Sciatica refers to the pain that radiates along the sciatic nerve, which branches off from the lower back and travels through the hip and buttocks and down each leg.
Sciatica (pronounced as sigh-at-eh-kah) is not actually a medical diagnosis or a disease, it is a symptom of an underlying condition. It describes the symptoms of pain in the lower back as well as one or both legs, including numbness, tingling or weakness, usually at the back of the leg where the sciatic nerve is present.
A pinched nerve, on the other hand, may result in sciatic pain. As the name suggests, a pinched nerve is a nerve that has been compressed or ‘pinched’ at some point along its path. The location of the compressed part of the nerve will determine what kind of symptoms occur.
Anatomy of the Sciatic Nerve
The sciatic nerve begins at the level of L3 (or lumbar segment 3) of the spine in the back. This is the largest nerve in our body. It carries various nerve roots, which start at the lower back and branch down the back of each leg. Various nerve fibres branch out into the leg, innervating the thigh, calf, foot, and toes along the way.
Causes of Sciatic Pain
As we already know, sciatica pain is usually caused by an underlying medical condition. Some of the common causes of sciatica or conditions resulting in sciatic nerve pain are as follows:
- Lumbar herniated disk (bulging of the vertebral disc due to rupture)
- Bone spur (bony projection)
- Degenerative disc disease (when the disc degenerates, its structure is beginning to break down and can no longer properly fulfil their role to act as cushions between the vertebrae and support them)
- Spinal Stenosis in the lumbar region (narrowing of the spinal canal in the lower back, where the spinal cord passes through)
- Spondylolisthesis (one vertebra slips forward over another one)
- Muscle spasm in the back or buttocks
- Infections affecting the spine
- Lumbar radiculopathy or compression of the sciatic nerve root
Some other things that can worsen the back pain include being obese or overweight, lack of regular exercise, wearing high heels, sleeping on a mattress that is either too soft or too hard.
Sciatic Nerve Pain/ Sciatica Symptoms
Most often, sciatica symptoms include:
- The main feature of sciatica is a constant pain in the leg, usually on one side of the body, which may include the lower back, legs, and even feet. Pain in both the legs rarely occurs, but is still possible, and it is called bilateral sciatica.
- The pain typically starts in the lower back and can extend from the buttock down the leg and sometimes even to the calf, foot and toes.
- The pain is very sharp, burning or piercing.
- Pain is worse while sitting down (especially for long periods of time) or may make it difficult to stand up or walk.
- Weakness, tingling or numbness when moving the leg, foot or toes.
The pain may be severe and constant, or not very frequent and just somewhat irritating. This depends on the location where the nerve is pinched. Most of these symptoms occur when the Sciatic nerve is compressed or pinched near its point of origin.
Sciatic pain rarely develops in young people. It occurs more commonly around the age of 40-50 years. As this term is generally used to refer to any pain in the leg and back, its prevalence varies widely. This tends to develop over time rather than being caused by an injury or a trauma.
Treatment options for sciatica include:
- Physical therapy to help with the pain.
- Anti-inflammatory medication to temporarily reduce and manage the symptoms.
- Using a spinal decompression device to remove any compression in the back, including that which has led to a herniated disc which now pinches on the sciatic nerve.