For some people, sciatica pain can be severe and debilitating. For others, the sciatica symptoms might be infrequent and irritating, but have the potential to get worse.
Low back pain may be present along with the leg pain, but typically the leg pain is markedly more severe than the low back pain. Patients often describe their sciatica symptoms as electrical shocks running down the leg, or searing or burning pain.
Common Sciatica Symptoms
Usually, sciatica affects only one side of the lower body and the pain radiates from the lower back to the back of the thigh and down the leg.
Some combination of the following symptoms is most common:
- Constant pain in only one side of the buttock or leg, but rarely in both sides
- Pain that originates in the low back or buttock and continues along the path of the sciatic nerve—down the back of the thigh and into the lower leg and foot
- Pain that feels better when patients lie down or are walking, but worsens when standing or sitting
- Pain typically described as sharp or searing, rather than dull
- A "pins-and-needles" sensation, numbness or weakness, or a prickling sensation down the leg in some cases
- Weakness or numbness when moving the leg or foot
- Severe or shooting pain in one leg, making it difficult to stand up or walk
- Pain and other symptoms in the toes, depending on where the sciatic nerve is affected
- Lower back pain that, if experienced at all, is not as severe as leg pain
Symptoms may intensify during sudden movements, such as a sneeze or cough, or when changing positions, such as when moving from a sitting position to standing up.
Certain symptoms are unique depending on the underlying cause of the sciatica. For example, bending the body backward or walking more than a short distance often triggers symptoms when spinal stenosis is the cause. Bending the body forward may trigger symptoms if the cause is a lumbar herniated disc.
Sciatica Symptoms for Each Nerve Root
There are two nerve roots that exit the lumbar spine (L4 and L5) and three that exit the sacral segment (S1, S2, and S3).
All five nerves bundle together to form the sciatic nerve, and then branch out again within the leg to deliver motor and sensory functions to specific destinations in the leg and foot.
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Sciatica symptoms vary based on where the compressed nerve root is located. For example:
- L4 nerve root sciatica symptoms usually affect the thigh. Patients may feel weakness in straightening the leg, and may have a diminished knee-jerk reflex.
- L5 nerve root sciatica symptoms may extend to the big toe and ankle (called foot drop). Patients may feel pain or numbness on top of the foot, particularly on the "web" of skin between the big toe and second toe.
- S1 nerve root sciatica affects the outer part of the foot, which may radiate to the little toe or toes. Patients may experience weakness when raising the heel off the ground or trying to stand on their tiptoes. The ankle-jerk reflex may also be reduced.
Since more than one nerve root may be compressed, patients may experience a combination of the above symptoms.
Sciatica Symptoms Needing Immediate Medical Attention
Rarely, sciatica symptoms that worsen quickly may require immediate surgery. The following symptoms indicate a need for immediate medical care:
- Symptoms that continue to get worse rather than improve, which may indicate possible nerve damage, especially if the progressive symptoms are neurological (such as leg weakness).
- Symptoms that occur in both legs (called bilateral sciatica)—or that cause bladder or bowel incontinence or dysfunction or altered sensation in the genital area or "saddle area"—may indicate cauda equina syndrome. Cauda equina syndrome is an acute compression of one or several nerve roots that occurs relatively rarely (in approximately 2% of herniated lumbar disc cases) and can cause paralysis.7
Sciatica that occurs after an accident or trauma, or if it develops in tandem with other troubling symptoms like fever or loss of appetite, is also cause for prompt medical evaluation. Patients should seek medical attention right away if they feel there is cause for concern.