Sciatica is a term for symptoms of pain along the large sciatic nerve that runs from your lower spine and down the back of the leg. Sciatica is diagnosed when the sciatic nerve is irritated or compressed by some type of problem in your lower back.
Sciatica is nerve pain
When any of the nerve roots in your 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 and into your foot and/or toes.
Sciatica pain is often experienced as a shooting, searing pain that radiates down the back of the leg. Sometimes, numbness, tingling, or burning is felt along the nerve. Some people describe the nerve pain as electric-like. Conversely, sciatica symptoms may be experienced as more of a constant, dull pain.
Several lower back problems cause sciatica
The most common causes of sciatica in younger adults tend to be a lumbar herniated disc,degenerative disc disease, or isthmic spondylolisthesis.
In adults over age 60, the most common causes tend to be degenerative changes in the spine, such as lumbar spinal stenosis or degenerative spondylolisthesis.
The term sciatica is often misused, and people may be tempted to self-diagnose and self-treat the wrong cause of their sciatica. However, knowing the underlying cause of your sciatica symptoms is important in order to get the right treatment.
Some conditions mimic sciatica
Many people refer to any type of leg pain 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.
Examples of problems that are not sciatica but can cause similar symptoms include:
Joint problems in the spine, such as arthritis, can 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 therapies with the goals of preserving motion in the joints and reducing pain long term. Anti-inflammatory drugs are often prescribed to reduce joint inflammation.
Sacroiliac joint dysfunction is a relatively common cause of lower back, hip, and/or leg pain. Too much or too little motion in the sacroiliac joints can cause pain that radiates down your 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 fusionis available for severe, debilitating SI joint dysfunction.
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 path of the nerve into your 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 specific physical therapy.
Self-diagnosis of sciatica may be problematic
As many underlying conditions can cause sciatic or sciatica-like pain, it is important to consult a doctor for a clinical diagnosis. While rare, sciatica-like pain may be caused by medical conditions that need immediate treatment.
For example, any of the following serious medical conditions may cause sciatica-like symptoms:
A spinal tumor
Cauda equina syndrome
While the vast majority of causes of sciatica or sciatica-like pain are not serious, we advise anyone experiencing sciatic nerve pain to see a doctor for a correct diagnosis and the right set of treatment options.
Bottom line: get a diagnosis
If you feel symptoms of pain in your buttocks or leg, or numbness, tingling, or other neurological symptoms in your leg, it is important to see a doctor for clinical diagnosis that identifies the cause of your symptoms.
As you can see by reading the peer-reviewed articles on this site, treatment can be quite different depending on the underlying cause of your symptoms. For example:
A lumbar herniated disc and lumbar stenosis can cause similar sciatica symptoms; however, physical therapy for each condition can be different—while bending forward at the waist may be comfortable if you have spinal stenosis, it can cause increased pain if you have a lumbar herniated disc.
If spondylolisthesis is causing your sciatica, you may need surgery to align and stabilize the vertebrae before doing any sort of exercises at all.
Treatment is determined largely by the diagnosis.
When your doctor gives you the go ahead, make sure to include a controlled and progressive exercise and physical program as part of your treatment. Without it, your symptoms are likely to return and get worse over time. The following basics are fundamental to almost any successful sciatica treatment:
Get a prescription for the right exercises
Learn how to do the exercises with the right form
Keep doing the exercises even after you start to feel better
And finally, give yourself kudos, as right now you are already taking positive steps to feel better by researching and learning about your symptoms and treatment options.
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- Your team at Long Island Spine Specialists, P.C.
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