Sciatica Symptoms

Sciatica Symptoms

What are symptoms of sciatica?

Sciatica causes pain, burning sensation, numbness, or tingling radiating from the lower back and upper buttock down the back of the thigh to the back of the leg. Severe sciatica can make walking difficult if not impossible. Sometimes the symptoms of sciatica are aggravated by walking or bending at the waist and relieved by lying down
One or more of the following sciatica symptoms are typically experienced:

• Pain in the rear or leg that is worse when sitting.
• Burning or tingling down the leg.
• Weakness, numbness or difficulty moving the leg or foot.
• A constant pain on one side of the rear.
• A shooting pain that makes it difficult to stand up
  

Sciatica is a term for pain that radiates along the sciatic nerve, anywhere from the lower back, buttocks, down the back of the leg, to the foot. There may also be weakness, numbness, tingling, particularly in the leg and/or foot. The location of the pain and/or numbness varies according to the location that the sciatic nerve or nerve root is affected. The pain can range from burning to aching and can vary in intensity. The pain may be intermittent or constant. Sciatica usually occurs on only one side of the body. Prolonged sitting or standing, sneezing, coughing or lifting aggravates sciatica. Sciatic pain may be acute but often develops gradually


Sciatica is pain running down your leg in a pattern determined by the sciatic nerve. The pain often starts in the low back - (due to a herniated disc) - or in the buttock - (due to piriformis syndrome) - and extends as far as your toes. It can be accompanied by numbness, 'pins and needles' ("paresthesias") or, in more severe cases, actual weakness affecting the ankle or toes may accompany the sciatica.

Sciatica is a form of pain that is called a "radiculopathy" in medical terminology. This means that it often follows the path of a single spinal nerve root such as the Lumbar 5 (L5) or Sacral 1 (S1). This is often the case when sciatica is due to a herniated disc or bulging disc. If the cause is in the lumbar spine, the sciatica - or leg pain - is often accompanied by back pain.

Some patients also experience sciatica pain affecting all the dermatomes in the sciatic nerve, L4, L5 and S1. This sort of "pan-sciatic syndrome" may be due to piriformis muscle syndrome. This condition is due to a muscle in the buttock that goes into spasm and pinches the sciatic nerve.

When the sciatica symptom is due to a herniated disc, it often affects a single strip of skin or dermatome. A far lateral herniated disc affects the exiting nerve root – in this picture, the L4 root is compressed by an L4/L5 lateral disk herniation. More commonly, however, the disk bulge is close to the body’s midline. The illustration shows an L5/S1 disk herniation affecting the transiting S1 root but leaving the L5 root undisturbed. The patient’s detailed distribution of symptoms must match exactly with the MRI findings in the spine before a back surgery can be recommended.

The sciatic nerve starts in the lower back at lumbar segment 3 (L3). The sciatic nerve roots run through the bony canal in the spine, and at each level in the lower back a pair of nerve roots exits from the spine and then comes together to form the large sciatic nerve that runs all the way down the back of each leg. Portions of the sciatic nerve then branch out in each leg to innervate certain parts of the leg (e.g. the calf, the foot, the toes).

The nerve roots that originate in the lower back are named for the upper vertebral body that they run between (for example, the nerve that exits at L4-L5 in the spine is named L4). The nerve passing to the next level runs over a weak spot in the disc space, which is the reason discs tend to herniated (extrude) right under the sciatic nerve root and can cause sciatica.

The sciatica symptoms (e.g., low back pain, leg pain, numbness, tingling, weakness) are different depending on where the pressure on the nerve occurs. For example, a lumbar segment 5 (L5) nerve impingement can cause weakness in extension of the big toe and potentially in the ankle (foot drop) (See diagram of the sciatic nerve).

Fig 1: Diagram of sciatic nerve

Sciatica Terms and Conditions:

• Sciatica and pregnancy - The symptom of sciatica can be triggered during pregnancy for three reasons. The added weight and bending stress on the spine can worsen a bulging disc. The expanded uterus in the pelvis can press on some the lumbar and sacral spinal nerves that help form the sciatic nerve. Additional stresses from the weight of the pregnancy can trigger a piriformis syndrome.


• Sciatica and Back Pain - Radiating pain down the leg often occurs along with back pain, however, the two symptoms are not always linked. In piriformis syndrome, there may be buttock and leg pain without back pain. Also, a herniated disk will occasionally cause buttock and leg pain with virtually no back pain. When you have back pain alone but no sciatica, then your problem is generally something other than a herniated disk. Back pain alone can even have it's roots in life stress, however sciatica is almost always an indication of a specific nerve related problem.

Sciatica Treatment: Exercise, Accupuncture, and Chiropractors - When sciatica is due to the muscle spasm of piriformis syndrome, specialized exercises - often directed by a physical therapist - can be helpful, but exercises can make sciatica worse if it is due to a herniated disc. Accupuncture makes it easier to tolerate the pain but doesn't fix the problem. Chiropractors can be helpful or harmful in any case of sciatica depending on their skill and experience.

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