Is sciatica worse than back pain? This is a common question for patients who experience one symptom or the other. Some unfortunate people can provide an informed answer, since they suffer both conditions simultaneously or in alternating fashion.
Sciatica is not a form of back pain, despite popular misconception, since the symptoms are not found in any region of the anatomy that is considered to be part of the back. Instead, symptoms are located in the buttocks, legs or feet. However, since many of the same causes of sciatica might also be responsible for causing back pain, the two conditions are often related and found in patients concurrently.
This editorial brings together over ten years of research to provide answers on which condition is worse; back pain or sciatica. We will cite clinical presentation, capacity to disable and the all-important firsthand patient reports to determine if either condition is worse than the other during objective comparative analysis.
Sciatica is well known to be a persistent and debilitating condition. Below, we have collected an assortment of facts showing why many patients might consider sciatica to be the worse of the two dorsalgia problems, when compared to general back pain:
Many workers report that sciatica was directly responsible for them losing or quitting their jobs, or taking early retirements, since the syndrome prevented them from performing work duties well or at all.
Some patients report that sciatica is the main reason why they are basically confined to a chair or to bed throughout their days. Many patients report the virtual inability to stand or walk due to chronic leg symptoms.
A sizeable percentage of patients report being restricted in their participation in leisure activities, including sports and virtually all forms of athletic pastimes.
Many patients reported worse symptoms when driving and some gave up driving totally in an attempt to reduce their pain.
Meanwhile, back pain is also reported to be a major obstacle in life by affected patients. The following are all citations of how back pain may be worse and more disabling than sciatica symptoms:
Back pain is the primary reason above all other health issues why a person might not be able to accomplish family-related activities. Sciatica is less often cited as a reason to avoid domestic responsibilities, such as family time and household work.
Back pain is the single greatest reason why a person might call in absent to work in the developed world.
Acute back pain is one of the leading reasons why a person might visit a doctor or hospital.
Lower back pain, in particular, has been called the "most painful condition in clinical medicine" by several prominent physicians.
Chronic back pain is one of the leading reasons cited for disability claims and workers compensation payments.
Back pain is reported to be one of the major reasons why people change career paths, often settling on less physical and more cerebral vocations.
Now that some of the clinical facts have been stated, it is obvious that both conditions can be debilitating and extremely influential to a patient’s life path. However, we turn to our own research to fill in some of the blanks that are absent from patient-based symptomatic reporting.
Comparative analysis of patient reports for both types of symptomatic expressions show that either condition can be equally bad, depending on the degree of symptomology rated using classic pain score scales. Patients who rated their pain above a 7 on a consistent basis were universally affected by both back pain and sciatica, while patients who rated pain to be a 9 or 10 chronically were equally disabled.
For back pain expressions, lower back issues ranked the worst in terms of negative consequences, while neck pain came in a close second. Neck pain sufferers cited different reasons for their disability than lower back pain sufferers, including a variety of neurological effects compared to centralized and intractable pain in the lumbar spine. Middle and upper back patients seemed less affected by their pain and functioned better, despite having severe symptoms in some instances.
Meanwhile, sciatica suffers cited the worst symptoms in the legs, with the buttocks closely following. Foot symptoms were less often disabling and only occasionally created significant changes in lifestyle or life path. Thighs and calves were the most symptomatic locations among patients with the very worst sciatica problems.
We cannot make an absolute determination on which symptom set is universally worse, sciatica or back pain, being that there are too many individual variables to consider. Since the degree of pain varies from person to person and the effectiveness of their coping mechanisms also varies considerably, either condition can be a real nightmare to endure when it strikes with extreme and persistent fury.
One thing we can tell for sure is that the very worst expression is when patients are struck with both sciatica and back pain together. About half of our surveyed patients demonstrated a present combination of symptoms or a history of both symptoms in alternating fashion. These people are doubly affected by their pain and often have to cope with symptoms throughout large areas of their dorsal anatomy. Strangely, although these combination pain syndromes are ranked the highest in pain scores, the disability percentage is actually lower than in patients with the worst versions of either pain condition alone. Why this occurs is a mystery, but maybe these dually-affected patients have simply developed better pain tolerance or coping strategies based on increased need.
As a person who has suffered from back, neck and sciatica pain for decades, I can certainly make my own contribution to this research study. I have endured times when each of these expressions were terribly debilitating and could have disabled me with their agony. However, all things considered, I can not say that any of my pain has ever matched the ferocity of my worst lower back pain, since this was the only type of symptom that ever had me questioning my very will to live. In my book, despite the fact that sciatica is the worst thing ever, and neck pain was the weirdest and most frightening part of my dorsalgia history, the sheer violence of my lumbar symptoms qualifies as the all-time winner in terms of health issues which have left scars that run too deeply mentally and emotionally to ever fade.
Is sciatica worse than back pain? Only you can decide in your own particular case.