Common myths about sciatica (and what it really is and isn’t!)

It’s quite common for someone suffering from nerve pain in their leg to self-diagnose with sciatica. But, much like how someone with a bad head cold may say they have the flu (when they are entirely different illnesses) sciatica is a chronically misused and overused term that people mistakenly use in place of broader nerve pain in their legs.

There are a number of causes of nerve pinching in the lower limbs that have nothing to do with sciatica. But when pain occurs, how do you know whether it’s your sciatic nerve that is causing the issues or something else?

The most reliable way to know whether you have sciatica or another condition is to book an appointment with your physio, who will be able to perform a full assessment and land on an accurate personalised diagnosis and treatment plan. But, if you’re looking for some general information about what sciatica is (and some other conditions that are commonly confused with sciatica by patients who are prone to doing a bit of a Dr Google!) then this article may help.

Put simply, sciatica occurs when there is pinching in the sciatic nerve. The sciatic nerve starts in your lower back and goes down through your hips and buttocks into each leg, all the way down to the foot. It is the largest and longest nerve in the human body and is responsible for much of the functionality in your thigh, leg and foot. So, when all is not well in your sciatic nerve, it’s easy to appreciate how big of an impact it would have on your ability to do everything from run to comfortably sit or stretch without pain.

Symptoms of sciatica can include pain, numbness, altered sensation or weakness in the areas of the leg that are supplied by the sciatic nerve. Because the nerve originates in your lower back, sometimes an issue with the sciatic nerve can have its root cause in your back, even if the symptoms are displayed lower down in your leg. This can lead to confusion for people who are just treating their leg muscles through massage or other remedies and are not seeing long-term improvement. Normally sciatica will be limited to one side of the body (eg; one leg) but in some rare cases, both legs may be affected.

As mentioned above, not all nerve pain in the leg will be related to the sciatic nerve. But if it isn’t sciatica, then what is it? Two other common types of leg nerve pain include radicular pain and Piriformis Syndrome.

Like sciatica, radiculopathy travels from your back down into your hips, buttocks and legs. But instead of radiating specifically from your sciatic nerve, radicular pain occurs whenever there is inflammation or compression in any nerve root in your spine (which means technically sciatica is a type of radiculopathy!). So, while the symptoms may present similarly, the cause and consequently areas of focus of treatment can differ from sciatica.

Radiculopathy symptoms can also present as neurological issues, such as poor reflexes, loss of feeling or general weakness.

Piriformis syndrome is another condition that is commonly mistaken for sciatica. Your piriformis muscle is located deep in your buttock, running from your lower back to your upper thigh. The sciatic nerve normally runs directly below it, although in some people, they actually intercept.

While the cause of piriformis syndrome is not entirely known, there are a few different theories. The piriformis muscle can be susceptible to spasm, and it’s possible the spasms themselves actually cause the pain and irritation to the buttocks. It’s also possible that tightness or swelling of the muscle could cause the prolonged pain associated with piriformis syndrome.

Interestingly, while piriformis syndrome is different to sciatica, it can be a contributing factor in causing sciatica, especially when spasms are involved, as they can transfer strain and stress to the nearby sciatic nerve.

Not only can a physio help ensure you end up with the correct diagnosis, but also the correct treatment plan. What you should do to avoid making sciatica or any other type of nerve pain worse will entirely depend on what is causing it and your individual circumstances.

A common misconception that people have with back or leg pain is that you should “stretch it out” and may take up yoga or pilates. But if the particular class you attend involves lots of poses in the bent forward position, this will likely exacerbate the weakness in your spine that is causing pain, so caution is recommended. Alternatively, impact work such as running could be problematic for your condition, as all your leg muscles are linked to the sciatic nerve.

Ultimately, this is why you should visit a qualified physio, as they will be able to use a range of different techniques to ensure they have a deep understanding of exactly what’s going on with your body, and consequently, the best way to treat or manage that issue for you.