The term sciatica describes the symptoms of leg pain—and possibly tingling, numbness or weakness—that originate in the lower back and travel through the buttock and down the large sciatic nerve in the back of the leg.
Sciatica (pronounced sigh-at-ih-kah) is not a medical diagnosis in and of itself—it is a symptom of an underlying medical condition, such as a lumbar herniated disc, degenerative disc disease, or spinal stenosis.
Sciatica Nerve Pain
Sciatica is often characterized by one or a combination of the following symptoms:
- Constant pain in only one side of the buttock or leg (rarely can occur in both legs)
- Pain that is worse when sitting
- Leg pain that is often described as burning, tingling or searing (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
Sciatic pain can vary from infrequent and irritating to constant and incapacitating. Specific sciatica symptoms can be different in location and severity, depending upon the condition causing the sciatica (such as a lumbar herniated disc ).
While symptoms can be painful and potentially debilitating, it is rare that permanent sciatic nerve damage (tissue damage) will result.
The Sciatic Nerve and Sciatica
Sciatica symptoms occur when the large sciatic nerve is irritated or compressed in the lumbar spine.
The sciatic nerve is the largest single nerve in the body and is composed of individual nerve roots that start by branching out from the spine in the lower back and combine to form the "sciatic nerve."
- The sciatic nerve starts in the lower back at lumbar segment 3 (L3).
- At each level of the lower spine a nerve root exits from the inside of the spine, and these respective nerve roots then come together to form the large sciatic nerve.
- The sciatic nerve runs from the lower back, through the buttock, and down the back of each leg
- Portions of the sciatic nerve then branch out in each leg to innervate certain parts of the leg - the thigh, calf, foot, toes.
The specific sciatica symptoms - the leg pain, numbness, tingling, weakness, and possibly symptoms that radiate into the foot - largely depend on where the nerve is pinched. For example, a lumbar segment 5 (L5) nerve impingement can cause weakness in extension of the big toe and potentially in the ankle.
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The Course of Sciatica Pain
The incidence of sciatica increases in middle age. Rarely occurring before age 20, the probability of experiencing sciatic pain peaks in the 50s and then declines.1
Often, a particular event or injury does not cause sciatica, but rather it tends to develop over time.
The vast majority of people who experience sciatica get better within a few weeks or months and find pain relief with non-surgical sciatica treatment. For others, however, the leg pain from a pinched nerve can be severe and debilitating.
There are a few symptoms that may require immediate medical, and possibly surgical, intervention, such as progressive neurological symptoms (e.g. leg weakness) and/or bowel or bladder dysfunction (Cauda Equina Syndrome).
Because sciatica is caused by an underlying medical condition, treatment is focused on addressing the underlying causes of symptoms, such as spinal stenosis or a herniated disc. Treatment is usually self-care and/or non-surgical, but for severe or intractable pain and dysfunction it may be advisable to consider surgery .
- Frymoyer J, “Lumbar Disc Disease: Epidemiology,” Instructional Course Lectures, 1992:41:217-23.