My father told he have something in nerve back of the both legs from the hip till down he can't explain it rightly like he have pain i think and maybe like pulling or pain inside it and he doesn't have any numbness
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Based on your description - bilateral leg pain/pulling sensation running from the hip down the back of both legs, without numbness - this sounds like it could be sciatica (sciatic nerve irritation) or a related condition like piriformis syndrome or lumbar spine pathology. Let me look this up properly.
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bilateral sciatica both legs pain from hip down causes diagnosis
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Here is a thorough breakdown of what your father is likely experiencing, based on his symptoms:
What Your Father Is Describing
The symptoms - a deep pain/pulling sensation running along the back of both legs from the hip downward, bilaterally (both sides), without numbness - point strongly to sciatic nerve involvement, most likely from a spinal cause.
The Sciatic Nerve - What It Is
The sciatic nerve is the largest nerve in the body. It starts in the lower back (lumbar spine), travels through the buttock, and runs down the entire back of each leg all the way to the foot. When this nerve or its roots get irritated or compressed, you feel it anywhere along that path - hip, back of thigh, calf, foot.
The pain can feel like:
- A deep aching or pulling sensation
- Shooting or burning
- Throbbing or dull pressure
- A "nerve pain" that is hard to describe (exactly like your father is saying)
Why BOTH Legs? - The Key Point
Most people get sciatica in one leg. When both legs are affected at the same time, it usually points to a problem at the center of the spine (not just one side), and the most common cause is:
1. Lumbar Spinal Stenosis (Most likely in an older person)
- The spinal canal in the lower back narrows, squeezing the nerve roots on both sides
- Classic symptoms: bilateral buttock and leg pain, often worse with standing and walking, better when sitting or bending forward
- Very common in older adults, often from age-related wear and tear (arthritis, thickened ligaments, bone spurs)
- The textbook description: "bilateral buttock or leg pain, neurogenic claudication" - [Rheumatology, Elsevier 2022]
2. Herniated Disc (Prolapsed Disc)
- A disc in the lower back slips or bulges and presses on the nerve roots
- 95% of important disc problems happen at L4-L5 and L5-S1 levels, causing pain down the back of the legs (S1 nerve: posterior thigh, calf, heel)
- Can affect both sides if the disc herniates centrally
- Typically worsened by coughing, sneezing, sitting for long periods - [Symptom to Diagnosis, 4th Ed.]
3. Lumbar Radiculopathy (Nerve Root Irritation)
- Irritation of the nerve roots where they exit the spine
- Pain, pulling, or aching down the leg without necessarily having numbness (numbness comes later or may be mild)
4. Piriformis Syndrome
- The piriformis muscle in the buttock compresses the sciatic nerve
- Typically causes mid-buttock pain that radiates down the leg
- Pain is worse with sitting and with rotating the hip outward
The Absence of Numbness - What It Means
The fact that your father has no numbness is actually reassuring. It suggests the nerve is irritated but not severely compressed yet. Numbness, weakness, or loss of bladder/bowel control would be more urgent warning signs. That said, bilateral symptoms still deserve prompt medical attention.
Red Flags to Watch For - Seek Emergency Care Immediately If:
- He develops numbness or tingling in the groin, inner thighs, or "saddle area"
- Loss of bladder or bowel control (can't hold urine/stool, or can't pass them)
- Leg weakness - legs giving way, difficulty walking
- Pain after a fall or injury
These would suggest Cauda Equina Syndrome, a medical emergency.
What He Should Do
- See a doctor soon - ideally a GP first, who will examine him and likely order:
- An MRI of the lumbar spine (the best scan for nerves, discs, and stenosis)
- Or an X-ray to start with
- Describe the pain clearly: both legs, back of legs, from hip downward, pulling/deep pain
- Ask about age, occupation, and activity - these help narrow the diagnosis
- In the meantime:
- Avoid prolonged standing or walking if it makes it worse
- Gentle walking is usually better than complete bed rest
- A warm compress on the lower back may help
- Over-the-counter pain relief (ibuprofen or paracetamol) if he has no contraindications
Summary
| Most Likely Cause | Why |
|---|---|
| Lumbar spinal stenosis | Bilateral, from hip down, common in older adults |
| Herniated disc (L4-L5 / L5-S1) | Bilateral nerve root compression |
| Lumbar radiculopathy | Nerve irritation without full numbness |
He needs an MRI of the lumbar spine to find the exact cause. This is very manageable once diagnosed - treatment ranges from physiotherapy and pain management to injections or, in some cases, minimally invasive spine procedures.
Note: This information is for educational guidance only. A proper physical examination and imaging are needed for a real diagnosis. Please have him see a doctor.
My father get pain on both leg from the hip and muscle fatigue and he get pain only at standing and walking and relieve at rest sitting
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This new detail changes things and actually makes the picture much clearer. Pain in both legs from the hip that only appears with standing/walking and goes away with sitting/rest, plus muscle fatigue, is a classic pattern with a specific name.
This Is Very Likely "Neurogenic Claudication" from Lumbar Spinal Stenosis
This is a well-recognized clinical pattern where the space around the nerves in the lower spine narrows (spinal stenosis), and the nerves only get "pinched" enough to cause pain and fatigue when he's upright and moving - because standing/walking naturally arches the lower back, which narrows the spinal canal further. Sitting flexes the spine forward, which opens the canal back up and relieves the pressure instantly. That's exactly the pattern he's describing.
Why this fits so well
- Table 7-9 from a clinical diagnosis textbook (Symptom to Diagnosis) lists the classic features:
- Pain worsened by walking or standing
- Pain improved by sitting or bending forward (not just standing still)
- Often bilateral, involving the buttocks and back of the thighs
- Walking distance before pain starts can vary day to day
- Leg muscle fatigue/heaviness alongside the pain is typical
- Pulses in the feet/legs remain normal, skin looks normal (this matters, see below)
The important thing to rule out: Vascular Claudication (poor circulation)
There is a leg-pain-with-walking mimic caused by blocked arteries (peripheral artery disease), and it's important your father's doctor tells these apart, because treatment is completely different:
| Feature | Neurogenic (nerve/spine) | Vascular (circulation) |
|---|---|---|
| Relieved by | Sitting or bending forward | Just standing still, no need to sit |
| Pain location | Buttock, hip, back of thigh (bilateral) | Usually calf, can be one-sided |
| Foot pulses | Normal | Weak or absent |
| Skin | Normal | Shiny, hair loss, possibly cool to touch |
| Walking uphill | Sometimes easier (leaning forward) | Worse than walking downhill |
Since he says rest relieves it when he sits (not just standing still), and the pain is bilateral from the hip down, this leans toward the neurogenic/spinal pattern rather than a circulation problem. But this distinction needs a doctor to confirm with a pulse exam and possibly an ankle-brachial pressure test, since both conditions can coexist, especially in older adults.
What's Likely Happening Anatomically
The lower spine canal (usually L4-L5 or L5-S1 level) has narrowed - from age-related disc bulging, thickened ligaments, or bone spurs - and it's compressing the nerve roots that supply both legs. Standing/walking extends the spine and further narrows this already-tight space; sitting flexes the spine and opens it up, instantly relieving the pressure. Muscle fatigue happens because the nerves supplying the leg muscles are being intermittently starved of proper signal/blood flow during exertion.
What He Should Do Now
- See a doctor (GP or orthopedic/spine specialist) soon - describe exactly this pattern: bilateral leg pain from the hip, brought on by standing/walking, relieved by sitting, with muscle fatigue, no numbness.
- The doctor will likely:
- Check his foot and leg pulses to rule out a circulation problem
- Examine his back and test flexion/extension
- Order an MRI of the lumbar spine - this is the definitive test for spinal stenosis
- Note how far he can walk before pain starts and bring that info to the appointment - it helps track severity and progress
- Red flags requiring urgent care: numbness in the groin/inner thighs, loss of bladder or bowel control, or leg weakness/buckling - none of which he has now, which is reassuring
Good News on Treatment
Lumbar spinal stenosis with this claudication pattern is very manageable and does not progress to paralysis - it's monitored based on how much it affects daily activity. Options range from physical therapy (flexion-based exercises), weight management, and pain control, to epidural steroid injections, and in more severe or unresponsive cases, decompression surgery.
Sources: Symptom to Diagnosis: An Evidence-Based Guide, 4th Ed., p. 146-147; Current Surgical Therapy 14e; Schwartz's Principles of Surgery, 11th Ed.
This is educational information, not a diagnosis. A doctor needs to examine him and confirm with imaging.
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