Pain that radiates down the back of your leg, numbness or tingling that extends down to your foot, a quick jolt each time you cough or sneeze — sounds like sciatic nerve pain, right?
For one thing, sciatica is actually a symptom, not a condition. It's leg pain (anywhere from the lower hip and butt region, all the way down to your toes) resulting from a pinched nerve — most likely because of a herniated or slipped disc.
Contrary to popular belief, actual back pain doesn't usually come along with sciatica — or it's a minor part of the overall problem.
"If a patient has 80 percent leg pain and minimal back pain, it really turns on our radar for sciatica," explained Dr. Eric Mayer, sports, and spine specialist at Cleveland Clinic's Center for Spine Health.
How do you know for sure that shooting pain is nerve related and not coming from somewhere else — like your muscles?
Here are tips on getting to the root of your agony, once and for all.
1. You feel weak in your knees
Well, actually just one knee—and it runs throughout the entire leg. The sciatic nerve — the one that gets pinched and causes sciatica — is the largest single nerve in the entire body, running from the lower spine all the way down to the foot.
When that nerve is pinched, its function is disrupted, resulting in all kinds of unwanted sensations, such as pain, weakness, and tingling. And while pain is pretty common (and oftentimes hard to diagnose), pain and weakness in a single leg act as a red flag for doctors.
"Patients often drive to the emergency room for pain, but it's really the weakness that's concerning — if you see that you're getting weak, you should seek care," advised Mayer.
2. You're a walker, not a runner
If you're not training for your next marathon or logging hours on the treadmill, there's a good chance your leg pain is sciatica caused by a herniated disc, not the less-common piriformis syndrome, which mainly affects athletes.
The funny thing is that piriformis syndrome presents itself almost exactly like sciatica: pain, tingling, numbness starting in the buttocks and extending down the leg.
But instead of a slipped disc causing the issues, your piriformis muscle (found in the butt near the top of your hip joint) is pressing on that touchy nerve.
3. You can't summon your pain (not that you'd want to)
Telling a doctor you have pain is kind of like going to a pizza shop and ordering pizza — specificity is key. Sometimes the pain you think is sciatica isn't actually nerve-induced pain at all, but rather, something muscular.
So how do you find out?
“Use your thumb”, suggested Jacob Teitelbaum, M.D., author of Real Cause, Real Cure. "Push around on the muscles in your lower back and see if you can find spots that affect your pain.”
If you can trigger pain by a push — not a gentle push, you want to exert at least 5 to 10 pounds of pressure — your pain is most likely muscular and the result of a shortened, tightened muscle.
"When a muscle gets stuck in the shortened position, it gets thicker and doesn't get the blood or nutrients that it needs," concluded Teitelbaum. “And when you press on those tightened muscles — especially on the small, tender knot in the center — it can send pain throughout the body.”
If this resonates with you, consider making an appointment with your physician to obtain an official sciatica diagnosis and find ways to live your best life — despite your symptoms. While you're at it, check out some of the conversations about this condition on our website.