The term sciatica is used to describe the symptoms of pain, weakness, numbness, or tingling that radiates along the sciatic nerve from the buttock through the back of the thigh and down the leg to the ankle and foot.
The sciatic nerve is the largest and longest single nerve in the body. Formed by a combination of nerves in the lumbar and sacral spine, the sciatic nerve travels from the lower back, through the pelvis and down each leg. The sciatic nerve and its branches enable movement and feeling in the thigh, knee, calf, ankle, foot, and toes. If the sciatic nerve is compressed, it may cause pain and other neurological symptoms known as “sciatica” to develop and radiate from the buttock to the foot.
A variety of lower back problems can compress the sciatic nerve and lead to the development of sciatica. Among the possible causes of sciatica are a bulging or herniated disc, degenerative disc disease, spinal stenosis, spondylolisthesis, piriformis syndrome, pregnancy, trauma, a spinal tumor or infection. Sciatica is the most common symptom of a lumbar herniated disc.
The pain and neurological dysfunction of sciatica most often occur on one side of the body and can vary widely in both the type of and degree of discomfort. Depending upon where the compression of the nerve roots or sciatic nerve in the lower back originates, the specific sciatica symptoms in the leg and foot will be different. Individuals with sciatica may experience one or more of the following symptoms:
- Leg pain that is characterized as burning, tingling, or searing
- Constant pain in one side of the buttock or leg
- Pain that can intensify with sitting, sneezing, or coughing
- Weakness, numbness in the leg or foot
- Pain that makes it difficult to stand up or walk
- Some individuals with sciatica can have difficulty bending at the knee or moving the foot and toes.
A complete medical history and physical exam is the first step in evaluating sciatica and determining the underlying cause. The doctor will review the symptoms and check for pain, weakness, sensory loss, and try to pinpoint the affected nerves. Further diagnostic testing may be recommended.
It is important to identify and manage the underlying cause of sciatica. Conservative therapy will provide improvement for many individuals with sciatica. Non- surgical treatments may include heat and cold therapy, pain medications, non-steroidal anti-inflammatory medications, epidural steroid injections, and physical therapy. Surgery may be recommended to address the underlying cause of sciatica in cases where the symptoms are getting progressively worse, and the pain is severe.