So You Think You Have Sciatica
The sciatic nerve begins in the lower back and extends to the soles of the feet. When the nerve become pinched or injured, it can cause severe pain in the back as well as the legs and feet. While the cause of trauma to the nerve is often unknown, pelvic fractures, trauma to the buttocks or thighs, prolonged lying or sitting as well as heath conditions that affect the nerves, such as a ruptured disk, the growth of tumors or diabetes, can all trigger sciatica.
Sciatica Starts in the Back
When the sciatic nerve is pinched in the upper portion of the lower back, near the lumbar vertebrae L3 or L4, it often reduces the knee-jerk reflexes that your doctor performs during your regular check-up. Sciatic nerve pain that stems from this portion of the lower back may not include much back pain at all; rather, it tends to cause pain and numbness in the calf and foot. In severe cases, the patient may not be able to flex the toes upward or walk on the heels.
The Foot Drop
When you have a pinched sciatic nerve a bit further down the lumbar spine, near the vertebrae L4 or L5, there may be only limited pain in the back. Sciatica beginning at this level of the spine is often referred to as foot drop, as the patient often has trouble lifting the big toe and in severe cases cannot lift the ankle. Symptoms of sciatica stemming from the lumbar vertebrae L4 or L5 may also cause pain and numbness between the big toe and second to as well as on the top of the feet.
Can't Walk on Your Tippy Toes?
If you have difficult lifting your heals off of the floor or walking on your toes, the causes of sciatica is most likely a pinch in the sciatic nerve between the last lumbar vertebrae, L5, and the first sacral vertebrae, S1. Sciatica at this level also reduces the ankle-jerk reflex which your doctor performs during regular check-ups and may also cause pain and numbness on the outside of the feet.
Pressure on the Piriformis
Sciatica caused by pressure on the piriformis muscle, a thin muscle that runs diagonally across the gluteal muscles, is the most common form of sciatica, as stress and tension can quickly cause the piriformis muslce to compress the sciatic nerve. This form of sciatica is also known as piriformis syndrome and often causes pain or numbness in the back of the leg, usually beginning above the knee. Piriformis syndrome can mimic multiple signs and symptoms of other forms of sciatica but is also the easiest to treat, requiring rest, relaxation and massage.