Sciatica

You might already know sciatica is one of the most common forms of back and leg pain. But did you know that sciatica is not a medical diagnosis, but rather a symptom? It’s important to understand what sciatica is because 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.

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

What are the Symptoms of Sciatica?

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

    • Constant pain in only one side of the buttock or leg (rarely occurs in both legs)
    • Pain that worsens 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 completely incapacitating. Specific symptoms also vary widely in type, location and severity, depending upon the condition causing the sciatica. While symptoms can be very painful, it is rare that permanent sciatic nerve damage (tissue damage) will result.

Common Causes

There are a variety of lower back problems that frequently cause symptoms of sciatica. Some include:

  • Lumbar herniated disc
  • Degenerative disc disease
  • Isthmic spondylolisthesis
  • Lumbar spinal stenosis
  • Piriformis syndrome
  • Sacroiliac joint dysfunction

Once the source of your sciatic pain is determined, your doctor can come up with your treatment plan.

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).

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

Non-surgical sciatica treatments encompass a broad range of options, with the goal of relieving pain caused by compressed nerve roots. It is always advisable to have a qualified medical professional oversee any type of sciatica treatment.