For many people, sciatica can be severe and debilitating. True sciatica is often referred to clinically as a radiculopathy, which simply means that there is a nerve injury. Typically, a protruded disk or herniated disk in the lower back (lumbar spine) is pinching or “putting pressure” on a spinal nerve root that forms part of the sciatic nerve. Sciatic nerve pain and sciatica symptoms include the following:
- Pain radiating from the low back, down the back of the thigh, into the lower leg and possibly into the foot and toes.
- Numbness or paresthesia and tingling and/or burning down the back of the thigh and leg.
- Pain may be constant or intermittent.
- Severe cases may include muscle weakness and/or bowel or bladder incontinence (inability to control the bowel or bladder).
It is very important to understand that symptoms of sciatica can vary greatly and a thorough evaluation is necessary to determine the underlying cause of the sciatic pain. For example, oftentimes a MRI (magnetic resonance imaging) is necessary to determine which spinal nerve root is being “pinched”. X-rays are very helpful to reveal areas of spinal degenerative disc disease or arthritis.
To complicate things further, you may not have true sciatica. Pain radiating from the low back into the leg could be “referred” pain from something other than a prolapsed or herniated disk. Referred pain is not true sciatica. Referred pain that mimics sciatica can be caused by a joint problem in the pelvis (i.e., sacroiliac joint or hip joint) or a joint problem in the lumbar spine (i.e., lumbar facet). Referred pain is quite common.