What You Need to Know About Sciatica

The term sciatica describes the symptoms of leg pain and possibly tingling, numbness or weakness that originates in the lower back and travels 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.

Sciatica Nerve Pain

Sciatica is often characterized by one or more 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
  • Burning or tingling down the leg (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 also vary widely in type, location and severity, depending upon the condition causing the sciatica (such as a lumbar herniated disc).

While symptoms can be very painful, it is rare that permanent sciatic nerve damage (tissue damage) will result.

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The Sciatic Nerve and Sciatica

Sciatica symptoms occur when the large sciatic nerve is irritated.

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 then comes together to make up the large sciatic nerve.
  • The sciatic nerve runs from the lower back, 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 buttock, thigh, calf, foot, toes.

The sciatica symptoms (e.g., leg pain, numbness, tingling, weakness, possibly symptoms that radiate into the foot) are different depending 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.

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, sciatica 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 relieving the underlying causes of symptoms. Treatment is usually self-care and/or non-surgical, but for severe or intractable cases surgery may be an option.

Resources

  1. Frymoyer J, “Lumbar Disc Disease: Epidemiology,” Instructional Course Lectures, 1992:41:217-23.
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