Sciatica - Is it Really Back Pain?

Sciatica is the Latin word for "Pain down the back of the leg". It is a referred pain usually caused by trapping the sciatic nerve in the lower back. Sciatica is a set of symptoms rather than a diagnosis for what is irritating the root of the nerve, causing the pain. These symptoms are generally caused by the compression of a lumbar spine nerve root L4 or L5 or sacral nerve roots S1, S2 or S3, or far less commonly, by compression of the sciatic nerve itself.

Pain

Pain often increases on exertion or bending forward. It can also be triggered by coughing or straining and can be so severe that the lower back becomes locked in sideways bending position (scoliosis) caused by a strong contraction. Pain and paraesthesiae (pins and needles) may be apparent in one or more of these areas: the lower back, groin, perineum, buttock, hip, back of the thigh, leg and foot or the sacroiliac (SI) joint. Pain referred from trigger points in the gluteus medius is less likely to involve the thigh; gluteus maximus trigger points restricts flexion at the hip whilst Piriformis trigger points restricts medial rotation. Pain also occurs on rising from a chair, particularly if sitting crossed legged, and remains as a nagging pain when lying down causing disturbed sleep.

Symptoms

Sciatica is a symptom not a cause thus the trigger points refer pain into the lower back, either alongside the spine or across the back. The trigger points in the hamstring muscles usually results in pain being experienced on walking, possibly resulting in a limp. Typically, the symptoms are only felt on one side of the body. One of the conditions associated with the symptoms of sciatica is piriformis syndrome, this is when the sciatic nerve is being compressed by the piriformis going into spasm.

Sciatica is less common than most people think, much less common than back pain. It is often caused by standing or sitting badly, but the pain can be made worse by bending without use of the legs or unsupported twisted or sideways movements. Sciatica is pain in the distribution of the sciatic nerve and is felt in the buttocks and down the back of the leg. It is usually diagnosed through a physical exam and an MRI scan. Sciatica is different from other forms of low back pain because there are 2 sciatic nerves, although the pain is usually just on the one side.