Sciatica is characterized by pain, tingling or numbness down the leg. (Low back pain may also be felt, but this is less common than pain down the leg) Sciatica is caused by irritation to or stretching of the sciatic nerve.
Sciatica is not an actual diagnosis you would get from your doctor after an exam and tests; rather, it's a collection of symptoms brought about by other problems in the spine. If you have herniated a disc, for example, the material that escapes from the tough outer fibers of the disc may possibly compress the sciatic nerve, causing pain and other symptoms. Spinal stenosis and spinal arthritis are two more conditions that could bring about sciatica.
There are a few main population groups who have a higher risk for sciatica than the rest of us. At highest risk are people between the ages of 30 and 50 years old. These people may be very active, which increases the possibility of injury. But they are also beginning to age, and that can mean degenerative changes in the spine. Spinal conditions common to this group include stenosis and arthritis.
The next highest risk group is the sedentary. Many people who fall into the 30-50 age group are also sedentary. Sitting all day may put pressure on the sciatic nerve, causing pain down the leg. Other people who need to watch out for sciatica are walkers, runners, diabetics and pregnant women.
So how do you know when you have sciatica? It usually shows up as a radiating pain down the leg, but may include buttock pain, weakness or numbness. If weakness of the leg or foot keeps getting worse, or if you lose control or feeling in bowel or bladder, you may have cauda equina syndrome, a serious condition that requires immediate medical attention.
Remember that sciatica is a condition of the large sciatic nerve, which produces sciatic nerve pain when irritated. Like any nerve in the body, when pressured, it may be responsible for sharp, burning pins and needles or electrical type feelings. Positions and activities that put pressure on the sciatic nerve can worsen the pain. Sitting for a long period of time is perhaps the best example.
Piriformis syndrome is a rare type of sciatica. When the piriformis muscle, located in the buttock, is the structure that puts pressure on the sciatic nerve, the pain and other symptoms that result are collectively called piriformis syndrome.
Like the other forms of sciatica, piriformis syndrome is characterized by pain, tingling and/or numbness in the buttock and sometimes down the leg. Unlike the other types, however, determining that piriformis syndrome is at the root of symptoms requires the doctor to first rule out all possible causes. This makes diagnosing it a controversial topic in the medical world.
Generally piriformis syndrome is treated with physical therapy, especially stretching the piriformis muscle. Surgery is rare.