Sciatica is a common source of lower back pain that often extends to parts of the lower extremities. The longest single nerve in the human body, the sciatic nerve runs from the lower back (starting at segment L3) into the legs before branching off into other nerve groups. Sciatica is a type of nerve compression often triggered by herniated discs, bone spurs, and abnormalities such as spinal stenosis that narrow spaces around nerves. To help you get a better idea of whether or not your symptoms may be related to sciatica, let’s discuss what this condition typically feels like based on which spinal segments are affected.
Discomfort associated with sciatica originating at this level normally originates within the L3-L4 level of the spine and is usually felt most in the lower leg and foot and not so much in the lower back area, although it’s possible to have both localized and radiating nerve pain. This form of sciatica may also produce symptoms such as:
• General muscle weakness in the lower extremities
• Difficulty extending the affected foot upward
• A reduced “knee-jerk” reflex (patellar reflex)
Affecting the L4-L5 segment, this type of sciatica is characterized by what’s referred to as “foot drop” symptoms, a progressive weakening of the muscles responsible for helping ankles and toes flex properly. If you have this type of sciatica, you may feel numbness and/or pain around the top of your foot, especially around the big toe or the adjacent toe. Incidentally, the L4-L5 segment is a common source of sciatica pain/symptoms because this part of the spine provides significant support to the upper body and is also highly flexible in multiple directions.
Sciatica affecting the L5-S1 level—which is where the lumbar spine ends and the sacral spine begins—tends to produce symptoms that are more noticeable around the outside part of the foot. If you have sciatica originating at this spinal level, you may also experience muscle weakness around the affected foot. The lower back area may be affected as well. Symptoms could also include:
• Difficulty lifting the heel off the ground
• Changes in walking patterns (e.g., walking on tiptoes to avoid back of the foot/heel pain)
• Reduced ankle-jerk reflex
It’s entirely possible to have your own unique set of symptoms related to some type of compression or irritation of the sciatic nerve. The nature of your symptoms will also depend on what’s causing your discomfort. For instance, spinal arthritis that’s contributing to sciatic nerve pain may produce symptoms that are more widespread, since multiple levels of the spine tend be affected by degenerative and progressive conditions such as this.
No matter where the pain originates, a variety of treatments are available, from physical therapy to spinal fusion alternatives. Santa Monica patients should see their spine specialist to determine whether they need to undergo surgical procedures such as a microdiscectomy (partial/complete disc removal) or a lumbar laminectomy (removal of part of a vertebral bone).
Minor sciatic nerve pain may respond well to alternating applications of ice and heat to ease inflammation and increase circulation in the affected area. Over-the-counter pain and anti-inflammatory meds can also reduce disruptive symptoms.
If discomfort is severe or not going away with self-care efforts, you may want to consider physical therapy or consulting with a minimally invasive spine surgeon. Santa Monica patients who suspect they have sciatica should contact the experienced spine specialists at The Spine Institute for diagnosis and treatment. Call us today at 310-828-7757 to schedule a consultation.