
Not all leg pain starts in the leg. Sometimes it starts deep in the lower back, when a disc presses on a nerve that travels down the leg. That’s where I may recommend spinal decompression.
We use Triton DTS to reduce pressure inside that disc. As the vertebrae gently separate, it creates negative pressure that allows the disc to retract and take pressure off the nerve thus calming down symptoms like the burning pain in your calf, or sharp stabs down your thigh.
Chiropractic Adjustments
Using either my hands or specialized instruments, I apply gentle, precise adjustments to the bones in your hips or pelvis, restoring proper motion to the joints that influence your leg mechanics.
The goal is to correct any structural misalignments, whether it’s a rotated pelvis or a restricted sacrum, so your legs can function at their best, with optimal mobility and less leg pain.
Soft Tissue Therapy
For less severe issues, I may recommend soft tissue therapy, which includes hands-on release massages in combination with tools like our Rapid Release Pro.
We aim to reduce muscle tightness and restore proper joint movement. This approach provides fast relief, especially for conditions like hamstring strains and contusions.
Therapeutic Exercises and Rehab
Once the pain is gone and you’re moving better, we focus on exercises that help keep you feeling strong in the long run. Simple moves like glute activation or balance drills help fix any bad habits and rebuild strength where it’s needed.
This is usually part of your maintenance after treatment, helping prevent leg pain from coming back.
Shockwave Therapy
For stubborn leg pain especially those coming from older injuries. I recommend shockwave therapy. Using the Intelect RPW 2, we send acoustic waves into the trouble areas like the hamstring, or calves to break up calcified trigger points and scar tissue, these boost blood circulation, and restarts your body’s natural healing process.
FAQs About Leg Pain
What Causes Leg Pain That Starts in the Lower Back?
Leg pain that begins in the lower back and travels down the leg is typically caused by nerve irritation or compression, often from a disc bulge or joint misalignment in the lumbar spine. This type of pain may signal conditions like sciatica, where nerves are inflamed or pinched as they exit the lower spine.
Can a Chiropractor Help With Leg Pain?
Yes, chiropractors are trained to treat sciatica and other conditions that lead to leg pain. Chiropractic adjustments and spinal decompression therapy can reduce pressure on the sciatic nerve by targeting the vertebrae itself causing the irritation thus improving mobility and reducing pain without relying on drugs or surgery.
How do I know if my leg pain is from a nerve or a muscle?
Nerve pain usually feels sharp, burning, or electric and may radiate down the leg. Muscle pain is often dull, sore, or tight and tends to be localized. If your symptoms follow a pattern or involve numbness or weakness, a nerve may be involved.
Why Do I Have Leg Pain but No Back Pain?
Yes, it’s possible to have leg pain without any back pain, especially if the problem starts in the major muscle groups of the leg, like the hamstrings, quads, or calves. Sudden movements or forceful extensions can trigger pain directly in the legs.
Can Poor Posture Cause Leg Pain?
Yes, poor posture can alter the way your legs absorb force, leading to pain in the knees, hips, or shins. These imbalances often cause overuse or strain on muscles and joints throughout the lower body.
How Does Chiropractic Care Treat Leg Pain?
Chiropractic care for leg pain works by correcting joint misalignments, restoring natural movement, and easing pressure on nerves. If the problem comes from tight or overworked muscles, I may also recommend soft tissue therapy or shockwave treatment.
Do I Need X-Rays or an MRI for Leg Pain?
Not in every case. Digital X-rays are taken if structural issues are suspected. MRI may be recommended if soft tissue or disc damage is involved. The goal is to identify the source of pain accurately so that treatment is effective from the start.
How Long Does Chiropractic Care Take To Relieve Leg Pain?
Relief can begin within the first few sessions, depending on the severity of the condition causing the leg pain, usually for muscle spasms or contusions you might see results as fast as three days after a session of shockwave therapy, again each case is different.
Take the First Step Toward Real Leg Pain Relief
If you’re tired of stretching, foam rolling, and guessing why your leg still hurts, let’s do something about it. Your first visit is just $97 and includes a full consultation, spinal exam, and my detailed report of findings.
Book an Appointment Now or Call: 720-573-4910