Is It Sciatica? Symptoms and When to Seek Help

Could you please tell me if this is sciatica?

I am 60 years old and have had diabetes for many years, which I manage with medication.
Recently, I have been experiencing pain from the outer side of my hip down to my thigh, and the pain can last all day.
Sometimes my calf also hurts (it feels very sore when it does).
I am wondering if this could be sciatica? If so, which specialist should I see?

phoebe, 60~69 year old female. Ask Date: 2007/08/15

Dr. Su Hongci reply Rehabilitation

Sciatica is a symptom that can be caused by various factors, and identifying the exact cause is essential for appropriate treatment.
The sciatic nerve is a large nerve in the lower limb, formed by the fourth and fifth lumbar nerves and the first three sacral nerves.
It passes through the buttocks and the back of the thigh, and at the back of the knee, it divides into the common peroneal nerve and the tibial nerve.
Sciatica refers to pain that follows the path of the sciatic nerve, typically radiating from the buttocks down the back of the thigh, and sometimes extending to the calf.
There are many potential causes of sciatica, and here are some of the most common ones:
1.
Nerve root pathology: The nerve root refers to the point where nerves emerge from the spinal cord.
Most cases of sciatica are not due to pathology of the sciatic nerve itself but rather to issues with the nerve roots, most commonly the fifth lumbar nerve root and the first sacral nerve root.
Conditions such as herniated discs, lumbar degenerative disease, spinal stenosis, and tumors can compress these roots, leading to symptoms.
In addition to pain, patients may experience numbness, muscle weakness, and diminished tendon reflexes in the lower limbs.
The sciatic nerve can also be affected by compression from tumors or fractures, and injections in the buttock area may also injure the sciatic nerve.
Symptoms can also arise if the nerve is compressed by the piriformis muscle.
Individuals who are lean or have experienced significant weight loss may have thinner fat pads in the buttocks, which can lead to sciatic nerve compression after prolonged sitting.
2.
Myofascial pain: A significant portion of pain can originate from the muscles in the buttocks, particularly the gluteus medius and gluteus minimus.
These muscles may develop trigger points due to injury, excessive exercise, or prolonged standing or walking, leading to referred pain that mimics sciatica.
Therefore, if you experience similar issues, neurologists and rehabilitation specialists can provide assistance.
Wishing you good health!

Reply Date: 2007/08/15

More Info

Sciatica is a term that refers to pain that follows the path of the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg. It typically occurs when the sciatic nerve is compressed, often due to a herniated disk, bone spur on the spine, or narrowing of the spine (spinal stenosis). The pain can vary widely, from a mild ache to a sharp, burning sensation, and it can also cause numbness, tingling, or muscle weakness in the affected leg.

Given your age and medical history of diabetes, it is essential to consider that the symptoms you are experiencing could be related to sciatica, especially since you describe pain radiating from the outer side of your hip down to your thigh and possibly into your calf. Diabetes can lead to various complications, including peripheral neuropathy, which may cause pain and discomfort in the legs. However, the specific pattern of pain you describe, particularly if it is sharp and follows a nerve pathway, suggests that sciatica could be a possibility.

When to seek help for sciatica or similar symptoms is crucial. You should consider consulting a healthcare professional if:
1. The pain is severe: If the pain is debilitating and affects your daily activities, it is essential to seek medical attention.

2. Symptoms persist: If the pain lasts for more than a week without improvement, it is advisable to see a doctor.

3. Numbness or weakness: If you experience significant numbness, weakness in your legs, or difficulty controlling your bladder or bowels, you should seek immediate medical attention, as these could be signs of a more serious condition.

4. Worsening symptoms: If your symptoms worsen over time, it is important to consult a healthcare provider.

In terms of which specialist to see, you might start with your primary care physician, who can evaluate your symptoms and provide a referral to a specialist if necessary. Depending on the findings, you may be referred to a neurologist, who specializes in nerve-related issues, or an orthopedic surgeon, who focuses on the musculoskeletal system. Physical therapists can also play a crucial role in managing sciatica through targeted exercises and treatments.

In the meantime, there are several self-care measures you can take to alleviate your symptoms. These include:
- Rest: Avoid activities that exacerbate the pain, but try to remain as active as possible without overdoing it.

- Heat and Ice Therapy: Applying heat or ice packs to the affected area can help reduce inflammation and relieve pain.

- Over-the-counter Pain Relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help manage pain and inflammation.

- Gentle Stretching: Engaging in gentle stretching exercises may help relieve pressure on the sciatic nerve.

In conclusion, while your symptoms could indicate sciatica, it is essential to consult a healthcare professional for a proper diagnosis and treatment plan, especially considering your diabetes and age. Early intervention can lead to better outcomes and help you manage your symptoms effectively.

Similar Q&A

Understanding Sciatica: Causes, Symptoms, and When to Seek Help

Hello, doctor. Recently, I've been feeling soreness on both sides of my lower back when I wake up in the morning. Additionally, since Wednesday, I've been experiencing a sensation in my right buttock that feels like the bone is displaced, moving towards the area near th...

Dr. Shi Guozheng reply Orthopedics
It could be an issue with the hip joint or lumbar spine; you can schedule an appointment with an orthopedic specialist to have it checked.

Understanding Sciatica: Symptoms, Treatment, and Cost Concerns

Hello Doctor: I am a student, and this issue occurred about a week ago. Suddenly, I experienced pain on the left side of my buttocks. It’s manageable when I stand, but lying down causes significant pain, especially when lying on my side, making it impossible to sleep. Sometimes, ...

Dr. Ye Boshou reply Neurology
Hello: It seems like you have sciatica. I recommend seeing a neurologist for an examination. The medical expenses will be covered by health insurance, so there's no need to worry.

Understanding Sciatica: Symptoms, Treatment Options, and When to Seek Help

Hello, Doctor: I would like to ask if these symptoms are related to sciatica? Can they be treated with rehabilitation alone, or do I need further examinations? If so, which specialist should I see? Thank you! I have pain in the lumbar region, neck and shoulder discomfort, knee pa...

Dr. Lai Zhaokang reply Neurosurgery
Hello: Your lumbar spine, cervical spine, and knees all need to be examined. It is recommended to consult a neurosurgeon for evaluation. Physical therapy can be attempted, but whether you can recover through rehabilitation will depend on your condition. Best wishes. // Dr. Lai Ch...

Understanding Sciatica: Symptoms, Treatment, and Recovery Insights

Hello, Doctor: I would like to ask for your help! Thank you for your previous assistance. I used to feel pain (numbness) in the back of my thigh while walking, and my right foot felt numb when I was jogging. At that time, I didn't think it was important and ignored it. The s...

Dr. Wang Shouji reply Orthopedics
Based on your age, the likelihood of a herniated disc causing sciatica is the highest. X-rays cannot detect this condition (it is usually identified through MRI or CT scans). Treatment generally involves rest, medication, rehabilitation, and possibly surgical intervention. If con...