Sciatica, as a rule, radiates down only one side of the body, it can radiate down both sides although it’s rare in fact I have never come across this. The pain will start in the lower back or the buttocks and continues down the back of the thigh into the lower leg and foot.
The pain is usually described as sharp searing pain rather than a dull ache. A pins-and-needles sensation, numbness or weakness, or a prickling sensation down the leg in certain cases. Weakness or numbness when moving down the leg or foot. Severe or shooting pain in the leg, making it difficult to stand up or walk.
Depending on where the impingement is the pain may radiate in the foot or toes. You may or may not get lower back pain, and it’s usually not as severe as the leg pain. The pain is worse when sitting than when lying or standing this varies upon where the impingement is.
The treatment for sciatica varies with every individual as there are many causes. It mainly depends on the cause and where the impingement is. The most common are listed below they are:
Disc degeneration this is a natural process that occurs with aging, for some people one or more degenerated discs in the lower back can also irritate a nerve root and cause sciatica. Degenerative disc disease is diagnosed when a weakened disc results from inflammatory proteins from inside the disc leak out and irritate the nerve root(s) in the area.
Bulging discs, also known as a disc protrusion, are very common. You may have a bulging disk and never know; however, they can cause discomfort and disability in various parts of the body if the disc compresses on the spinal cord. As we age, the outer fibrous portion of our discs can weaken. Pressure from the central core of the disc can then stretch to the outer rim, causing the disc to bulge. If left untreated, the disc can continue to bulge until it tears, which is classified as a herniated disc.
Herniated Disc are also known as a slipped or ruptured disc is when the soft inner material of the disc leaks out, or herniates, through the fibrous outer core and irritates contiguous nerve root.
The thinning disc is age-related and is when the discs flatten and the area between the vertebrae become narrow this sometimes may need surgery to fuse the vertebrae together.
Disc degeneration with osteophyte formation. Osteophytes are bone spurs that form on the back as a result degenerative changes to the spine as the cartilage breaks down this allows extra movement between the vertebrae and this is when spurs grow to stabilize the spine. Spinal Osteoarthrosis and spinal stenosis may also cause spur growth.
Piriformis syndrome is when sciatic nerve can get irritated as it runs under the piriformis muscle or through the muscle in the buttock. If the piriformis muscle irritates or pinches a nerve root that comprises the sciatic nerve, it can cause sciatica-type pain.
As I mentioned above symptoms vary as to where the impingement is located for example if it’s at the L1 disc it may affect the outer part of the foot, which may radiate to the little toe or toes. Patients may experience weakness when raising the heel off the ground or trying to stand on their tiptoes. The ankle-jerk reflex may also be reduced. If it’s the L4 it may affect the thigh. Patients may feel weakness in straightening the leg and may have a diminished knee-jerk reflex. If it’s the L5 it may affect the big toe and ankle this is most commonly called foot drop. Patients may feel pain or numbness on top of the foot, particularly on the “web” of skin between the big toe and second toe.