What is Sciatica?
Sciatica refers to a condition that is characterized by sharp shooting pains, such as burning, stinging, or numbing, that begin in the buttocks and travels down the leg to the foot.
These may or may not be associated with lower back pain. The most common cause of lower back pain is a compressive neuropathy from a disc herniation impinging one or more of the bottom three nerve roots of the lower back (L4, L5, and S1) that make up the largest and longest nerve in the body, the sciatic nerve.
What are the symptoms of Sciatica problems?
The pain is usually one-sided, but it can occur bilaterally. True sciatica is a radicular pain that travels and displays a dermatomal pain pattern. Dermatomes are part of a clinical map that indicates the distribution of nerve fibers in the skin. Dermatomes also indicate how we perceive pain and sensory information.
S1 Nerve Distribution
The S1 nerve distribution is the most common impinged or pinched nerve root by the L5 disc. If this nerve root is affected, experiences of pain and numbness of the back of the thigh may follow. The pain radiates through the back and part of the side of the lower leg as well as the side of the foot. The L5 distribution occurs at the most lateral aspect of the lower leg and the L4 on the inside of the lower leg.
These clinical symptoms help doctors diagnose the level of impingement or herniation preliminarily before an MRI is ordered to confirm the lesion.
Patients may experience:
- Weakness
- Loss of reflexive response
These symptoms correspond to the dermatomal pain distribution and classifies a more serious impingement.