PAIN in heel, foot, calf, knee and hip, groin needs to be evaluated well
Western ideas that these pains are causing back pain are not scientific.

Hip Pain, groin pain, coccyx pain, Knee Pain, Heel Pain - Is it because of your spine?


Intervertebral Disc related changes can give rise to various symptoms in the Lower Limb as we age, these may be inform of chemical or mechanical

  • at the hip, groin, coccyx
  • at the knee
  • at the ankle, heel or foot

There is a basic dictum that if the pain in the Lower Limb

  • is not because of injury
  • is not because of infection and
  • is not because of reduction in the blood supply

then it has to be because of Neuralgia, that is, nerve mediated.

GORE SIGN can identify the pain in the Lower Limb as Neuralgia or Sciatic Pain.

  • pain around hip joint behind the tip, or what sometimes maybe called as trochanteric bursitis;
  • pain can also be behind the knee or the outer aspect of the knee, where it may be called as biceps femoris tendonitis or popliteal pain
  • one may also feel pain at the heel where it is sometimes erroneously called as plantar fasciitis.


This pain is commonly felt as a stabbing pain. Very commonly, the patient points at the area covered by the hip pocket of the trousers or to a spot which may be behind hip bone.

Pain normally increases when the patient sits with his/her legs crossed and this pain becomes so unbearable that the patient has to get up or change the position of his/her legs while sitting.

The pain may be associated with tingling, numbness, heaviness in the leg; it may be associated with pain going down the leg.


You may feel pain around the knee, on the back side of the knee or on the outer side of the knee – which is extremely common. You may also feel pain on the inner side of the knee. People generally refer to all types of pain as pain in the knee. However, we need to distinguish this from pain which originates from the knee. The distinguishing features are:

  • The pain coming from the knee is on inner aspect of the knee and this pain reduces when you walk for some time. There is increase stiffness of the joint but as you walk and become mobile the pain and stiffness reduces as the time passes. This type of pain originates from the knee.
  • Whereas the pain around the knee, on the back side of the knee or the outer side of knee normally increases after walking and it may go up and down the leg. This pain on the outer side of the back side of the knee also increases on sitting cross-legged or sitting on the floor with the legs crossed as we Indians do. This pain then becomes so severe after sitting cross-legged that the pain can be relieved only by making the knees straight and moving the leg in order to reduce the stretch on the nerve. This can be called as a moderate degree reduction of the mobility of the nerve. Sometimes when you sit cross-legged, it can give rise to tingling and numbness going down the leg and the numbness may become severe that the whole leg becomes totally numb and the patient is unable to stand on that limb.

Download PDF and Read publication by Dr. Gore on Knee Pain


The pain in the heel commonly is observed on the inside of the heel below the heel bone. Sometimes it is along the outer border of the heel and sometimes it is at the back side of the heel over the tendo achillis. The pain is known to be more the first thing in the morning and a patient may experience very severe difficulty in walking after getting up from bed in the morning. This difficulty  reduces after walking a few steps and then the patient becomes more comfortable .

Pain in the heel has erroneously been called as plantar fasciitis without any evidence.

We must remember that many times the pain in the heel, pain in the knee, all the pain around the hip maybe SCIATICA AND  the earliest indications of the REDUCED stretchability of the nerve, DUE TO changes around the intervertebral disks L4-L5 and L5-S1.

There is pain which is very commonly seen called as coccydynia AND GROIN pain.  This pain is seen around the tip of the tailbone – and or in groin area. The patient is unable to sit in a slouching position. If the patient sits upright and erect the back pain normally reduces.  Groin and coccyx pain can be diagnosed with GORE SIGN as back related but other causes may be present.

detect, confirm and monitor pain by Gore Sign

Gore Sign, we detect the inflammation of the nerve and we can also treat pain at the hip, knee, ankle or just behind the ankle.

We need not worry about the cause of the pain as it can be relieved in many cases by improving the flexibility of the back, the strength of the back, and taking  medication to reduce the inflammation around the nerve. only a small % may need surgery.