Sciatica or something else

Usually, sciatica only affects one side of the lower body and the pain often radiates from the lower back all the way through the back of the thigh and down through the leg.

Some combination of the following symptoms is most common:

• Lower back pain, if experienced at all, is not as severe as leg pain
• Constant pain in only one side of the buttock or leg, but rarely both the right and left sides
• Pain that originates in the low back or buttock and continues along the path of the sciatic nerve – down the back of the thigh and into the lower leg and foot
• Pain that feels better when patients lie down or are walking, but worsens when standing or sitting
• Pain that is typically described as sharp or searing, rather than dull
• Some experience a “pins-and-needles” sensation, numbness or weakness, or a prickling sensation down the leg

It occurs when the sciatic nerve is compressed when a problem such a herniated disc occurs in the lower back. When nerve roots in the lower back are irritated, pain travels from the nerve root to the sciatic nerve, down to the buttock or hip and sometimes down the back of the leg. This may causes inflammation, pain and often numbness in the affected leg. The severity of sciatica pain can range from infrequent and irritating to sever and debilitating. It can make walking difficult and sometimes the symptoms are aggravated by bending at the waist. Usually, sciatica pain is worse in the leg and felt while sitting.

The most common cause of sciatica is a herniated disc, degenerative disc disease or isthmic spondyloslisthesis amongst younger adults. Amongst older adults common causes may be spinal stenosis or degenerative spondylolisthesis.

Some conditions mistaken for sciatica

The term sciatica is often incorrectly used in reference to leg pain. There are many causes of leg pain that are not medically classified as sciatica and should be treated differently.

• Arthritis pain in your legs, is technically not sciatica and the treatment for it is different.
• Sacroiliac joint dysfunction is a common cause of back and leg pain. This common cause of acute or chronic low back pain can be caused by stretching and weakening of ligaments that keep the join in place. This may result in radiating pain down the leg and feels like sciatica.
• Piriformis syndrome (PS) also exhibits symptoms similar to sciatica. It occurs when the piriformis muscle in the buttocks region irritates the sciatica nerve which causes pain to run along the sciatic nerve. This pain is technically not sciatica because it does not originate from the lower back.

Self- diagnosis of sciatica can be dangerous because of the multitude of conditions that can cause sciatic –like pain. Although it may be rare sciatica-like pain may be caused by serious medical conditions that need immediate treatment. For example, a spinal tumor, spinal infection or Cauda equine syndrome. It is important to see your physiatrist if you feel symptoms of pain in the buttocks or leg, numbness, tingling or other neurological symptoms in your leg. An accurate diagnosis is crucial to match the appropriate treatment options based on your clinical diagnosis.