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. Instability and pain in one of your legs
The sciatic nerve is the largest nerve in your entire body, running from the lower spine into your foot. Those with the sciatica generally have a reoccurring of back problems, but sciatica often starts without warning. You can tell when you have sciatica pain if the sensation is sharp, stabbing, and confined to a single leg. While sciatica can be sometimes difficult to diagnose or easily confused with other ailments (see piriformis syndrome below), the tell-tale sign to know if you have sciatica is by judging the intensity of the pain in the affected leg.
2. You're a tortoise, not a hare
Another way to tell if you have sciatica is if your preferred fitness activity is walking. Chances are the tingling and numbness you’re feeling in your leg is caused by a herniated disc, not the less-common piriformis syndrome, which mainly affects running athletes.
Piriformis syndrome, which happens when piriformis muscle—located in the buttocks—compresses the sciatic nerve. It mimics the pain sensation of sciatica: shooting pain, tingling, numbness starting in the buttocks and traveling down the leg. But instead of a herniated disc being the culprit of your pain, it’s your piriformis muscle.
3. You can't pinpoint the pain's source
Sometimes the pain you think is sciatica isn't actually nerve-induced pain at all, it’s muscular. Here's an easy way to figure out if your pain is muscular or nerve-based using what's called the Straight Leg Raise (SLR) test. You can do at home to tell whether or not your pain is sciatica.
- Lie down on your back with your arms to either side and both legs straight, toes pointed upward.
- Have your examiner slowly lift one of your legs toward the top of your head.
- The indicator of a positive test is when raising the leg between 30 to 70 degrees pain occurs and radiates down the leg to at least below the knee (sometimes down as far as the great toe)
- If the pain is predominantly in your lower back without radiation to below knee, the test is negative.
You can also try the SLR test seated. When extending the leg at the knee, if pain radiates below the knee your test is positive.
The purpose of the test is to place a little tension on your spine to pinpoint the pain. If any of this sounds like the pain you’re having, make an appointment with your physician. It’s the best way to know if you have sciatica. You can then get a treatment plan and be on your way to improved health. While you're at it, check out more posts about this condition on our website.