Is it sciatica?

I've had a few patients that come in with back and leg pain and the most common self diagnosis (or often the medical/health professional diagnosis) is that it is sciatica.

The thing is, not all forms of leg pain that seem to stem from the back is sciatica.  In fact as far as what I have seen come through our clinic, the vast majority isn't.

The danger is that when diagnosed with true sciatic pain, it can be debilitating and very difficult to treat.  Very often it can require corticosteroid or neurosurgery.  I find that it is important to ensure that you are dealing with true sciatic pain only before taking those steps.

Sciatica refers to lower back pain associated with leg pain due to compression of a spinal nerve root which travels down the leg and becomes the sciatic nerve.  This compression usually occurs as a result of degenerative disc changes.

So how can we tell if it is or isnt sciatica?
Well firstly you want to ensure that the assessment is complete.  You could be dealing with back pain in conjunction with a lower limb condition such as anterior hip impingement, ilitibial band syndrome, peripheral nerve tension or hamstring strain.

I find that in most cases though the leg pain IS directly related to the lower back however not as a sciatica issue.  Rather the lumbar spine condition is occuring (or has led to) changes in pelvis orientation causing symptoms radiating from the posterior pelvis.  The most common mechanism I come across is a form of piriformis syndrome where either spasming of the piriformis muscle can create pain or the muscle can irritate the nearby sciatic nerve, causing pain that travels down the leg.

In all cases of sciatic symptoms short term physiotherapy or chiropractic can be valuable in identifying and differentiating between various lower back injuries.  If it isn't scaitica then treatment can significantly reduce symptoms within days.  ​