Taking the Mystery Out of Sciatica
(Frequently Asked Questions About Sciatica and Leg Pain)
By Dean Moyer
Author of Rebuild Your Back
There are many myths and misconceptions about sciatica. There is also some confusion about why sciatica occurs and just what to do about it.
In this article I will attempt to help you understand the causes of sciatica, the warning signs and just what you can do to eliminate the low back pain and leg pain associated with it.
Question: So What Exactly Is Sciatica?
Answer: Sciatica is a group of symptoms associated with a pinched sciatic nerve.
The symptoms of sciatica manifest themselves in various ways. You may have just one of them or you could experience several of them at the same time. They usually only affect one side of the body, but occasionally have been known to affect both sides at the same time. And to top it off, sometimes you will find that they move to different locations.
The symptoms of sciatica may or may not include lower back pain, pain on one side, pain in the left or right buttock, pain down the back of the leg and/or foot pain. These symptoms are often described as numbness, tingling, pins and needles or a burning, achy soreness that can travel down through the buttocks to the leg or foot.
One thing to keep in mind is that, even though the pain is usually in the legs or buttocks, it is actually a "referred pain" that has nothing to do with those locations at all. It is caused by a structural element in the lower back impinging on the sciatic nerve and your brain just thinks the pain is in your legs or buttocks. Sciatic nerve irritation often occurs at the L5 or S1 levels of the spine where the nerve exits the spinal canal.
Question: Is sciatica the same for everyone?
Answer: No, it can be different for each individual
Your symptoms will differ depending on the location of the pinched nerve. For example, your pain may remain centered in your lower back. For someone else, it may run down the back of each leg or it may affect only one leg. Sometimes the pain can go all the way down to the feet and toes. Other people describe sciatica as a tingling or burning sensation. While others experience a prickly feeling like pins and needles in their feet and toes.
The severity and duration of the pain will vary from person to person. Some find the pain to be merely irritating and inconvenient. Others find it to be severe and debilitating. For some the pain may come and go, while others experience it on a continuous basis.
Sciatica usually only affects one side of the body but even this is not always the case.
Question: Where is the sciatic nerve?
Answer: The sciatic nerve runs from the lumbar region of the back down to the toes.
The sciatic nerve is the longest nerve in your body. It is comprised of two branches on either side of the spine. The root of each nerve exits the spine from several locations including the two lowest vertebrae in the lumbar spine. It travels down the back of each leg all the way to the foot and toes.
Question: How long does sciatica usually last?
Answer: No one can predict how long the symptoms will persist.
A single episode of sciatica can last anywhere from a few days to as long as a few months.
Most people find that the symptoms subside within a few weeks and they erroneously conclude that their problems are over. Depending on the cause of your sciatica, the leg pain or low back pain will probably return if proper steps are not taken to correct the source of the nerve compression.
If left untreated it will grow worse and could become a chronic problem. The longer you delay treatment, the longer it will take for the situation to be corrected. Sciatica will continue to persist as long as the sciatic nerve remains pinched.
And finally, even when the symptoms do disappear, the pinched nerve can still take another six months to fully heal. How long sciatica remains a problem for you will depend on how long it takes you to rebuild the support structure of your back.
Question: Do herniated discs cause sciatica?
Answer: That is one possibility, but there are several others...
It is a well-established fact that sciatica is caused by a pinched or irritated sciatic nerve. And while it was once believed that a herniated disc could be at fault, it is far more likely that the source of the irritation is an inflamed facet joint, a stiff section of scar tissue or a hard bony surface that the nerve is coming in contact with.
While herniated discs are a symptom of degenerative disc disease and definitely not a desirable condition, they are seldom painful and there is little evidence that they actually irritate or pinch nerves as was once believed.
There have been numerous studies done over the past 20 years that have shown that herniated discs are quite common and are merely a sign that you need to begin a back reconditioning program. They are not an indication that you need surgery. For more on this read, The Truth About Herniated Discs.
Question: Can sciatica lead to permanent damage?
Answer: Yes, serious nerve damage can occur with sciatica.
The pain from sciatica is the result of very real damage to your sciatic nerve. Usually, this damage is only minor and will heal once the pinched nerve is relieved. In all probability it will not result in permanent nerve damage, but the possibility does exist.
However, sciatica is nothing to fool with and you should always see your doctor if you suspect that your symptoms are the result of a pinched nerve. Some signs of serious nerve damage due to sciatica include the inability to control your bowel or bladder, an increasing weakness in your legs or the loss of feeling or sensation in your legs or feet. If you are experiencing any of these symptoms seek immediate medical attention.
Question: Is leg pain from sciatica caused by a problem in the leg?
Answer: No, sciatic leg pain is usually caused by a problem in the lower back.
Leg pain is a common symptom of sciatica and, while the pain may be felt in the legs, the source of the pinched nerve is not at the location of the pain itself. The pinched nerve is usually located in the lower back.
The reason the pain is felt somewhere else is because the sciatic nerve travels all the way from the lower back to the feet. So nerve compression in the low back can trick the brain into feeling the pain anywhere along that route.
Question: Is Piriformis syndrome the same thing as sciatica?
Answer: Piriformis syndrome is similar to sciatica but it's not the same thing.
Piriformis syndrome is a rare neuromuscular disorder that occurs when the piriformis muscle compresses or irritates the sciatic nerve. While not technically sciatica, it does manifest similar symptoms.
The piriformis muscle is a narrow muscle located in the buttocks. If this muscle becomes too tight it can compress the sciatic nerve and cause pain, tingling or numbness in the buttocks. These symptoms often travel down to the leg just as with sciatica.
For this reason, piriformis syndrome is often confused with sciatica. The difference between the two is the location of the irritation. With sciatica the pinched nerve is in the lower back. For piriformis syndrome the pinched nerve is in the buttocks. It may seem like splitting hairs but it is important to distinguish between the two problems because the exercises used to treat them are different.
About the Author
Rebuild Your Back
Rebuild Your Neck
The Pain Relief Manual
Last updated: April 12, 2010