Sciatica: Symptoms, Causes, Tests, and Treatments
Published May 4, 2023
Are you suffering from persistent pain, numbness, or discomfort in your lower back, leg, or foot? Sciatica, a condition that occurs when the sciatic nerve—the largest nerve in the human body—becomes pinched, could be the culprit. Most prevalent in individuals between the ages of 30 and 50, this ailment can be debilitating, affecting daily activities and overall quality of life.
Here's everything you need to know about sciatica:
Sciatica Symptoms Explained
Symptoms of sciatica are typically one-sided and can include:
- Lower back pain, generally more on one side
- Loss of sensation or numbness
- Pins and needles feeling in feet or legs
- Difficulty bending forward or backward
- Stabbing, burning, or shooting pain that starts in the back and radiates down the leg
- Weak reflexes
- Difficulty bending the foot, Particularly when you try to raise the foot (lifting your toes toward your nose)
Did you know?
Sciatica can also have other, stranger symptoms. For example, patients have reported a feeling of water dribbling down their leg, or coldness. Loss of bladder or bowel control and worsening pain with movement (even involuntary movements like sneezing, coughing, and laughing) are also sometimes associated with sciatica.
Understanding the Causes of Sciatica
Sciatica is typically caused by a herniated or bulging disk in the spine that presses on the sciatic nerve. This condition can also be caused when an overgrowth of bone (bone spurs) forms on the spinal bones. Despite the pain sometimes manifesting solely in the foot or lower leg, the cause of the pain is still nerve root compression in the lower back.
Piriformis syndrome involves a small muscle that lays over the sciatic nerve in the buttocks tightening and causing compression to the nerve. Also, an injury or fracture to the pelvic bone as well as other conditions such as diabetes, may cause damage to the nerve. Rarely, a tumor in the area presses on the nerve, causing sciatica.
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Diagnostic Tests for Sciatica
A physical examination will be the first test that takes place when sciatica is suspected. Your doctor checks for pain in the low back, buttock, thigh, and leg, as well as for response to certain stimuli (e.g. gently pressing the toes or calf region).
Specific reflexes and sensations will be tested that correspond to the area of the foot and lower leg where the sciatic nerve sends signals. When certain reflexes and sensations are diminished when compared to the other side of the body, it is a strong sign that the cause of your pain may be sciatic nerve compression.
One common clinical test is the straight leg raise (SLR) test. This consists of having the patient lie on their back and lifting one leg while the other leg is flat or bent at the knee. Pain when lifting the symptomatic leg can indicate sciatica. However, if sciatica is caused by inflammation or chemical irritation of the nerve this test may not work.
NOTE: If you're experiencing back pain along with radiating symptoms, the pain in the foot and leg is often more severe than the back pain. It's vital to perform a thorough biomechanical assessment to accurately diagnose the exact cause of the pain.
Your doctor may order imaging of your spine, such as a CAT scan, x-ray, or MRI, to further assess the situation. A nerve conduction velocity test may also be done to see if there is a diminished response of the muscles to electrical impulses traveling through the sciatic nerve.
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Effective Sciatica Treatment Options
Physical therapy is often successful in alleviating sciatica symptoms without the need for surgery. It emphasizes postural education and proper body mechanics for lifting and carrying objects, and incorporates strengthening, stretching, and aerobic conditioning exercises. Typically, acute sciatica improves within 4-6 weeks with consistent physical therapy.
When the discomfort is so bad that you need immediate relief from sciatica pain, ice and heat therapy can be beneficial. Additional options include medications for inflammation and pain, therapeutic injections, and alternative therapies that are frequently recommended.
Wearing insoles in your shoes can significantly ease pain associated with sciatica. Limited range of motion in the foot can cause the force generated when the heel strikes the ground during walking to transfer up the posterior chain. By cushioning and evenly distributing the forces beneath your feet, insoles may help reduce some of the pressure on your foot caused by walking.
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Try Insoles for Relief From Sciatic Nerve Pain
Insoles provide cushioning to the heel, toes, and foot, redistribute the forces from your body weight, promote neutral alignment, and take pressure off sciatic trigger points in the foot. All of which can help to reduce irritation of the sciatic nerve. Explore Footora's website to find the best insoles we recommend for lower back pain.