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Many things can cause leg pain – pinched nerves in the lower spine, lumbar radiculopathy, herniated discs in the spine, even spinal arthritis and space-occupying lesions.

However, sciatica is a term you often may hear people use to talk about pain they have in the buttocks, hip and then down one leg (sometimes both legs, but typically occurring specifically on one side).

Sciatica describes pain, weakness, numbness or tingling in the leg that is caused by injury to, or pressure on, the sciatic nerve. It is not a diagnosis but rather a symptom of an underlying medical condition. The sciatic nerve starts in the lower back at the 3rd lumbar segment and is formed by the exiting nerve roots of L3-L5, S1 and S2 to become the longest and widest nerve in the body.It runs down the lower back along the spine and down the back of each leg.Portions of the sciatic nerve branch out in each leg to innervate certain parts of the leg, e.g., the buttock, thigh, calf, foot and toes.Depending upon where the sciatic nerve is being affected determines where the pain is.Since the sciatic nerve controls the muscles of the lower leg and provides sensation to the thighs, legs and soles of the feet, sciatica can be felt as a dull ache or an intense pins-and-needles sensation.

What does the healthcare provider do to determine what is causing your pain and then treat your pain?The neurologist, physiatrist or chiropractor will first perform a clinical exam to determine exactly where the pain is.Imaging studies may be ordered (either CT scan or MRI studies) to see if bones, nerves, soft tissues, ligaments, etc are the source of the pain.If the pain is determined to be coming from a nerve, tests called nerve conduction studies can be performed to see if the signals are traveling properly through the nerves.

A course of treatment is then planned based on the information the healthcare provider has found in the course of your exam and diagnostic testing.This may include physical therapy, acupuncture, chiropractic care, stretching exercises, medication or injection therapy.It may be determined that a surgical consultation is needed.The good news is that back pain that radiates down the legs can be diagnosed, treated and managed.The key is to be able to discuss with your healthcare provider what your symptoms are and be able to describe them as accurately as possible.Try to note when you have your pain, where exactly you have your pain and what activities tend to make your pain better or worse.These are all pieces of information that will assist your healthcare provider in being able to treat you successfully and reduce the chance of recurrence.

Yours in Good Health!


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