What is Sciatica?
Sciatica describes pain felt along the sciatic nerve, which runs from your lower back, down through the buttock, hamstrings and into the lower leg. The sciatic nerve is the longest nerve in the body. The spinal sections it originates from include L4, L5 or S1. See the diagram below for a general idea where you may feel sciatica symptoms.
Sciatica is commonly misdiagnosed, which can result is either slow or non-responsive treatment. Leg pain can have various sources. It can be a local leg injury or it may even be referred from your lower back. The main nerve that travels from your lower back to your leg is your sciatic nerve. Irritation or pinching of your sciatic nerve can cause severe leg pain known as sciatica.
Common Causes of Sciatica
Pressure on the sciatic nerve from a herniated disc usually causes sciatica. Otherwise joint inflammation, compression of the nerve from bony arthritic growths or a locked facet joint in the lower spine can commonly cause sciatica.
Leg pain can have various sources. Pain can be a local leg injury or it may even be referred from your lower back and travel along the sciatic nerve. The main nerve that travels from your lower back to your leg is your sciatic nerve.
Injury that irritates or pinching of your sciatic nerve can cause severe leg pain known as sciatica. You're most likely to get sciatica when you're 30 to 50 years old. It may happen due to the effects of general wear and tear, plus any sudden pressure on the discs that cushion the vertebrae of your lower (lumbar) spine.
While there are numerous causes of sciatica, the most common are:
Other sources include:
You're most likely to get sciatica when you're 30 to 50 years old. It may happen due to the effects of general spine wear and tear (spondylosis) or a traumatic injury that sudden pressure on the lumbar discs eg lifting, bending or sneezing.
What are Sciatica Symptoms?
Sciatica causes pain that usually begins in the lower back and spreads through the buttock, leg, calf and, occasionally, the foot. The pain can vary between dull, aching or burning sensations and sharp, shooting pains.
Sciatica can also cause tingling, numbness or muscle weakness in the affected leg. It is very important to seek medical attention in these situations as long-term nerve compression can permanently damage the nerve and its function. In these cases your symptoms may become permanent.
One or more of the following sensations may occur because of Sciatica:
- 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 calf
- A shooting pain that makes it difficult to stand up
How is Sciatica Diagnosed?
Sciatica is a clinical diagnosis based upon your symptom description, the behaviour of your pain and a thorough physical examination.
While the diagnosis of sciatica is reasonably simple, the primary cause of your sciatica may require further investigations to eliminate or confirm its origin. It is also important to determine how significant your sciatic nerve has been compressed.
Your physiotherapist will examine you, paying special attention to your spine and legs. In addition to asking you if you have low back pain that spreads to the leg and calf, your physiotherapist will test you for muscle weakness, sensation deficits and altered reflexes in your leg or foot.
They will also want to know if you've had an injury, fever, problems controlling your bowels or bladder, previous cancers and whether you've been losing weight without trying. The answers to these questions are important because if these symptoms are present, the cause of sciatica could be a serious condition, such as a bone fracture, infection or cancer.
Your physiotherapist or doctor may send you for X-rays, or arrange for a computed tomography (CT) scan or a magnetic resonance imaging (MRI) scan to check for problems in the spinal vertebrae (backbones) that may be irritating or compressing your sciatic nerve. Most cases of sciatica affect the L5 or S1 nerve roots.
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