SCIATICA

Sciatica is a symptom. It consists of leg pain, which might feel like a bad leg cramp, or it can be excruciating, shooting pain that makes standing or sitting nearly impossible.

The pain might be worse when you sit, sneeze, or cough. Sciatica can occur suddenly or it can develop gradually. You might also feel weakness, numbness, or a burning or tingling (“pins and needles”) sensation down your leg, possibly even in your toes. Less common symptoms might include the inability to bend your knee or move your foot and toes.

What causes Sciatica?

Sciatica might be a symptom of a pinched nerve affecting one or more of the lower spinal nerves. The nerve might be pinched inside or outside of the spinal canal as it passes into the leg.

Conditions that cause Sciatica:

• A herniated or slipped disc that causes pressure on a nerve root — This is the most common cause of sciatica.
• Piriformis syndrome — This develops when the piriformis muscle, a small muscle that lies deep in the buttocks, becomes tight or spasms, which can put pressure on and irritate the sciatic nerve.
• Spinal stenosis — This condition results from narrowing of the spinal canal with pressure on the nerves.
• Spondylolisthesis — This is a slippage of one vertebra so that it is out of line with the one above it, narrowing the opening through which the nerve exits

 How is Sciatica Diagnosed?

A complete medical history, including a review of your symptoms, and a physical exam can help the health care provider diagnose sciatica and determine its cause. For example, he or she might perform a straight-leg-raise test, in which you lie on your back with your legs straight. The health care provider will slowly raise each leg and note the elevation at which your pain begins. This test can help pinpoint the affected nerves and determine if there is a problem with one of your discs. 

Other diagnostic tests might be performed to look for other causes of sciatic pain. Depending on what your health care provider finds, he or she might recommend further testing. Such testing might include:

• X-ray to look for fractures in the spine
• Magnetic resonance imaging (MRI) or computed tomography (CT) scan to create images of the structures of the back
• Nerve conduction velocity studies/electromyography to examine how well electrical impulses travel through the sciatic nerve
• Myelogram using dye injected between the vertebrae to determine if a vertebra or disc is causing the pain 

Most patients with sciatica can be treated without the need for further diagnostic testing.