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Spine Q&A – Do I Have Sciatica?

May 29, 2012

Edward H. Scheid, Jr., MD, FAANS, Capital Region Neurosurgery

Q.  For a couple months now, I have had some minor lower back pain and numbness that travels down from my butt, hip through my entire leg, all on the right side only and makes my right side feel very weak.  Could this be sciatica?  And if so, does that mean I have a pinched sciatic nerve? 

A. Only about 5% of people with lower back problems will have pinched sciatic nerve symptoms. Most people will have non-specific lower back pain. Don’t automatically assume that because you have pain in your back or buttock that it is sciatic nerve pain.  Sciatica is most often caused by spinal disc problems.

One thing to keep in mind is that, even though the pain is usually in the legs or buttocks, it is actually a “referred pain” that has nothing to do with those locations at all. It is caused by a structural element in the lower back impinging on the sciatic nerve and your brain just thinks the pain is in your legs or buttocks. Sciatic nerve irritation often occurs at the L5 or S1 levels of the spine where the nerve exits the spinal canal.

Most people find that the symptoms subside within a few weeks and they erroneously conclude that their problems are over. Depending on the cause of your sciatica, the leg pain or low back pain will probably return if proper steps are not taken to correct the source of the nerve compression.

If left untreated it will grow worse and could become a chronic problem. The longer you delay treatment, the longer it will take for the situation to be corrected. Sciatica will continue to persist as long as the sciatic nerve remains pinched.

Bottom line is that proper diagnosis is essential.   Sciatica is nothing to fool with and you should always see your doctor if you suspect that your symptoms are the result of a pinched nerve. Some signs of serious nerve damage due to sciatica include the inability to control your bowel or bladder, an increasing weakness in your legs or the loss of feeling or sensation in your legs or feet. If you are experiencing any of these symptoms seek immediate medical attention.

Originally published in the Schenectady Gazette

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