Sciatica Conditions

Sciatica Symptoms

Sciatica symptoms vary greatly among all people. Most people feel a burning or tingling sensations in the buttocks, and as the pressure on the nerve increases, the pain can travel down the hamstring and even all the way into the foot, and even cause pain in the toes. It can be felt on both sides of the buttocks simultaneously and can cause weakness and increased pain when sitting down. Sometimes, there is associated lower back pain.

Sciatica

Sciatica symptoms occur when the large sciatic nerve is irritated. The sciatic nerve starts in the lower back at lumbar segment 3 (L3). The sciatic nerve roots run through the bony canal in the spine, and at each level in the lower back a pair of nerve roots exits from the spine and then comes together to form the large sciatic nerve that runs all the way down the back of each leg. Portions of the sciatic nerve then branch out in each leg to innervate certain parts of the leg (e.g. the calf, the foot, the toes). The nerve roots that originate in the lower back are named for the upper vertebral body that they run between (for example, the nerve that exits at L4-L5 in the spine is named L4). The nerve passing to the next level runs over a weak spot in the disc space, which is the reason discs tend to herniate (extrude) right under the sciatic nerve root and can cause sciatica.

Typically Experienced Symptoms

  • Pain in the rear or leg that is worse when sitting
  • Wakness, numbness or difficulty moving the leg or foot
  • Burning or tingling down the leg
  • A constant pain on one side of the rear
  • A shooting pain that makes it difficult to stand up

Sciatica symptoms occur when the large sciatic nerve is irritated. The sciatic nerve starts in the lower back at lumbar segment 3 (L3). The sciatic nerve roots run through the bony canal in the spine, and at each level in the lower back a pair of nerve roots exits from the spine and then comes together to form the large sciatic nerve that runs all the way down the back of each leg. Portions of the sciatic nerve then branch out in each leg to innervate certain parts of the leg (e.g. the calf, the foot, the toes). The nerve roots that originate in the lower back are named for the upper vertebral body that they run between (for example, the nerve that exits at L4-L5 in the spine is named L4). The nerve passing to the next level runs over a weak spot in the disc space, which is the reason discs tend to herniate (extrude) right under the sciatic nerve root and can cause sciatica.

Sciatica Conditions

Listed are the primary conditions that are responsible for sciatica nerve pain.

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Piriformis Syndrome

The piriformis syndrome is a condition in which the piriformis muscle irritates the sciatic nerve, causing pain in the buttocks and referring pain along the course of the sciatic nerve. This referred pain, called "sciatica", often goes down the back of the thigh and/or into the lower back. Patients generally complain of pain deep in the buttocks, which is made worse by sitting, climbing stairs, or performing squats. The piriformis muscle assists in abducting and laterally rotating the thigh. In other words, while balancing on the left foot, move the right leg directly sideways away from the body and rotate the right leg so that the toes point towards the ceiling. This is the action of the right piriformis muscle.

Piriformis Syndrome

Herniated Disc

The bones (vertebrae) that form the spine in your back are cushioned by small, spongy discs. When these discs are healthy, they act as shock absorbers for the spine and keep the spine flexible. But when a disc is damaged, it may bulge or break open. This is called a herniated disc. It may also be called a slipped or ruptured disc.

You can have a herniated disc in any part of your spine. But most herniated discs affect the lower back (lumbar spine). Some happen in the neck (cervical spine) and, more rarely, in the upper back (thoracic spine). This topic focuses mainly on the lower back.

Herniated Disc

Spinal Stenosis

Spinal stenosis is a narrowing of one or more areas in your spine - most often in your upper or lower back. This narrowing can put pressure on your spinal cord or on the nerves that branch out from the compressed areas.

Spinal stenosis can cause cramping, pain or numbness in your legs, back, neck, shoulders or arms; a loss of sensation in your extremities; and sometimes problems with bladder or bowel function. Spinal stenosis is most commonly caused by osteoarthritis-related bone damage.

Mild symptoms of spinal stenosis are often helped by pain relievers, physical therapy or a supportive brace. In more serious cases of spinal stenosis, doctors may recommend surgery.

Spondylolisthesis

Spondylolisthesis occurs when one vertebra slips forward in relation to an adjacent vertebra, usually in the lumbar spine. The symptoms that accompany a spondylolisthesis include pain in the low back, thighs, and/or legs, muscle spasms, weakness, and/or tight hamstring muscles. Some people are symptom free and find the disorder exists when revealed on an x-ray. In advanced cases, the patient may appear swayback with a protruding abdomen, exhibit a shortened torso, and present with a waddling gait.

Pelvic injury or fracture

The pelvis is a butterfly-shaped group of bones at the base of the spine. The pelvis consists of the pubis, ilium and ischium bones (among others) held together by tough ligaments to form a girdle of bones. With a hole in its center, the pelvis forms one major ring and two smaller rings of bone that support and protect the bladder, intestines and rectum.

Fractures of the pelvis are uncommon and range widely from mild (if the minor ring is broken) to severe (if the major ring is broken). Pelvic rings often break in more than one place. A mild fracture (such as may happen from the impact of jogging) may heal in several weeks without surgery. However, a serious pelvic fracture can be life threatening and may involve damage to the organs the pelvis protects. This type of fracture often needs emergency medical care and lengthy physical therapy and rehabilitation.

Degenerative Disc Disease

Degenerative disc disease is not really a disease but a term used to describe the normal changes in your spinal discs as you age. Spinal discs are soft, compressible discs that separate the interlocking bones (vertebrae) that make up the spine. The discs act as shock absorbers for the spine, allowing it to flex, bend, and twist. Degenerative disc disease can take place throughout the spine, but it most often occurs in the discs in the lower back (lumbar region) and the neck (cervical region).

Slipped Disk

The disks are protective shock-absorbing pads between the bones of the spine. Although they do not actually "slip," a disk may split or rupture. This can cause the disk to fail, allowing the gel to escape into the surrounding tissue. The leaking jellylike substance can place pressure on the spinal cord or on a single nerve fiber and cause pain either around the damaged disk or anywhere along the area controlled by that nerve. This condition is also known as a herniated, ruptured, prolapsed, or, more commonly, slipped disk. The most frequently affected area is the low back, but any disk can rupture, including those in the neck.

Tumors

In the spine, tumors can occur inside the spinal cord, within the membranes (meninges) that cover the spinal cord, or in the space between the spinal cord and the vertebrae. As it grows, a tumor compresses the cord itself or the nerve roots.

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