Many of us have experienced shooting pains in our lower backs before. Sometimes these pains extend down the backs of the legs and into the feet. Sometimes the pain eventually passes, and sometimes it returns, worse than before.
Pain without any reasonable explanation is understandably frustrating. You want to know what’s causing it and how to make it stop. It’s easy to self-diagnose and simply assume you have sciatica.
But how do you go about actually diagnosing your pain? And how do you know if your pain stems from sciatica or from another, unknown cause? In this guide, we hope we’ll answer some of your questions and help you determine whether or not your pain might be sciatic in nature.
Information About Sciatica
What Is Sciatica?
Did you know sciatica isn’t a condition in and of itself? Instead, it’s a symptom of several different possible conditions. The meaning of your sciatica symptoms is that there’s something else that has gone wrong with your back. The sciatica is just a side effect of the larger problem.
Sciatica refers to the intense, shooting pains in the sciatic nerve. This is a large nerve that begins in the lower back and extends down the buttock and the back of the leg. Sciatic pain occurs when this nerve becomes irritated or compressed due to an underlying condition in the back itself.
Sciatic pain is a relatively common problem, but it affects everyone a little differently. With some patients, the pain can reach debilitating levels that disrupt their daily lives. With others, pain levels are comparatively low and never become more than a minor nuisance.
It can be confusing at times, because sciatica also has a different name. Among medical professionals, it’s sometimes referred to as Lumbar Radiculopathy. Don’t get too hung up on the names, however, as they mean the same thing.
What Are the Symptoms of Sciatica?
This pain often feels like it begins in the lower back, but it quickly travels down into the buttock and shoots down the back of your leg. Sometimes it might even reach all the way into the foot and toes.
It’s an intense shooting, searing type of pain. Some sufferers of sciatica have even described it as an “electric” kind of pain. Others say it’s more of a dull ache. Sometimes it can be accompanied by a tingling or numbness in the surrounding areas. In other words, sciatic pain has some unifying characteristics, but it tends to look slightly different in everyone.
Despite what’s commonly believed, sciatic pain is typically not the strongest in the lower back. Instead, the pain tends to be more heavily focused in the back of the leg. In addition to the pain, some sciatica patients may find it difficult to straighten their legs all the way
What Causes Sciatica?
It’s easy to self-diagnose incorrectly and assume that you have sciatica. However, not all lower back and leg pain is sciatic. To help you find out what’s really going on in your back, let’s take a look at some of the most common causes of sciatica.
- Lumbar Herniated Disc
This refers to a problem with one of the discs in your lower back. It means that the soft cushioning material inside the disc is leaking out through the disc’s outer core. This soft material is then pinching or irritating the sciatic nerve root that happens to be nearby. - Degenerative Disc Disease
This means one of the discs in your spine is degenerating and causing you a significant amount of back pain in the process.The name can be slightly confusing, however, since this condition is not truly a disease at all. Disc degeneration is natural and happens to everyone. Only in some rare cases does it cause pain. When this happens and the patient experiences pain, the condition gets diagnosed as Degenerative Disc Disease. Sometimes this type of degeneration leads to sciatic pain. - Isthmic Spondylolisthesis
This is a condition where one of the vertebrae slides forward onto the vertebrae below it. It happens because of a tiny stress fracture in the back of the bone that connects the two joints. This type of fracture typically occurs in childhood, but the symptoms don’t start exhibiting themselves until adulthood. In fact, this kind of fracture can go years without causing pain. It’s even estimated that anywhere between 5 to 7 percent of the population suffers from this type of fracture. It is these vertebrae sliding out of place that puts pressure on the sciatic nerve and causes sciatica. - Lumbar Spinal Stenosis
Spinal Stenosis occurs when the spinal nerves in the lower back become choked. This leads to pains in the lower back as well as the backs of the legs. Because of this, sciatic pain is a common symptom of spinal stenosis.This is a condition that sometimes occurs as the spine begins to age, and it is probably not a likely candidate for sciatic pain in a younger person. There isn’t one truly definitive cause for spinal stenosis, as this is a naturally occurring disorder that happens due to the slow and ongoing aging process of the vertebrae, discs, ligaments and muscles of the spine. - Degenerative Spondylolisthesis
As indicated by the name, this condition is similar to isthmic spondylolisthesis. It still refers to the process of one vertebra slipping forward over another. In this case, however, the cause isn’t due to a fracture. Rather, it’s due to the natural aging process of the spine.Again, this type of condition is very capable of causing painful symptoms of sciatica. Because the aging process causes this condition, however, it is more likely to be the cause of sciatica in older patients versus younger ones. All of these conditions mentioned above are fully capable of producing different levels of sciatic pain. A herniated disc is the most common cause, especially in younger patients, but the others are all possibilities as well.
If I Don’t Have Sciatica, What Do I Have?
One of the reasons that it can be difficult to tell if a person is truly experiencing sciatica is that many other types of pain can mimic sciatica. As someone trying to self-diagnose, you may find it difficult to tell if your pain is truly sciatic in nature or if it’s simply lower back pain.
Here are some of the most common problems that can cause sciatica-like symptoms.
Spinal Joint Problems
This might be any number of joint problems, such as arthritis, but it’s different from sciatica. Sciatica is a nerve pain whereas joint problems cause pain that stems from inflammation or irritation. The reason for this distinction is that treatment options will likely be different.
Sacroiliac Joint Dysfunction
This is a very common cause of pain in the hips, legs and back. It means that there is either too much or not enough motion in the sacroiliac joints, which are located in the hips. This irregularity of motion can cause a radiating pain down the backs of the legs that can mimic sciatic pain.
Piriformis Syndrome
This condition occurs when the piriformis muscle, which is located in the buttock, happens to irritate the sciatic nerve. Although this is the same type of pain as sciatica and will exhibit the same classic symptoms, it is not classified as sciatica. The reason for this is the pain originated in the buttock instead of the lower back.
Do I Have Sciatica? Here Are 5 Ways to Tell
With so many possible causes of sciatica and so many other conditions that can easily masquerade as sciatica, is there ever a way to know for sure? How can you definitively determine if your pain is sciatica or not?
The most definitive way is to visit your doctor and receive an official diagnosis. However if you’re just looking to get an idea for yourself before you visit your doctor, here is a guide to help you determine if you are truly experiencing sciatica.
- Your Knees Feel Wobbly
We’ve discussed how the sciatic nerve gets either pinched or irritated and causes shooting pains down the back of the leg. This irritation or pinching of the nerve might affect your leg in an additional way by causing sudden weaknesses in the affected knee.While the leg pain could come from any number of different causes and could be a symptom of many different conditions, the weakness in one single leg is a very strong indicator sciatica is the culprit. - You’re Not a Runner
If you’re a regular runner who’s experiencing something like sciatic pain, there’s a good chance it actually isn’t. The reason for this is runners frequently have problems with their piriformis muscle pressing into their sciatic nerve. As we mentioned, this feels like sciatica, but it technically isn’t because of the difference in where the pain originates. However, if you don’t run regularly and you’re still experiencing symptoms of sciatica, the odds that it is sciatica increase significantly. - You Can’t Summon the Pain on Purpose
This might sound like a strange one, but it’s actually a very helpful indicator of whether your pain is muscular or nerve-related:
- Try using your thumbs to massage and feel the muscles in your lower back. You’ll have to use a significant amount of force, as a gentle push might not do the trick.
- If you can touch the right muscle and cause the pain to flare up with greater intensity, then your pain is most likely muscular.
While the cause of this muscular pain could be any number of things, the most likely candidate is a shortened muscle. This means a muscle has become stuck in a tightened, shortened position and isn’t getting the nutrients and blood that it needs to function correctly.
When you press on this muscle with your thumbs, you’ll feel an immediate flare of pain. Nerve pain, on the other hand, typically can’t be summoned in this same way.
- You Can’t Pass the Sciatica Test
There’s a test doctors will usually perform to test for sciatica. It’s an easy test, however, and you can do it at home on your own.The test requires you to lie down flat on your back. You’ll then straighten your affected leg and try to raise it somewhere between thirty and seventy degrees. If the pain becomes intense because of this action, there’s a good chance your pain is from sciatica.The reason this test works well is that this action causes the sciatic nerve to straighten. If the nerve is pinched, it will be impossible to miss when you straighten your leg and raise it in this way. - You Have to Go to the Bathroom More Often
To clarify, this doesn’t just mean you have to go a few more times during the day. This means you’re losing control of your bowel and your bladder. It isn’t the case with every sciatica patient, but it is possible.The reason for this symptom is the spinal column puts too much pressure on the sciatic nerve and causes the patient to lose control of their bladder and bowel. If you experience this in conjunction with classic sciatica symptoms, contact your doctor immediately.
Should I Be Worried About My Sciatica?
If you’ve gone through these steps and determined you probably have sciatica, what then? Is it something to be worried about?
Not necessarily. While sciatica can cause horrible pain and can be an extremely frustrating condition to experience, there is some good news. It usually goes away on its own. In most cases, there’s no need for extensive treatments.
In most cases, symptoms last for roughly 90 days, or about 3 months, before gradually dissipating. If your symptoms persist much longer than this 3-month mark, it might be time to consider calling your doctor and seeing what other options are available to you.
The one exception to this is if you experience trouble with your bladder and bowel in addition to your sciatic pain. This is something that your doctor needs to be notified of as soon as you notice the pattern emerging.
Treating Symptoms of Sciatica
In the meantime, there are plenty of ways to help ease your sciatic pain. Some patients use over-the-counter pain medications. If these don’t touch the pain, your doctor might be able to prescribe you some stronger pain relief or perhaps some anti-inflammatory medication. Other patients have discovered physical therapy can help.
You might also try applying heat or chilling the impacted area:
- Use a heating pad on low or medium setting for about fifteen to twenty minutes about every two to three hours.
- Try alternating a warm shower for one of these heating pad sessions.
- You can also try ice packs, using them for ten or fifteen minutes every few hours.
There isn’t strong evidence ice packs and heating pads help, but they have occasionally brought relief to patients and are certainly worth a try.
Talk to NJ Spine & Orthopedic About Your Sciatic Pain
Your doctor will advise you to try methods like these to manage your pain. The conversation about surgery will only begin after all of these other methods have been tried and failed to relieve your pain.
If your pain truly is sciatica, methods like these should help to ease the pain. Sciatica isn’t fun for anyone to live with, but there are ways to manage it. And at the end of the roughly 3-month period, you should be able to look forward to your pain going away. If this doesn’t happen, don’t hesitate to contact NJ Spine & Orthopedic and see what other treatment methods might be available to you.