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The following article was published in our article directory on December 6, 2014.
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Sciatica: What is it?

Article Category: Lifestyle

Author Name: John B. Adams, DO, FIPP

"Sciatica" is a symptom that often results from inflammation of the sciatic nerve or the nerves forming it. The signs of sciatica include leg discomfort, tingling, tingling, mild weakness and radiate into the buttocks, leg, and foot.

The large bulk of individuals who experience sciatica get much better within a few weeks or months and achieve improved pain and function with non-surgical sciatica treatment. However, for others, sciatica discomfort from a pinched nerve can be extreme and incapacitating. In a minority of cases, surgery is required to treat the underlying cause. Severe or life threatening causes of sciatica such as cancer of the spine are rare but do occur. Persistant sciatica symptoms should be thoroughly evaluated by a physician with knowledge and experience dealing with the nervous and musculoskeletal systems.

Sciatica (Pronounced sigh-at-ti-kah) is not a clinical diagnosis in and of itself - it is a description of a constellation of symptoms of that may originate from a number of clinical conditions.

The term sciatica is not a specific diagnosis. Instead is a description of the signs and symptoms of leg discomfort and/or tingling, feelings numbness and/or mild weakness that comes from the lower back and travels through the buttocks and down the large sciatic nerve in the back of each leg.

Sciatica: Nerve Discomfort
Sciatica is frequently defined by several of the following signs and symptoms:
1. Continuous discomfort in just one side of the buttocks or leg (rarely occurs in both legs)
2. Discomfort that is even worse when sitting
3. Burning or tingling down the leg (vs. a dull pains).
4. Weakness sensations, feeling numb or problem moving the leg or foot.
5. An acute pain that could make it hard to stand or to walk.

Sciatic discomfort can differ from irregular and annoying to consistent and incapacitating. Certain sciatica signs and symptoms, likewise differ commonly in type, location and severity, depending on the underlying cause of the sciatica (such as a lumbar herniated disc, sacroiliac sprain, or muscle strain).

While signs and symptoms can be very uncomfortable, it is unusual that long-term sciatic nerve damage or tissue damage will result, although nerve and tissue damage can occasionally occur in a minority of cases.

Although not an exhaustive list, one or more of the following signs may indicate a more severe pathological process and need for immediate evaluation for problems such as cancer, fracture, nerve compression, or infection include some of the following signs:
1. Bowel or Bladder incontinence or dysfunction
2. "Saddle" anesthesia (Numbness in the Perineal or Perianal areas)
3. Severe and/or progressive weakness or neurological changes in the legs and/or feet
4. Onset of severe pain in people younger than 20 or older than 50 years.
5. Major trauma such as a significant fall or car wreck
6. New onset of severe pain in people with a history of osteoporosis
7. Severe pain that wakes a person from sleep
8. New onset of pain in a person with a history of cancer
9. Pain along with fever, chills, or night sweats
10. Significant muscle weakness or muscle wasting in lower extremities
11. Structural deformity of the spine
12. Immunosuppression
13. Recent history of bacterial infection (e.g. urinary infection or "staph" infection)

A person suffering sciatica symptoms who also has one of the conditions, signs or symptoms listed above may need an urgent or emergency evaluation by a specialist such as a neurosurgeon, neurologist and may need further evaluations such as lab work, an MRI and/or nerve studies such as an EMG.

The Sciatic Nerve and Sciatica.
Sciatica signs occur when the large sciatic nerve or the nerve roots forming it become inflamed.
The sciatic nerve is the largest single nerve in the body and is made up of specific nerve roots that begin by branching off from the spinal column in the lower back, form the lumbar plexus, and incorporate to form the "sciatic nerve."

The sciatic nerve begins in the lower back at the 3rd lumbar nerve root (L3) between the 3rd and 4th vertebral levels.

At each level of the lower spinal column a nerve root exits from the within the spinal column and after that comes together to comprise the large sciatic nerve. There is a set of these nerve roots on each side and at each level of the lumbar spine and they form a bilateral (both sides) set of sciatic nerves.

The sciatic nerves runs from the lower back, down the back of each leg.
Parts of the sciatic nerve then branch out in each leg to innervate particular parts of the leg - e.g. the buttocks, thigh, calf, foot, toes.

With conservative non-surgical care, the large majority of people suffering from sciatica improve within a short time frame. For those who do not or for those with worsening symptoms, evaluation by a qualified physician is indicated to identify the underlying cause as well as to rule out the presence of rare but severe problems such as nerve compression, fracture, or cancerous tumors.

This article is intended for educational purposes only. It is not medical advice. It discusses the general issues of sciatica but each person's condition is unique. This article is not and should not be used as a replacement for medical evaluation and recommendations from a qualified physician.

Keywords: Sciatica, Pain, Low back pain, herniated disc, neurologist, neurosurgeon, MRI

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