Sciatica, Explained: Why Leg Pain Can Start in Your Back
If you have felt sharp or aching pain running from your lower back through your hip and down your leg, you may have wondered why it hurts so far from where the problem seems to start. With nerve-related pain, the place that hurts is not always the place where the problem is.
This type of pain is often called sciatica, after the sciatic nerve, which runs from the lower back through the buttock and down the leg.
This article gives general information about what sciatica is, why it can cause pain far from the spine, and some possible causes. If you have leg or back pain that concerns you, please discuss your situation with a provider.
What Sciatica May Feel Like
Sciatica is not a single diagnosis. It describes a pattern of symptoms that can occur when the sciatic nerve or the nerve roots that form it are irritated or compressed. People often describe a burning, shooting, or electric sensation down one leg. Others notice numbness, tingling, or a dull ache that makes sitting or standing uncomfortable.
The pain may start in the lower back or buttock and move downward, sometimes as far as the foot. In some cases, the back itself hurts very little and most of the discomfort is in the leg, which is one reason an evaluation can be helpful.
Why the Pain Can Travel
The sciatic nerve is formed from several nerve roots that leave the spine in the lower back and join to travel down the leg.
When one of those nerve roots is irritated near the spine, the pain is often felt along the nerve's path in the leg rather than only at the spine. This is sometimes described as radiating or referred pain.
This is why someone may have a problem in the lower back but feel most of the pain in the calf or foot, and why evaluating only the painful area of the leg may not identify the source.
Possible Causes of Sciatic Nerve Irritation
Several conditions in the lower spine can be associated with sciatica. A disc may bulge or herniate and press on a nearby nerve root. Age-related changes in the joints or bones of the spine can narrow the space where nerves travel.
In some cases, symptoms begin after an injury such as a fall, an accident, or repetitive strain. Because different causes can produce similar symptoms, an evaluation is important before assuming what is behind them.
How Sciatica May Be Evaluated
An evaluation generally starts with a history and examination. A neurological examination may check reflexes, strength, and sensation in different parts of the leg.
Depending on the situation, electrodiagnostic testing may be used to assess nerve function, and imaging of the spine may be reviewed for findings such as disc changes or narrowing.
Considering these findings together can provide more information than looking at the painful area alone.
When to Reach Out
Leg pain that starts without a clear reason, or back pain that spreads down the leg, is worth paying attention to. Mild symptoms sometimes settle on their own, but ongoing numbness, weakness, or pain that limits daily activity may deserve a closer look. Sudden leg weakness or loss of bladder or bowel control calls for emergency care.
Causes of sciatica differ from person to person. If you have pain that travels down your leg, you can call our office to discuss your symptoms and possible next steps.
Questions about your own care? The team at Complete Care is happy to help — call us at 212-239-2112 or request an appointment.
This content is for general information only and isn't medical advice. Talk with a qualified provider about your own situation. If you have a medical emergency, call 911.