Sciatica: Symptom or Diagnosis?

The term sciatica is oftentimes used incorrectly to explain leg pain, low back pain and other sciatica symptoms. It’s a condition so widespread that many people think they can self-treat it or just follow another person’s advice for how to relieve the pain. However, as this article will explain, there are many myths and misconceptions about sciatica, and patients are well-served to fully understand what can cause sciatica, warning signs that it may be a dangerous condition, and the full range of treatment options, including sciatica exercises.

Sciatica (often misspelled as ciatica or siatica) is a relatively common form of leg pain that is often misunderstood by patients. There are frequent misconceptions about what the term sciatica means, why sciatica occurs and how to find relief from the low back pain and leg pain. Contrary to what many patients believe, sciatica is actually a set of symptoms rather than a diagnosis for what is causing the pain. Especially for more severe cases, the cause of the low back pain and leg pain needs to be correctly addressed in order to relieve discomfort.

Truth: Sciatica is a symptom, not a diagnosis

Sciatica means that a patients sciatic nerve is being compressed by another spinal structure, usually causing pain in the low back, on one side of the rear and/or down the back of the leg. Sciatic nerve irritation usually occurs at the L5 or S1 level of the spine.

The clinical diagnosis (and the focus for treatment) would be whatever problem is actually causing the nerve compression and the sciatic pain. The most common low back problems that cause sciatica are:

  • Lumbar disc herniation – where the inner core of a spinal disc in the low back extrudes and places pressure on a nerve root; also called a pinched nerve, slipped disc, bulging disc or protruding disc
  • Lumbar degenerative disc disease – when weakened discs in the low back allow excess motion in the spine and cause irritation of the nerve roots
  • Isthmic spondylolisthesis – where one vertebral body slips over another and pinches a nerve root
  • Lumbar spinal stenosis – in which a narrowing of the spinal canal in the low back pinches nerve roots, sometimes as the result of a bone spur
  • Lumbar subluxation a term describing an altered position of the vertebra in the low back and the functional loss that results
  • Others causes Although less common than those listed above, there are several other conditions that can cause sciatica and require medical attention. For example, patients who have a spinal tumor or infection should seek help immediately.

Truth: The sciatica experience can be different for each patient

Sciatica pain can run from the low back, down the back of each leg and sometimes into the feet and toes. Other sensations associated with sciatica may include tingling and/or a burning or prickly feeling, usually only on one side of the body. Patients typically feel different types of sciatic pain depending on the location of the nerve compression.

The severity and duration of pain from sciatica also vary among patients. Some find sciatica pain severe and debilitating, while others experience it as irritating and intermittent. Many patients recover from an episode of sciatica within a few weeks, but there is no hard and fast rule. Depending on the particular cause of the patients sciatica, the leg pain or low back pain could worsen over time and/or take much longer to be relieved.

Truth: Serious problems or damage can occur (though rare)

Pain from sciatica results from damage to the patients nerve tissue. In the vast majority of cases, the nerve damage is not permanent. However, the following signs indicate that there may be a more serious problem that requires immediate medical attention:

  • Patients who feel weakness or numbness may require surgery, and any patient experiencing these symptoms should seek professional attention.
  • Patients who experience bowel or bladder incontinence (inability to control the bowel or bladder) and/or increasing weakness or loss of sensation in the legs should see a doctor immediately.

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