Patients write to us weekly asking for an accurate explanation of sciatica. These letters usually fall into 2 different varieties, with some patients wanting to better understand their specific types of back and leg pain, while other readers simply desire a comprehensive overview of the condition and its symptoms.
Since we receive these requests often, we thought that a dedicated discussion might help to address the topic of sciatica causes and symptoms from a new perspective. Therefore, we have created this essay as a means of helping readers to better comprehend the exact meaning of sciatica in their own cases, as well as in general discussion.
This report focuses on providing an explanation of sciatica that will make sense to all who read it. We will concentrate on exploring why pain exists and the underlying spinal explanations for this terrible and often chronic condition.
When we are discussing true sciatica, we are talking about a lower body symptomatic syndrome that might cause pain, tingling, numbness and weakness in the buttocks, legs and/or feet. These symptoms might exist in various regions of the anatomy, over a wide area of affected tissue, but are all sourced in the lumbar spine.
The spinal nerves branch off the spinal cord at each level of the vertebral column. In the upper lumbar spine, the spinal cord ends, with the cauda equina continuing downwards to serve the neurological needs of the mid lumbar to coccygeal regions. The cauda equina is simply a mass of individual nerve roots that branch off all together when the spinal cord ends. These nerves slowly thin out as they descend the remainder of the spinal column, since 2 exit at each vertebral level, bilaterally.
Spinal nerves connect the brain to the rest of the body. They are the origin of the vast network of neurological tissues that provides sensory, motor and autonomic innervation to the entire human anatomy. When something affects a spinal nerve root, the effects will be expressed in the region of the body that is served by the affected root. This is why sciatica is expressed in the buttocks, legs or feet, when the cause resides in the spine itself.
For a detailed look at the processes that can affect these lower spinal nerve roots, potentially causing symptoms, please refer to our section devoted to sciatica causes.
When a spinal nerve root is compressed or chemically irritated, it might suffer dysfunction. After all, the lower nerve roots are some of the most sensitive of all bodily tissues and are crucial in providing all the neurological functionality to the lower body.
When a nerve is compressed, it suffers from the inability to signal correctly. The signals simply can not traverse the closed-off section of the nerve fibers. This is why discomfort results, followed by progressive numbness and weakness in the innervated anatomical regions. Remember, without active nerve signal, the body can not provide neurological feedback to the brain and the brain can not get the body to move normally.
Partial compression syndromes might also exist, where only some degree of subjective numbness and weakness exist, possibly combined with lasting pain locally and in the served bodily zones.
When chemical irritation is the source of sciatica, then the patient is likely to suffer pain more than numbness or weakness. This is because the nerve can still signal, but is also being directly traumatized by the irritating chemical substance, which usually consists of proteins that have leaked out of an annular tear in a compromised intervertebral spacer; also known as a herniated disc.
To better understand the full range of possible expressions associated with true spinally-motivated sciatica, please study our detailed resource section dedicated to sciatica symptoms.
Only symptoms that are sourced in the lower spine can be called sciatica in the purest sense. This is because these are the nerve roots that directly combine to create the sciatic nerve after leaving the vertebral column. However, a great number of patients have symptoms that mirror sciatica in every way possible, yet are not caused by any lumbosacral problem. These conditions are known as pseudo-sciatica. The pseudo prefix does not mean that the symptoms are not real. It simply means that the symptoms are not caused by a lumbar or sacral neurological abnormality.
Pseudo-sciatica can commence for almost countless possible definable reasons and many idiopathic contributory factors, as well. Accurately diagnosing pseudo versions of sciatic nerve pain can be a very challenging obstacle to overcome.
Some of the most common causations of pseudo-sciatica include cervical or thoracic spinal stenosis, localized sciatic nerve damage, piriformis syndrome, diabetic neuropathy, certain disease processes and mindbody causations. You can get a detailed glimpse at the fascinating topic in its own dedicated resource section: pseudo-sciatica.
While this essay concentrates on exposing many of the facts of sciatic nerve pain, its most primary explanation is best saved until last. The most important thing to remember about sciatic nerve pain is that it is a torture to endure and often factors into a disabling condition in chronic and recurrent cases.
Sciatica can prevent physical activity, work and sleep, as well as making time spent sitting or standing into utter misery. There is no way to adequately describe the worst cases of sciatica in words alone. Having suffered the condition for decades, I can provide testimony that the most virulent attacks can compare to the most extreme pain that any possible causation can muster.
Therefore, to fully understand sciatica, you must study it from a firsthand perspective. Simply reading about it is not enough. Most of you reading this have endured their own experiences with the dreaded disorder, but the degree of the symptoms ranges wildly. If you are lucky enough to suffer tolerable symptoms, then at least be thankful for this small kindness. Remember, the worst cases of sciatica are akin to having legs, feet and posture destroyed under the constant injury of complete nerve dysfunction. It can be hell on Earth.