By Dr. Stephen Ritter

Many of my patients are surprised to learn that a disorder of their lower back could cause mild to intense leg pain. Known as sciatica, this condition occurs when one or more of the five sets of nerve roots in the back are compressed. Several different types of spinal disorders can cause spinal nerve compression and sciatica. The six most common include:

  • Lumbar bulging or herniated disc – If a disc bulges or becomes herniated, disc material can press against an adjacent nerve root and compress delicate nerve tissue, which is the worst cause of sciatica. In this case not only does the herniated nucleus cause direct compression of the nerve root against the interior of the bony spinal canal, the disc material itself contains an acidic, chemical irritant that causes nerve inflammation. This often leads to extreme numbness, tingling, pain and muscle weakness in the legs.
  • Lumbar spinal stenosis – Leg pain similar to sciatica may occur as a result of lumbar spinal stenosis, which happens when the nerve root passage way becomes narrow or closed due to nerve compression. The pain is usually brought on by certain activities such as standing or walking, and can be relieved by sitting dowm.
  • Spondylolisthesis – Characterized by one vertebra slipping forward over an adjacent vertebra, spondyloisthesis often affects the lumbar spine. When a vertebra slips and is displaced, spinal nerve root compression occurs and often causes sciatic leg pain. This condition can develop at birth or might be acquired from spinal degeneration, trauma or physical stress.
  • Trauma – Sciatica can result from direct nerve compression caused by external forces to the lumbar or sacral spinal nerve roots. Trauma from a motor vehicle accident, a fall or physical impact while playing a sport can injure the nerves or cause fragments of broken bone to compress the nerves.
  • Piriformis syndrome – The piriformis muscle is located in the lower part of the spine and connects to the thighbone, which assists in the rotation of the hip. When this muscle becomes inflamed and begins to spasm it can irritate the sciatic nerve, causing sciatica.

If you think you are suffering from sciatica, you should contact an orthopedic spine specialist for a proper evaluation. A proper diagnosis is the first step to reversing the damage and relieving the pain.


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