Sciatica: The Need for a Proper Diagnosis

Woman sits on exam table and talks with doctor about her sciatica

According to the National Institutes of Health (NIH) Library of Medicine, up to 40% of people experience sciatica at some point during their lifetime. Interestingly, the diagnosis is often missed. It is important for patients to seek care from experienced physicians who can accurately identify this condition and treat it. Centers for Neurosurgery, Spine & Orthopedics serves patients throughout northern New Jersey. Learn more about sciatica, why a proper diagnosis is imperative, and the treatment options patients can consider to alleviate the pain and discomfort.

Sciatica 101

Sciatica is described as unpleasant symptoms in the lower back and into the legs as a result of nerve-root pressure within the lumbar portion of the spinal column. The sciatic nerve is the nerve that is pinched and Sciatica is considered a type of radiculopathy because the discomfort is experienced distal to the point where the nerve is pinched. The sciatic nerve begins in the base of the spine and runs down the hips, buttocks, and legs. Discomfort along the path of this nerve is known as sciatica. Most commonly occurring on only one side of the body, this condition is associated with the following symptoms, ranging from mild to severe:

  • Sharp pain
  • Numbness
  • Tingling
  • Burning
  • Weakness

Sciatica can greatly impact the ability to participate in the everyday activities and interferes with quality of life. Depending on the severity of the symptoms, the patient may find it difficult to sit or stand for prolonged periods, as well as walk or sleep comfortably.

During pregnancy, sciatic nerve pain is common, especially during the third trimester. This is due to the loosening of the pelvic and spine ligaments which stabilize the spine and protect the discs between the vertebral bones. Increased ligament flexibility can lead to slipped discs, which may pinch the nerve and cause sciatica to develop.

What Makes Diagnosing Sciatica Complex?

Sciatica may stem from a variety of causes. Symptoms arise when the nerve is compressed, inflamed, or pinched within the spine. It takes a true healthcare expert to accurately diagnose the root cause of the leg and back pain. Common causes of sciatica include:

Sciatica can be difficult to diagnose so the treating pain management doctor, neurosurgeon, or spine surgeon needs to be extremely well trained on how to isolate the anatomical structures to prove to root cause. The treating physician must be an expert on the neurological and musculoskeletal physical exam which will involve several different aspects including:

  • Range of motion test
  • Neurological assessments (i.e., reflexes, limb strength, balance, etc.)
  • Palpation
  • Muscle tone and conditioning

Collectively, these aspects are important. They help the physician isolate the affected area and help determine the necessary treatment plan. If symptoms are severe, an image will be necessary.

Risks of Misdiagnosing Sciatica

Sciatica often is misdiagnosed because the same or similar symptoms can be produced by a variety of other disorders. It also often overlaps with other diagnoses. Identifying the issue not only involves pinpointing the underlying cause but also eliminating other possible conditions. Health conditions that often mimic sciatica include:

  • Vascular disease
  • Peripheral neuropathy
  • Peroneal neuropathy in the leg
  • Pelvic disorders, such as piriformis syndrome and sacroiliac joint dysfunction

Usually, sciatica treatments begin with non-invasive or minimally invasive procedures, such as physical therapy or epidural injections. After methods like these are explored, physicians may recommend surgery if the symptoms have not resolved.

Misdiagnosis can lead to unwarranted surgical procedures, undue risk of possible complications, and increased downtime for the patient. Additionally, the appropriate treatment plan will have been delayed once the physician eventually identifies the condition as sciatica, which can be highly frustrating, uncomfortable, and costly for the patient in the long run.

What Patients Should Do if They Think They Have Sciatica

Each patient’s experience is unique, and the severity of the condition may depend on several factors. However, it is important to know that, in many cases, mild sciatica may resolve itself with a few self-care techniques. This may include:

  • Ice/hot pack application
  • Over-the-counter (OTC) medications
  • Gentle stretches
  • Rest

If the symptoms do not alleviate within a few days through these or other recommended self-care methods, patients should consult a trusted physician who has experience diagnosing and treating sciatic nerve pain. Alternatively, patients should seek immediate medical attention if the symptoms are severe, such as unbearable leg pain lasting more than a few hours.

Centers for Neurosurgery, Spine & Orthopedics in northern New Jersey is made up of a compassionate group of leading orthopedic spine surgeons, neurosurgeons, interventional pain management physicians, physiatrists, rehabilitation specialists, and certified physical therapists. Taking a multidisciplinary approach to care, the team works together to diagnose sciatica and find solutions that suit the individual needs of each patient. For more information about sciatica and its symptoms, contact Centers for Neurosurgery, Spine & Orthopedics today.

Centers for Neurosurgery Spine & Orthopedics
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