Simply stated, sciatica is the sensation of pain, tingling, or numbness in the lower back, buttocks, and/or legs that are produced when there is irritation of the sciatic nerve. The sciatic nerve is formed by a number of nerve roots that branch off of the spinal cord in the lumbar spine.

The sciatic nerve travels down through the buttocks and the back of the legs to the ankle and foot. Typically, a patient complains of pain from the lower back that travels down the back of the thigh and calf and often to the little toe, often accompanied by tingling or numbness. See the accompanying diagram.

Sciatic pain is most often caused by herniated, bulging or degenerated discs producing pressure on the sciatic nerve as it exits the lower back. Additional causes include small bony growths on the spine (bone spurs), as well as compression or pressure causing a pinching of the nerve as a result of injury.

Other causes of sciatica can be tumors, pregnancy or spinal stenosis (a narrowing of the spinal canal).

Understanding Leg Pain

The location and distribution of leg pain can help the doctor pinpoint the cause of your discomfort. Pain down the back of the leg and calf as described above is usually sciatica and results from nerve pressure between the 5th lumbar vertebrae and the 1st sacral segment, often referred to as L5-S1 disc pathology.

Pain down the side of the thigh and calf that crosses over the top of the foot to the big toe is often the result of disc pathology at the L4-5 level of the spine.

These are just two examples of how the location and distribution of pain can assist the doctor in understanding the source of your complaint. Be sure to share with your doctor as best you can the location and distribution of your pain and any other symptoms you may be experiencing.

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