For some people, pain may be severe and frequent, while for others the pain may be rare and slightly irritating. However, keep in mind that this “annoying pain” can very quickly deteriorate and develop into a strong and frequent.
Pain in the lower back can be present along with pain in the legs, however and usually the pain in the legs is more severe than the pain in the lower back. Patients often describe their sciatica symptoms as electrical shocks extending down the leg or as a burning sensation/pain.
Common symptoms of sciatica
Typically sciatica affects only one side of the lower body, with the pain extending from the lower back, buttocks, back of the thighs and down the leg.
A combinations of the following symptoms are quite common:
- Permanent pain in only one side of the buttocks or leg, but rarely do they appear on the other side of the body
- The pain that originates from the lower back or buttocks and continues through the thighs and extends down the leg.
- The pain subsides when lying down, however increases when standing or walking
- The pain that is usually described as sharp or “hot”
- Feeling a “pinching pain”, stiffness, weakness or stinging down the leg can present in some cases
- Weakness or stiffness when moving the leg or feet
- Severe pain or pain in one leg, making it difficult to get up or walk, the pain may also appear in the fingers depending on where the inflammation is
- Pain in the lower back, which (if it’s at all felt) is not as severe as pain present in the legs
- Symptoms can be increased during sudden movements such as sneezing, coughing or when moving from the sitting position to standing upright.
Certain symptoms are unique depending on the cause of the sciatica. For example, bending backwards or walking short distances often causes spinal stenosis. Bending forward can cause pain mimicking those symptoms of spinal disc dislocation.
Sciatica symptoms vary depending on where nerve root is compressed (location of pressure). For example:
- The symptoms of the L4 nerve root usually affect the thighs. Patients may experience weakness in their legs and may have reduced knee reflex.
- The symptoms of the L5 nerve root syndrome may spread to the toe and ankle (also referred to as the foot fall). Patients may feel pain or numbness at the top of the foot, particularly in the “tissue” of the skin between the thumb and the second toe.
- The S1 nerve root affects the outer part of the foot, which can radiate to a small finger or toe. Patients may experience weakness when trying to lift the heal of the ground or when trying stand on your tiptoes. Ankle reflex can also be reduced.
Since more than one nerve root can be compressed, patients may have a combination of the above symptoms.
Symptoms requiring immediate medical attention
Rarely, do symptoms of sciatica require an immediate surgery. The following symptoms indicate the need for urgent medical attention:
- Symptoms that continue to worsen and over time do not improve, which may indicate possible nerve damage, especially if progressive neurological symptoms (such as leg weakness) are present.
- Symptoms that occur in both legs (called bilateral sciatica) – or which cause bladder and/or bowel dysfunction or incontinence or if there is an altered feeling in the genital area – may indicate caudate syndrome.
- Cauda equina syndrome is an acute compression of one or more nerve roots which occurs relatively infrequently (in about 2% of the lumbar disc herniation) and can cause paralysis.
- Other concerning symptoms such as; fever and/or loss of appetite may also require immediate medical assessment.