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A 20-year-old male asked:

I have had lower back pain which goes down my hip and right leg. the pain reaches down to my calf. what could be causing it? muscle relaxers didn't work.

4 doctor answers7 doctors weighed in
Dr. Heidi Fowler
Psychiatry 27 years experience
? Sciatic nerve: Please see your physician or orthopedic surgeon to be evaluated for possible sciatica. If your sciatic nerve is inflammed, the medical provider can evaluate for cause to determine what can be done to improve it. Take care.
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Dr. Douglas Linville II
Orthopedic Spine Surgery 32 years experience
Sciatica: True sciatica is leg pain that shoots from back, down the leg past the knee. This mimics the path of the sciatic nerve, thus it's name. Mri of the spine or pelvis would serve to differentiate in most cases if exam and history is not clear. Young patients more likely to have herniated disc. Older patients, pressure from arthritic spurs. All can be treated non-surgically if not getting worse.
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Dr. Laurence Badgley
General Practice 53 years experience
Cause of sciatica: Sciatica is a pain pattern caused by many different mechanisms.
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Dr. Laurence Badgley
General Practice 55 years experience
Provided original answer
Chronic pain radiating along sciatic nerve tract in 20 year old likely musculoskeletal.  Medical literature supports that 10-30% people with chronic low back pain have pain generation, including sciatica, from a unilateral hypermobile sacroiliac joint (SIJ).  Medical literature reports permanent SIJ injury from mundane mechanical injuries. 
Jul 31, 2013
Dr. Laurence Badgley
General Practice 55 years experience
Provided original answer
The reason that SIJdisorder is grossly under-diagnosed in the United States is that detection by imaging technology is not possible.  The disorder is one of hypermobility absent inflammation, and best discovered via an in-depth history and hands-on physical examination (per the Occupational Disabilities Guidelines).  Many specialists still think that the SIJ is immobile, without a normal range of motion, that biomechanical injury and loosening is impossible, and that SPECT scans can detect the disorder.  They are wrong as to all four assertions; as reported in the peer reviewed medical literature.  I theorize that an hypermobile SIJcauses sciatica.  Amongst my patients, SIJ disorder is common in youngish (20's and 30's) extreme sports (skateboard, snowboard, motorcross, etc.) enthusiasts, who have commonly fallen onto their buttocks numerous times.  Many have chronic low back pain, sciatica, and SIJ hypermobility disorder. 
Jul 31, 2013
Dr. Laurence Badgley
General Practice 55 years experience
Provided original answer
As Dr. Mechanic points out in his answer of this question, stenosis and lumbar spinal nerve root impingement, at the level of the lumbar vertebrae and disks, can also be offending pain generators.
Aug 1, 2013
Dr. Bennett Machanic
Neurology 54 years experience
Could be disc: Agree with dr badgley that your description is of sciatica. Real question to be answered is whether a nerve root in lower back is compressed by a protruded or ruptured disc, or if a more peripheral pain generator such as sacro-iliac dysfnctn or piriformis syndrome may be the cause. Would not expect muscle relaxer to help here. You need to uncover causation, and treat the pain generator itself.
Created for people with ongoing healthcare needs but benefits everyone.
Last updated Sep 28, 2016

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