What is Sciatica?
Sciatica describes pain felt along the sciatic nerve, and anything that irritates or compresses the nerve can cause sciatic pain.
The sciatic nerve is the longest in the body, which runs from your lower back down through the buttock, hamstrings, and lower legs. The sciatic nerve originates from spinal segments L4, L5, S1, S2 and S3.
Leg pain can have various sources. It can be a local leg injury, or it may even be referred from your lower back. The main nerve that travels from your lower back to your leg is your sciatic nerve. Irritation or pinching of your sciatic nerve can cause severe leg pain known as sciatica. Sciatica is commonly misdiagnosed, which can result in either slow or non-responsive treatment.
Common Causes of Sciatica
Pressure on the sciatic nerve from a herniated disc is usually what causes sciatica. Otherwise, joint inflammation, nerve compression from bony arthritic growths or a locked facet joint in the lower spine can cause sciatica. Anything that irritates or compresses the sciatic nerve can cause sciatic pain.
While there are numerous causes of sciatica, the most common are:
Other sources include:
You’re most likely to get sciatica when you’re 30 to 50 years old. It may happen due to the effects of general spine wear and tear (spondylosis) or a traumatic injury that causes sudden pressure on the lumbar discs (e.g. lifting, bending or sneezing).
What are Sciatica Symptoms?
Sciatica causes pain that usually begins in the lower back and spreads through the buttock, leg, calf and, occasionally, the foot. The pain can vary between dull, aching or burning sensations and sharp, shooting pains.
Sciatica can also cause tingling, numbness or muscle weakness in the affected leg. In these cases, your symptoms may become permanent. It is crucial to seek medical attention in these situations as long-term nerve compression can permanently damage the nerve and function.
One or more of the following sensations may occur because of Sciatica:
- A pain in the rear or leg that is worse when sitting
- Burning or tingling in the leg
- Weakness, numbness or difficulty moving the leg or foot
- Constant pain on one side of the rear calf
- A shooting pain that makes it difficult to stand up
How is Sciatica Diagnosed?
Sciatica is a clinical diagnosis based on your symptom description, the behaviour of your pain and a thorough physical examination.
While the diagnosis of sciatica is reasonably straightforward, the primary cause of your sciatica may require further investigations to eliminate or confirm its origin. It is also essential to determine how significant your sciatic nerve has been compressed.
Your physiotherapist will examine you, paying particular attention to your spine and legs. In addition to asking you if you have low back pain that spreads to the leg and calf, your physiotherapist will test you for muscle weakness, sensation deficits and altered reflexes in your leg or foot.
They will also want to know if you’ve had an injury, fever, problems controlling your bowels or bladder, previous cancers and whether you’ve been losing weight without trying. The answers to these questions are important because if these symptoms are present, the cause of sciatica could be a severe condition, such as a bone fracture, infection or cancer.
Your physiotherapist or doctor may send you for X-rays or arrange for computed tomography (CT) scan or a magnetic resonance imaging (MRI) scan to check for problems in the spinal vertebrae (backbones) that may be irritating or compressing your sciatic nerve. Most cases of sciatica affect the L5 or S1 nerve roots.
For specific advice regarding how to best diagnose or manage your sciatica, please seek the advice of your physiotherapist or doctor.
Common Lower Back Pain Causes
The following conditions may cause lower back pain.
- Back Cramps
- Back Muscle Pain
- Core Stability Deficiency
- DOMS - Delayed Onset Muscle Soreness
- Side Strain
- Back Stress Fracture
- Scheuermann's Disease
- Spinal Stenosis
- Stress Fracture Spine (Cricket Bowlers)
Back Joint Injuries
Youth Spinal Pain
Teenager Neck & Back Pain
Teenagers can be particularly vulnerable to back pain, mainly due to a combination of high flexibility and low muscle strength and posture control.
The competitive athlete and most individuals who exercise regularly or maintain fitness and core stability control are less prone to spine injury and problems due to the strength and flexibility of supporting structures. Luckily, issues involving the lower lumbar spine are rare in athletes and account for less than 10% of sports-related injuries. Injuries do occur in contact sports and with repetitive strain sports. Your physiotherapist can assist in the resolution of any deficits in this area.
Sports such as gymnastics, cricket fast bowlers, and tennis have a higher incidence of associated lumbar spine problems related to repetitive twisting and hyper-bending motions.
Spondylolisthesis is a significant concern and needs to be appropriately treated by a physiotherapist with a particular interest in these types of injuries. Luckily, most injuries are minor, self-limited, and respond quickly to physiotherapy treatment.
Common Adolescent Spinal Injuries
Lower Back (Lumbar Spine)
Midback (Thoracic Spine)
Neck (Cervical Spine)
For specific advice regarding youth neck or back pain, please seek the professional advice of your trusted spinal physiotherapist or doctor.