“I’ve got sciatica” whilst pointing towards the buttock and thigh region, is something I commonly see and hear when patients visit me with lower back pain, however sciatica isn’t something I regularly find within those patients. This blog will explain sciatica symptoms, its causes and describe other conditions which can cause symptoms mistaken for sciatica.
The sciatic nerve is the longest and thickest nerve in the body, it spans from the lower back, moves through the buttocks, back of the thigh; then branches into the leg and foot.
At its widest point the sciatic nerve is as thick as an adults thumb.
What Is Sciatica? Sciatica is a collection of symptoms which occur when the sciatic nerve becomes irritated by structures within the lower back, pelvis or buttock area.
Symptoms:
- Sharp electric shock, stabbing or burning type pain; which can occur in the buttocks, back of the legs, feet and/or toes. This can be accompanied with numbness and/or pins and needles within these regions.
- Walking with a limp.
- Weak leg muscles.
- Hot or cold sensations in the leg.
- Symptoms can often be aggravated by bending forward, twisting and coughing.
Causes of sciatica:
Herniated or prolapsed disk – when the disk between the bones in the spine changes shape in an outward direction, compressing the sciatic nerve.
Spinal stenosis – When areas nerves pass through within the spine become narrower and compress the sciatic nerve.
Piriformis syndrome – Compression of the sciatic nerve as it passes through the buttocks by a muscle called ‘piriformis’.
Inflammation irritating the nerve – Following an injury or infection.
You are at a greater risk of developing sciatica if you are tall, overweight and with age.
Symptoms similar to sciatica can be a sign of a serious condition ‘Cauda Equina’. The NHS recommend you dial 999 or go to A&E if you:
- Have sciatica on both sides.
- Have severe weakness or numbness in both legs that is getting worse.
- Have numbness around your genital/buttock area.
- Have any abnormal changes to your bowel or bladder habits such as difficulty starting urination or loss of bladder/bowel control (incontinence).
What other conditions can cause symptoms mistaken for sciatica?
Sacroiliac joint dysfunction is the most common condition I find within patients who visit the clinic with lower back pain. Pain from the sacroiliac joint can occur in similar areas as sciatica; in the lower back, buttocks and thigh.
Facet joint irritation can occur in the lower, mid-back and neck. When the facet joints become irritated in the lower back, pain can be felt in the back, hip and thigh.
Hip conditions such as the early stages of osteoarthritis and hip bursitis can cause pain in similar regions to when the sciatic nerve is irritated.
How can I help you if you have ‘sciatica’ type symptoms?
As an osteopath I have been trained to differentiate between conditions that can cause similar symptoms. This can be achieved by gathering information regarding your medical history, symptoms, observing the way you move and by conducting orthopaedic tests. This process allows me to diagnose and treat the cause of your pain and not just the symptoms.
Blog wrote by Lee Clarke BOst (Hons) Published June 2020
