If You Feel Shooting Pain from Your Lower Back to Your Leg... Suspect Sciatica

A man in his 40s, referred to as Mr. A, recently began experiencing pain that started in his right lower back and radiated through his buttock down to the back of his leg. The pain intensified especially when sitting or coughing, prompting him to visit a nearby medical facility. After undergoing an MRI scan, he was diagnosed with a herniated disc that was compressing his sciatic nerve, causing the pain.

Running pain. [Image source=Clipart Korea]

Mr. A had always thought that a herniated disc would only cause back pain, but through his own experience, he learned for the first time that the pain could extend down to the leg.

The pelvis is composed of pelvic bones, which include the sacrum?also known as the tailbone?located below the lumbar spine, and the ilium, which has a wing-like shape on either side. The ischium, located beneath the ilium, is the part that touches the floor or a chair when sitting.

The sciatic nerve, which runs down the leg from inside the ischium, is a peripheral nerve formed by nerve roots that emerge from the spinal cord between the fourth lumbar vertebra and the third sacral vertebra. It is the longest and thickest nerve in the body and, along with the femoral nerve, plays a crucial role in the nerves of the leg.

When the sciatic nerve is compressed or damaged by inflammation, it leads to sciatica. Most cases are caused by nerve compression, with more than 90% resulting from lumbar disc herniation, commonly known as a herniated disc. Other causes may include osteoarthritis, spinal stenosis, spondylolisthesis, or swelling due to ligament sprains. Rarely, it may be caused by diabetic neuropathy or spinal tumors.

Pain typically radiates from the lower back through the buttock and down the back of the leg, and may be accompanied by aching, burning sensations, numbness, tingling, or muscle weakness. In severe cases, nerve root compression can lead to radiculopathy or cauda equina syndrome, resulting in loss of sensation or strength in both legs and even urinary problems.

Sciatica is sometimes confused with lower back pain. However, lower back pain is limited to the back, while 5?10% of patients with lower back pain may also experience sciatica.

Jung Dongmun, Director of the Spine Center at Daedong Hospital (Neurosurgeon), stated, "Sciatica is not a final diagnosis, but rather a symptom caused by an underlying condition. It is important to consult a neurosurgeon to determine the source of the pain and receive appropriate treatment." He added, "Since back pain is common and often taken lightly, if you experience pain that is different from usual, it is essential to visit a nearby medical facility for a proper diagnosis."

Jung Dongmun, Director of Spine Center at Daedong Hospital.

Based on the patient's reported symptoms, physical examinations such as the straight leg raise test are conducted, and depending on the physician’s judgment, X-rays, CT scans, MRI, nerve conduction studies, or electromyography may be performed.

Generally, sciatica resolves naturally, but to alleviate pain, bed rest, medication, and physical therapy may be recommended. If pain persists for more than four weeks or symptoms are severe enough to interfere with daily life, surgical intervention may be considered.

To prevent sciatica, it is advisable to regularly perform exercises and stretches that strengthen the core muscles, including the abdomen, buttocks, and back. Weight control is also recommended if overweight.

It is best to correct poor posture, such as slouching, sticking out the belly, or crossing the legs. If you must stand or sit for long periods due to work or other reasons, change your position frequently and stretch whenever possible.

This content was produced with the assistance of AI translation services.