Today there is a lot of confusion around back pain and its variants. Identifying the type of pain we have is fundamental to understanding why it arises and knowing how to treat it. For example, many people with lower back pain think they have ‘sciatica’ when they really don’t, while others suffer in silence without knowing why.
To begin with, it must be said that it is not ordinary back pain, nor does it strictly correspond to lumbar pain. For doctors, sciatica is “a neurological syndrome characterized by acute pain located in the territory of the sciatic nerve. It is almost always due to compression of its nerve roots in the spine, and is often the result of a herniated disc. lumbar, say specialists from the University Clinic of Navarra (CUN), but it can also be a consequence of osteoarthritis, tumors, diabetes or pregnancy”.
“When the pain exceeds the lower back and reaches the lower limbs, we speak of irradiated low back pain. If the pain extends from the lower back to the heel or foot, descending through the back or side of the thigh, we call it lumbosciatica or radicular syndrome, or plain sciatica”, they explain from the Spanish Foundation of Rheumatology. Its presence suggests injury to the nerve roots that come out of the lumbar spine and carry sensitivity or commands to contract the muscles to the lower limbs through the sciatic nerve. If the pain does not exceed the knee region, it should not be called sciatica and its cause is not usually injury to the nerve roots.
Unlike low back pain, whose ailment is specifically concentrated in the back, lumbosciatica paralyzes the person with pain so intense that it does not allow movement or standing up.
Overweight, sedentary lifestyle, heavy physical work and improper lifting are the main factors that trigger lumbosciatica, a disease characterized by pain that spreads along the sciatic nerve, passes through the buttocks, the back of the thigh, it extends to the leg and ends at the foot. To identify if what you suffer from is sciatica, you can check if the following signs appear:
- Constant pain in one buttock or in one leg (rarely it can occur in both legs), reaching the heel, the dorsal aspect of the foot, the sole or the fingers.
- Pain aggravation when sitting.
- Sharp pain down the back of the thigh.
- Tingling down the leg.
- Numbness or weakness to move the leg or foot.
- Sensation of numbness or numbness.
- Stabbing pain when standing up or walking .
- Lack of strength in the injured leg.
Many times these symptoms are associated with alterations in the spine, such as a herniated disc, spondylosis or osteoarthritis in the spine. For this reason, when the first symptoms appear, it is very important to consult the doctor so that he can assess the suitability of carrying out some tests and x-ray examinations on the spine or an MRI to see if there is any alteration that is pressing on the nerve and giving rise to to symptoms.
The main test consists of lying on your back and raising your leg outstretched from the stretcher. If there is a tingling sensation, the test indicates that there is compression of the nerve. If there is pain in the other leg this indicates a serious disorder of the spine such as a disc extrusion.
Another quick way to find out if you have sciatica and not plain lumbago is with the walking test, which consists of walking around the room barefoot on your heels. If you cannot keep your feet elevated, it may be due to a weakening of the lower limbs caused by sciatica. Perform the same test walking on tiptoes. Stretching the hamstring muscles can reproduce sciatic pain in the leg. If none of these occur, the pain is due to low back pain and not sciatica.
In the event that the spine is healthy and without alterations, the cause of the sciatica pain must be only muscular or connective tissue and the treatment is relatively simpler.
It is important that you are clear about the differences between lumbago and sciatica since this condition can cause permanent damage to the nerves and cause progressive weakness or loss of sensation in the legs, which beyond preventing you from walking normally, can cause a serious condition called ‘cauda equina syndrome’, and it is extreme pressure and swelling of the nerves at the end of the spinal cord accompanied by urinary retention and/or incontinence. If treatment is not received promptly, some of the adverse outcomes can be permanent paralysis, problems with bowel and urinary control, difficulty walking, or other neurological and physical problems. That is why it is important to seek medical attention if you have detected symptoms of sciatica.
Keep in mind that in addition to the type of pain and the affectation, the duration and the cessation of the pain is not the same in lumbago as in sciatica. In lumbago, the pain usually subsides by itself or through analgesics, exercises or the use of girdles or lumbar belts, with a maximum extension of six weeks. However, with sciatica, the pain can last between three and six months, and to heal the inflamed sciatic nerve, the treatment indicated by the orthopedic surgeon or by the physical therapist with medications, exercises and injections of corticosteroids must be carried out to relieve pain. acute, in addition to massage and physiotherapy.