Sciatica paresthesia is a common neurological symptom often known as tingling or pins and needles. Sciatica tingling is a typical expression of a wide range of causative issues which can create lower body pain and is considered a mostly subjective symptom.
While chronic paresthesia is certainly not the worst potential effect of sciatica, it can be annoying, disconcerting and uncomfortable, especially in certain areas of the body. It may also be the sign of growing neurological dysfunction in some patients, providing an indicator of worse things to come. Some particular types of numbness and tingling, such as saddle paresthesia, can be early warning signs of cauda equina syndrome.
Paresthesia due to sciatica can come about from any of the typically diagnosed sources of sciatic nerve symptoms, including structural issues in the spine and ischemic pain conditions. In most cases, the tingling is likely to be accompanied by sciatica pain, weakness and numbness, although every symptomatic complaint is unique and paresthesia can exist alone in rare circumstances.
There are many other causes of paresthesia which are completely unrelated to sciatica and a thorough diagnostic evaluation should always be performed to rule out more serious health conditions, such as: nerve damage due to injury, disease process, tumor formation, general neuropathy, atherosclerosis, vascular disease, infection, immune disorder or exposure to extreme cold.
Tingling may be the sign of a significant or harmless process. There is just no way to tell the seriousness of the symptoms from the expression itself. Most people liken sciatica tingling to a chronic version of pins and needles one would experience when lying on their arm for example. The feeling is dead, numb and tingly, often with waves of heat or pressure.
Most sciatica sufferers demonstrate paresthesia in the feet and particularly in the tips of the toes. Others may have it on the bottoms of their feet or on the side of the foot. Still more patients may have widespread areas of tingling anywhere on the leg, including the thigh, calf or knee.
Tingling is usually often blamed on involvement of a particular neurological structure, which can be determined by advanced diagnostic testing. However, there are many reasons why a particular nerve may be affected and finding the underlying source of the symptoms may be difficult, at best, and impossible in some cases. Even the finest neurologists will tell you that diagnosing nerve pain is a less than exact science.
Sciatica is a diverse condition with symptoms which may change over and over again. In my own experience dealing with tens of thousands of affected patients each year, I see many of the same concerns time and time again.
Often, the underlying reason for the pain has been traced to specific spinal nerve roots and blamed on a herniated disc or osteoarthritic process. Symptoms may be definitely verified as coming from the implicated nerve root; however, the patient has a plethora of other symptoms which would be inappropriate for the diagnosed condition.
The doctor usually either does not even consider why this occurs and makes an incorrect, or only partially correct, diagnosis based on an illogical, but structurally verifiable-conclusion. This dooms the patient to suffer through unnecessary treatments which do not work and give sciatica its reputation as such a stubborn disorder.
Some of these conditions turn out to be regional ischemia syndromes affecting the diagnosed nerve structures, as well as other nerve tissues, which helps to explain the diversity of seemingly inappropriate symptoms.
In other instances, there may be other structural reasons for additional symptoms which have not yet been discovered or diagnosed. Central spinal stenosis is the most prevalent of these spinal sources and often resides much higher up in the vertebral column than the patient or doctor might consider.