Sciatica: Causes, Symptoms, and When to Seek Help

Pain in the buttocks?

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 the perineum (with a protruding bone feeling).
There is no support point in my right buttock, and I am now completely unable to sit on a chair; as soon as I do, my toes start to sweat.
Today, it has become more severe, and suddenly I experienced weakness in my right leg, making it difficult to exert force while lying in bed.
However, after resting, I was able to exert force again, but I still feel weak in the area where my thigh meets my buttock when walking.
Could you please advise me on what might be wrong? Thank you.
Also, if I need to go to the hospital for an examination, which department should I visit? Thank you.

123, 20~29 year old female. Ask Date: 2015/09/20

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.

Reply Date: 2015/09/20

More Info

Sciatica is a term that refers to pain that radiates along the path of the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg. Typically, sciatica affects only one side of your body and can manifest in various ways, including pain, numbness, tingling, or weakness in the affected leg. Understanding the causes, symptoms, and when to seek help is crucial for managing this condition effectively.

Causes of Sciatica
Sciatica is often caused by a herniated disk, bone spur on the spine, or narrowing of the spine (spinal stenosis) compressing part of the nerve. This compression can lead to inflammation, pain, and often some numbness in the affected leg. Other potential causes include:
1. Herniated Disks: Disks act as cushions between the vertebrae in your spine. If a disk herniates or bulges, it can press on the sciatic nerve.

2. Spinal Stenosis: This condition involves the narrowing of the spinal canal, which can put pressure on the nerves.

3. Spondylolisthesis: This occurs when one vertebra slips forward over another, potentially pinching the sciatic nerve.

4. Injury or Trauma: Any injury to the lower back or pelvis can lead to sciatica.

5. Piriformis Syndrome: The piriformis muscle, located in the buttocks, can spasm and irritate the sciatic nerve.

Symptoms of Sciatica
The symptoms of sciatica can vary widely but typically include:
- Pain: This can range from a mild ache to a sharp, burning sensation. It often starts in the lower back or buttock and radiates down the leg.

- Numbness or Tingling: Many people experience numbness or a tingling sensation in the leg or foot.

- Weakness: Some may notice weakness in the affected leg, making it difficult to move or control.

- Worsening Symptoms: Symptoms may worsen with prolonged sitting, standing, or certain movements.

When to Seek Help
Given your description of symptoms—such as lower back pain, discomfort in the right buttock, and weakness in the right leg—it is advisable to seek medical attention. You should consider visiting a healthcare provider if:
- The pain is severe and does not improve with rest or over-the-counter pain medications.

- You experience sudden weakness in your leg.

- You have difficulty controlling your bladder or bowels.

- The pain persists for more than a week without improvement.

Recommended Medical Consultation
For your specific symptoms, it would be appropriate to consult a neurologist or an orthopedic specialist. These specialists can evaluate your condition through a physical examination and may recommend imaging tests such as an MRI or CT scan to determine the underlying cause of your sciatica.

Conclusion
In summary, sciatica can stem from various underlying issues, and recognizing the symptoms is key to seeking timely treatment. Given your current symptoms of pain, weakness, and discomfort, it is crucial to consult a medical professional who can provide a thorough evaluation and appropriate treatment plan. Early intervention can help alleviate symptoms and prevent further complications, allowing you to return to your daily activities with greater ease.

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