Sciatica

Did you know sciatica is not a medical diagnosis but a symptom? It’s important to understand what sciatica is because the sciatic nerve pain is most often a sign of another medical condition (such as a herniated disc) that needs to be treated in order to relieve pain.

Explaining Sciatica

The term “sciatica” describes the symptoms of leg pain, and sometimes tingling, numbness or weakness originating in the lower back that spreads to the back of the leg. The sciatic nerve is the largest single nerve in the body and is composed of individual nerve roots that start by branching out from the spine in the lower back and combine to form the “sciatic nerve.”

Symptoms

Sciatica is often characterized by one or more of the following symptoms:

Constant pain in only one side of the buttock or leg (rarely can occur in both legs)
Pain that is worse when sitting
Burning or tingling down the leg (vs. a dull ache)
Weakness, numbness or difficulty moving the leg or foot
A sharp pain that may make it difficult to stand up or to walk
Pain that is typically described as sharp or searing, rather than dull
Depending on where the sciatic nerve is affected, the pain and other symptoms may also include foot pain or pain in the toes.

Sciatic pain varies from infrequent and irritating to constant and incapacitating. Specific symptoms also vary widely in type, location and severity, depending upon the condition causing the sciatica (such as a lumbar herniated disc). While symptoms can be very painful, it is rare that permanent sciatic nerve damage (tissue damage) will result.

Generally, sciatica occurs later in life, peaking in your 50s and then declining with age.

Common Causes

There are 6 lower back problems that are the most common causes of sciatica:

Lumbar herniated disc
Degenerative disc disease
Isthmic spondylolisthesis (stress fractures that causes vertebral to slip forward on another)
Lumbar spinal stenosis
Piriformis syndrome (muscle that the buttocks that can irritate or pinch a nerve root)
Sacroiliac joint dysfunction (irritation of Sacroiliac joint at the bottom of the spine)

Other causes of sciatica include pregnancy, scar tissue, muscle strain, spinal tumor and infection.

Once again, it’s important to recognize the medical condition in order to determine treatment.

Treatment

Rarely, sciatica symptoms that worsen quickly may require immediate surgery. The following symptoms indicate a need for immediate medical care:

Symptoms that continue to get worse rather than improve, which may indicate possible nerve damage, especially if the progressive symptoms are neurological (such as weakness).
Symptoms that occur in both legs (called bilateral sciatica) and cause either bladder or bowel incontinence or dysfunction, which may indicate cauda equina syndrome. Cauda equina syndrome is an acute compression of one or several nerve roots that occurs relatively rarely (in approximately 2% of herniated lumbar disc cases).¹

Patients should seek immediate medical attention if they experience any of the above symptoms.