When the nerves roots in the lumbar region (lower back) are impacted by an irritation or abnormal compression, a condition known as sciatica occurs. Also known as lumbar radiculopathy, the result of the condition is pain, general weakness and changes in sensation in the lower back, hips buttocks, legs and feet.
As nerve roots radiate out from the spinal cord, they emit signals that travel to the brain and transmit information. However, when those nerve roots are affected by pressure through spinal compression—such as from a degeneration of a disc or fundamental changes to the spine itself—the roots become irritated and muscle weakness, pain and changes in sensation often occur.
The symptoms of sciatica include pain and weakness in the lower back, hips, buttocks, thighs, knees, legs and feet. Depending on exactly which nerve roots are being affected, the pain and weakness may be as specific as pain radiating downward on the outside of the leg and into the top of foot and big toe; weakness down the back of the calf to the foot and little toe; or variable pain in the knee and thigh only.
A diagnosis of sciatica begins with a physician asking questions to build a medical history, such as the location of the pain or weakness. A physical exam can help determine the level of flexibility and muscle strength a patient has as well as any problems with sensation that may be present. Imaging studies often help the diagnostic process, and may include x-rays to determine if an injury or trauma occurred or whether an infection or tumor is present; a CT scan which gives a view of the amount of space nerve roots have and whether there are problems with the vertebrae; and an MRI, which is ideal for finding the exact location of the impacted nerves as well as problems with the soft tissue, discs and ligaments in and around the spine.
The pain and weakness associated with sciatica is most often treated with a combination of medications that relieve inflammation, rest and physical therapy. In some cases bracing devices may be utilized, and most sufferers find relief within three months. But surgery may be needed to relieve the compression on the nerve root if symptoms don’t improve with the more standard treatments.