Do I have sciatica? This is a question we receive often, accompanied by a list of symptoms and possible causes of pain. In order for anyone to answer this question, they must first understand what sciatica truly is. Remember that sciatica is not a diagnosis, but merely a set of symptoms.
It amazes us that in this age of modern medicine, sciatica remains one of the most enigmatic of all chronic pain syndromes. The basic facts of sciatica are rarely understood by patients and are even perplexing to many doctors, as well. Add to the mix the truth that most cases of sciatica are actually pseudo-sciatica and the question of whether or not a particular person has sciatica becomes even more difficult to answer.
This discussion assists patients in better understanding sciatica and helps them to know whether or not they are suffering from sciatica, pseudo-sciatica or some different type of pain altogether. If you have pain and want to know more about its source, then this is the right essay for you.
Sciatica is defined as buttocks, leg and/or foot pain that is caused by a lumbar spinal source. The origin of pain can be a pinched nerve in the lower back due to foraminal stenosis, compression of the cauda equina syndrome due to some type of central spinal stenosis or chemical nerve irritation of the spinal nerve roots due to a ruptured intervertebral disc leaking proteins onto sensitive nerve fibers. These conditions can all cause severe symptoms, often known medically as spinal sciatica, true sciatica or simply sciatica.
However, much more common are identical symptoms that are not caused by a lumbar spinal issue. Although the symptoms might be an exact match to true sciatica, the origin of pain differs. Therefore, the symptoms are known medically as pseudo-sciatica or false sciatica. There are many, many reasons for pseudo-sciatica to exist, accounting for why most cases qualify to be called pseudo, rather than true sciatica. The scope of conditions which can cause pseudo-sciatica is too broad for this article, but we suggest reading our coverage of pseudo-sciatica to learn about the most common possible sources.
The symptoms of sciatica can be very diverse and do not definitely qualify a person to be said to be suffering from sciatica. As mentioned above, most cases of seeming sciatica symptoms are actually pseudo-sciatica pain syndromes, not true sciatica. Regardless of their origin, all types of sciatica syndromes can involve the following symptomatic activity:
All of the sciatica expressions can be felt in the buttocks, legs and/or feet unilaterally or bilaterally. Symptoms might be consistent or variable. For symptoms which change, variation might be reported in their actual expression, location, severity and duration making all types of sciatica some of the most diverse of all chronic pain conditions.
Pain can come in many different forms, ranging from sharp to dull, from shooting to radiating and from burning to numbing. Pain typically occurs in the rear or outside of the legs, but can affect any area from the buttocks down.
Tingling and numbness often go hand in hand. These disturbing symptoms can produce subjective feelings of a loss of sensation or object numbness in some instances.
Weakness can be expressed in subjective and objective versions, as well. Most patients will report weakness in the feet or legs, but will not demonstrate any neurological or muscular deficiency. Some patients may demonstrate actual objective weakness and resulting functional deficits, such as foot drop.
Pain in the back might exist along with sciatica or pseudo-sciatica. However, these symptoms are not considered sciatica or pseudo-sciatica, since they exist above the anatomical level where the sciatic nerve is formed.
Since sciatica is not a diagnosis, it is actually impossible to technical "have" sciatica. But we digress… If you are suffering from a spinal source of symptoms, then yes, you have sciatica. However, it is crucial to remember that most cases of true spinal sciatica are misdiagnosed, explaining their poor treatment outcomes.
If you are suffering what appears to be sciatica is every way, but the symptoms come from a source that is not located in the lumbar spine, then you are suffering from pseudo-sciatica in most instances. The diversity of possible causes here is virtually limitless, spanning a full range of mechanisms, conditions and profiles.
Some patients might be experiencing something that feels like sciatica, but is neither true nor pseudo-sciatica. Instead, it might be some form of local injury, deficit or condition affecting a specific part of the lower body anatomy. Therefore, these patients do not have any type of sciatica.
In order to find out where you fit in this complicated puzzle, we recommend learning all you can about the nature of your pain and seek qualified diagnostic evaluation from an enlightened and objective neurologist.