The term Sciatica is, as you noted below, is generally used as a general term for back pain into the buttock or leg. A true “sciatica” is from compression of the sciatic nerve which is a nerve composed by a number of spinal nerves, typically L3-S1. A true compression is from something like a piriformis syndrome whereas compression of one of the spinal nerves in the spine occurring from one of the conditions you list below.
The accurate term for compression of a spinal nerve with associated symptoms is “radiculopathy” which can be under the umbrella of “sciatica”.
What Is Sciatica and What Are The Causes?
Sciatica is a term used to describe pain that begins in the lower back and radiates downward to the buttocks and through the leg, sometimes even reaching the foot. The pain is the result of compression of the sciatic nerve.
Generally affecting only one side of the body, the pain can range from a mild ache to excruciating sharp-shooting pain. Sciatic pain can sometimes feel like an electric jolt down your back and leg. It may even feel worse with sudden jerking movements, such as sneezing or coughing.
In addition to pain, other symptoms may include numbness, weakness or tingling in the affected leg and foot.
In younger adults, sciatica is usually the result of conditions including:
- Degenerative disc disease (DDD): One of the most common causes of back pain, DDD is a term used to describe the natural breakdown of the spine over the course of time. DDD is actually a misnomer; it is not a disease at all, but rather a degenerative condition that results in pain due to a damaged spinal disc (the cushion between vertebrae)
- Herniated lumbar disc: Disc herniation occurs when the soft center of the spinal disc leaks through the tough exterior and places pressure on the nearby nerves or nerve roots
- Isthmic spondylolisthesis: This condition occurs when one of the vertebrae slips forward and over the one below it due to a stress fracture in the bone that connects the two joints on the backside of the spine
In older adults, sciatica is typically due to conditions such as:
- Degenerative spondylolisthesis: Like isthmic spondylolisthesis, degenerative spondylolisthesis occurs when one vertebrae slips over another. However, this is the result of a gradual degeneration of the spine and its parts over time
- Lumbar spinal stenosis: Lumbar spinal stenosis is a narrowing of the spinal canal in the lower back. The narrowing is the result of natural degeneration of the spine
The issue with the word sciatica is that is has become an umbrella term for any and all lower back/leg pain. This results in patients misdiagnosing themselves and then incorrectly administering self-treatment, which can potentially cause more damage and pain.
What Conditions Mimic the Symptoms?
The reality is that there are a variety of other spinal conditions that mimic the symptoms of sciatica. These include:
- Joint conditions in the spine: Joint conditions, such as arthritis, may end in radiated pain from the joints in the spine to the leg. However, treatments for arthritic conditions focus more on the use of prescribed anti-inflammatories and exercises that aid in preserving motion in the joints
- Piriformis syndrome: This condition occurs when a muscle in the buttocks (known as the piriformis) spasms and causes pain in the buttock. When going into spasms, the muscle may also irritate the nearby sciatic nerve
- Sacroiliac joint dysfunction: Generally the result of too much or too little movement of the joint that connects the bottom of the spine to the pelvic bone, sacroiliac joint dysfunction can mimic sciatic nerve pain
How Do I Know if I Have Sciatica or if My Pain Is Something Else?
Because other conditions are very clever at simulating sciatica symptoms, the best way to determine if you have sciatica is to contact a specialist for a complete assessment.
At the New Jersey Neck & Back Institute, Dr. Sandro LaRocca is one of the leaders in effectively treating orthopaedic spinal conditions, including sciatica and similar disorders. Working with a compassionate, professional staff, Dr. LaRocca offers patients comprehensive spinal care, complete with a personalized treatment plan tailored to meet your individual needs.
For more information or to schedule an appointment with Dr. LaRocca, contact us today.