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Sciatica Joint Pain

Sciatica Symptoms
Usually degenerative disc disease affects one side of the body. The pain may be dull, sharp, burning, or accompanied by intermittent shocks of shooting pain beginning in the buttock traveling downward into the back or side of the thigh and/or leg. Sciatica then extends below the knee and may be felt in the feet. Sometimes symptoms include tingling and numbness. Sitting and trying to stand up may be painful and difficult. Coughing and sneezing can intensify the pain.

The Cause: Nerve Compression
Compression of the sciatic nerve can cause any of the above-cited symptoms. Rarely is nerve damage permanent and paralysis is seldom a danger as the spinal cord ends before the first lumbar vertebra. However, increasing trunk or leg weakness, or bladder and/or bowel incontinence is an indication of Cauda Equina Syndrome, a serious disorder requiring emergency treatment.

Lumbar spine disorders known to cause herniated disc compression include the following:

  • Herniated discs are the most common cause of degenerative disc disease in the lumbar spine.
  • Degenerative Disc Disease, a natural biological process associated with aging, is known to cause disc weakness that can be a precursor to a disc herniation.
  • Yoga Props with cat!
    1 Sciatic Nerve (yellow)
    2 Sacrum
    3 Hip Bone
    Yellow = Nerve Structures
    Red Structures = Arteries
    Blue Structures = Veins
  • Lumbar Spinal Stenosis is a narrowing of one or more neural passageways due to disc degeneration and/or facet arthritis. The herniated disc may become impinged as a result of these changes.
  • Isthmic Spondylolisthesis results from a stress fracture often at the 5th lumbar vertebra (L5). The fracture combined with disc space collapse may allow the vertebra to slip forward on the first sacral segment (S1). The slippage may cause the L5 nerve root to become pinched as it leaves the spine.
  • Spinal Tumors and Infections are other disorders that may compress the herniated disc, but this is rare.

There are other conditions, which may occur, and may mimic true degenerative disc disease but these are difficult to diagnose.

Sciatic Nerve
Sciatic Nerve

Diagnosis of Sciatica
The physician's examination includes the patient's medical history, a review of current spondylosis, a physical and neurologic examination and, if warranted, x-rays, CT scan and/or MRI. A proper diagnosis requires an analysis of the patient's pain. The patient is often provided a Pain Diagram to illustrate pain distribution and sensation (eg, tingling and burning).

The physician's questions may include:

  • "How did the pain develop?"
  • "On a scale from 1 to 10, with 10 being the worst pain imaginable, rate your pain."
  • "Is the pain worsened by walking uphill or downhill?"
  • "How does the pain affect activities of daily living?"
  • "What type of treatment has been tried and what was effective?"

The patient's range of motion is observed. Reflexes and muscle strength are tested. The physician may use one or more movement tests to determine the source or cause of the pain.