Is My Pain Sciatica or Something Else?

Sciatica is a term for symptoms of pain along the large sciatic nerve that runs from the lower back down the back of each leg. It is relatively common, and occurs when the sciatic nerve is irritated or compressed by a problem in the low back.

When any of the nerve roots in the lower back are irritated, pain travels from the nerve root to the sciatic nerve, down to the buttock, and sometimes down the back of the leg.

The severity of sciatica pain can range from infrequent and irritating to severe and debilitating, and it can be experienced as either a shooting or a constant pain. Sometimes, numbness, tingling, or burning is felt along the nerve. Usually, sciatica pain is worse in the leg, and while sitting.

The most common causes of sciatica in younger adults tend to be a lumbar herniated disc, degenerative disc disease, or isthmic spondylolisthesis.

In older adults, the most common causes tend to be degenerative changes in the spine, such as lumbar spinal stenosis or degenerative spondylolisthesis.

Illustration of Sciatic Nerve Pain

The term sciatica is often misused, and patients may try to self-diagnose and self-treat the wrong cause of their sciatica.

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Some conditions mimic sciatica

Any type of leg pain is often referred to as sciatica, but in fact, there are many causes of leg pain that are not medically classified as sciatica and need to be treated differently.

Many other problems can also cause pain down the leg, including:

  • Joint problems in the spine, such as arthritis, can also refer pain from the joints into the leg, but this pain is not technically sciatica, and the treatment for it is different. For arthritis, treatment focuses on nonsurgical treatments that preserve motion in the joints and reduce pain long-term. Anti-inflammatory drugs are often prescribed to reduce joint inflammation.
  • Sacroiliac joint dysfunction is a relatively common cause of lower back and leg pain. Too much or too little motion in the sacroiliac joint can cause pain that radiates down the leg and feels like sciatica. Treatment for sacroiliac joint dysfunction is usually non-surgical and focuses on restoring normal motion in the joint.
  • Sacroiliac Joint Pain
    Sacroiliac joint dysfunction can cause symptoms similar to sciatica.

  • Piriformis syndrome also causes symptoms similar to sciatica. It occurs when the piriformis muscle in the buttocks irritates the sciatic nerve, which can cause pain to radiate along the nerve into the leg. This type of pain is technically not sciatica, because the nerve irritation does not originate in the lower back. Treatment for piriformis syndrome usually includes anti-inflammatory medication and physical therapy.
Piriformis Muscle and Sciatic Nerve Anatomy
The piriformis muscle in the buttocks can sometimes irritate the sciatic nerve.

Self-diagnosis of sciatica is dangerous

Given the multitude of conditions that can cause sciatic or sciatica-like pain, it is imperative to meet with a doctor for the appropriate diagnosis. While rare, sciatica-like pain may be caused by serious medical conditions that need immediate treatment.

For example, all of the following conditions may cause sciatica-like symptoms:

While the vast majority of causes of sciatica or sciatica-like pain are not serious, we advise anyone experiencing sciatic nerve pain to see his or her doctor for a correct diagnosis and the right set of treatment options.

Bottom line: get a diagnosis

If you feel symptoms of pain in the buttocks or leg, or numbness, tingling or other neurological symptoms in your leg, it is important to see a doctor for an accurate diagnosis of the cause of your symptoms. Treatment options will be determined based on the clinical diagnosis.

And exercise!

Make sure that a controlled and progressive exercise and physical rehabilitation program are part of your treatment for sciatica. Without it, your symptoms are likely to get worse over time. Doing the right types of exercises correctly helps increase your chances of living without sciatica.

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