An August 2026 review in the journal Diagnostics explains how often sciatica and hip arthritis overlap, and why a careful exam matters more than a scan alone. For people in Winter Garden and Horizon West with leg pain, the practical takeaway is to identify the source before choosing a treatment.
By Alena Wiese
A person steps out of the car after the drive home and feels it again: a deep ache in the buttock that seems to travel down one leg. Some days it burns below the knee. Other days it settles in the front of the thigh or the groin. The natural guess is sciatica.
The guess is not always right. Leg pain that seems to come from the back can come from the hip joint instead, and the two problems often exist together. In plain terms, sciatica usually means pain that follows a nerve path from the lower back down the leg, often past the knee, with numbness, tingling or weakness. Hip arthritis more often shows up as groin pain and stiffness when the hip turns.
A review published Aug. 10, 2026, in the peer-reviewed journal Diagnostics, written by 12 researchers affiliated with hospitals and universities in Athens and Patras, Greece, puts numbers to that overlap. The authors report that sciatica affects roughly 3% to 5% of adults, most often between ages 40 and 60, while hip osteoarthritis affects up to 10% to 12% of people over 60. Among people with hip arthritis, 20% to 30% also show degenerative changes in the lower spine on imaging, a combination clinicians call hip-spine syndrome.
What counts as sciatica, and what does not?
Sciatica is a description of symptoms, not a diagnosis by itself. MedlinePlus, the consumer health service of the National Library of Medicine at the National Institutes of Health, calls sciatica “a symptom of a problem with the sciatic nerve, the largest nerve in the body.” It lists a ruptured disk, spinal stenosis and injuries such as a pelvic fracture as causes, and notes that in many cases no cause can be found.
The classic pattern is pain, weakness, numbness or tingling that starts in the lower back and runs down one side, sometimes reaching the calf, foot or toes. Cleveland Clinic describes the pain as a burning or electric shock feeling that may get worse with a cough, a sneeze or bending.
Hip trouble can look similar at first. Cleveland Clinic notes that hip problems typically present with groin pain, while sciatica tends to run from the lower back down the leg with numbness and weakness. The Greek review adds that hip arthritis often brings restricted hip motion, especially limited inward rotation, and a limp, but no loss of nerve function.
Source: Sciatica, MedlinePlus, National Library of Medicine, September 2024. https://medlineplus.gov/sciatica.html
What did the new review find?
The review found that no single test reliably separates the two conditions, so clinicians need to combine several. The authors describe a sequence: watch how the person walks, check hip range of motion, test strength, reflexes and sensation in the legs, then use provocative maneuvers. A positive straight leg raise, in which lifting the straightened leg reproduces leg pain, points toward a nerve problem. Pain felt in the groin during the FABER or FADIR hip tests points toward the hip joint.
The authors also urge caution with imaging. They report that disc protrusions show up in 30% to 50% of adults who have no symptoms at all, and that the severity of hip arthritis on an X-ray often does not match how much pain a person feels. A scan can show something real that is not the cause of the pain.
For unclear cases, the review describes diagnostic injections. Numbing medicine placed into the hip joint was reported to be 85% to 90% accurate in identifying pain that truly comes from the hip.
The paper also introduces what the authors call the Athena Sign. While the person lies face down with the knee bent, the examiner rotates the hip inward and outward and watches for a reproducible compensating lift of the pelvis. The authors link it to problems inside the front of the hip joint.
Source: Differentiating Sciatica from Hip Osteoarthritis: Diagnostic Challenges and the Role of the Athena Sign, Diagnostics (MDPI), August 2026. https://www.mdpi.com/2075-4418/16/16/2515
What does the review not tell us?
It does not show that the Athena Sign works. The authors state plainly that the sign “has not undergone prospective clinical validation,” and that no data exist yet on its sensitivity, specificity or reliability from one examiner to the next. They describe it as a preliminary observation meant to generate hypotheses.
It is also a narrative review, not a systematic review or a clinical trial. The authors acknowledge the potential for selection bias and the absence of any pooled statistical analysis. The review also does not test which treatment works better once the pain source is found.
How long does sciatica usually last without surgery?
For many people, sciatica eases within weeks. Cleveland Clinic reports that many cases improve within four to six weeks without medical treatment and that most people recover without long-term problems. It lists aging, weak core muscles, prolonged sitting, heavy lifting, poor posture, diabetes, low physical activity and tobacco use as risk factors.
That is one reason conservative care, including staying active and guided exercise, is usually the first step. The exception is when warning signs appear. New or worsening leg weakness, loss of bladder or bowel control, and numbness in the groin or inner thighs call for prompt medical or emergency care; Cleveland Clinic lists muscle weakness and loss of bladder or bowel control among the serious signs. Leg pain after a hard fall, with fever, or with a cancer history also warrants a prompt medical evaluation.
Source: Sciatica, Cleveland Clinic, February 2026. https://my.clevelandclinic.org/health/diseases/12792-sciatica
Where can Winter Garden residents get leg pain evaluated?
In west Orange County, ReliefNow Disc Joint & Nerve Center Hamlin, at 5736 Hamlin Groves Trail, Suite 154, in Winter Garden, sees patients from Hamlin, Horizon West, Winter Garden and Windermere. The clinic’s phone number is 407-706-4944, and its stated approach is that every plan starts with an evaluation.
Dr. Jeffrey N. Shebovsky, DC, has more than 30 years of clinical experience and founded Orange Wellness in 1994. In a practice like his, the kind of exam the Greek review describes is the starting point: a history of where the pain travels and what makes it worse, a neurological screen of strength, reflexes and sensation, and hip range-of-motion testing to see whether the joint is part of the picture.
Conservative care may fit when the exam points to an irritated nerve without red flags. It does not fit when there are signs of significant or progressing nerve loss, bladder or bowel changes, a suspected fracture, infection or tumor, or when the hip joint looks like the main pain source and needs orthopedic evaluation. In those situations, referral to a physician, specialist or emergency department comes first.
Progress is typically tracked with measures a patient can recognize: how far down the leg the pain reaches, pain ratings, how long the person can sit or walk, and standardized function questionnaires. If symptoms are not improving after several weeks, re-evaluation and referral are part of the plan.
What should someone with leg pain do first?
The most useful first step is to describe the pain precisely, because location matters. Pain that runs below the knee with tingling or numbness points one way. Stiffness and groin pain when putting on socks or climbing out of a car points another.
The Greek review does not offer a new cure. It offers a reminder that “sciatica” is a word people use for many kinds of leg pain, and that the first job is figuring out which kind it is. For most people, that answer comes from a careful, hands-on exam, and the path forward follows from there.
About: Dr. Jeffrey N. Shebovsky, DC | ReliefNow® Disc Joint & Nerve Center Hamlin | 5736 Hamlin Groves Trail, Suite 154, Winter Garden, FL 34787 | 407-706-4944 | https://reliefnowlaser.com/providers/hamlin/
This article is for informational purposes only and does not constitute medical advice. Consult a qualified healthcare provider before beginning any treatment program.
