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Symptoms vary from a mild cramping or tightening sensation in the hamstring or calf muscles (that can sometimes be interpreted as the pre-cursor to a strain) to a constant shooting pain in the buttock, hamstring and down to the foot.
In some instances, flexion (bending) of the lower back can increase pressure on the discs and cause prolapsed disc material to aggravate adjacent nerve roots. This means that any bending forwards, such as when putting on or taking off shoes, will typically irritate the problem and lead to a worsening of the Sciatica pain. It is not just bending forwards that can aggravate the problem. Sitting for a prolonged period can increase disc pressure and Sciatica symptoms; so sitting in a theatre or at a desk, or driving often cause a flare up in people with Sciatica. Lifting also typically causes irritation of the nerve roots in the lower back. This can be extremely frustrating in people with Sciatica who have young children, as attending to them can aggravate their problem.
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The combination of mechanical and inflammatory factors that contribute to Sciatica means that exact diagnosis of the origin of the problem is not always straightforward. An MRI scan of the back can show whether a Herniated disc is present, together with the size and direction of the prolapse from the Herniated disc. However, as mentioned above, the size of a disc prolapse is not necessarily related to the level of pain reported by the patient. Indeed, patients with an obvious Herniated disc on an MRI can have no pain, whilst those with no obvious Herniated disc can have severe symptoms of pain and/or muscle weakness.
For this reason, further diagnostic tests provide valuable information for the medical team. Needle electromyography (EMG) records the electrical activity of muscle fibres. A fine gauge needle is inserted into muscles that are supplied by the Sciatic nerve, in what is an uncomfortable but tolerable examination. Needle EMG feedback can produce findings that suggest a nerve root injury.
Alternatively, Nerve Conduction Studies (NCS) use a non-invasive stimulator to apply a brief electrical impulse to a peripheral nerve, with the response being recorded by electrodes. The velocity of the nerve transmission can be accurately measured, with healthy nerves transmitting the electrical impulse faster than diseased ones.
Anyone with back pain who has any of the following should consult their doctor as soon as possible:
History of trauma – e.g. a fall or car crash
Aged younger than 20 or older than 55 when you first experienced back pain
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In some instances, flexion (bending) of the lower back can increase pressure on the discs and cause prolapsed disc material to aggravate adjacent nerve roots. This means that any bending forwards, such as when putting on or taking off shoes, will typically irritate the problem and lead to a worsening of the Sciatica pain. It is not just bending forwards that can aggravate the problem. Sitting for a prolonged period can increase disc pressure and Sciatica symptoms; so sitting in a theatre or at a desk, or driving often cause a flare up in people with Sciatica. Lifting also typically causes irritation of the nerve roots in the lower back. This can be extremely frustrating in people with Sciatica who have young children, as attending to them can aggravate their problem.
