Sciatica Red Flags: When Leg Pain May Require Medical Attention

Got pinching, compression, or irritation in your lower half? That sounds like sciatica.

It’s nearly impossible to ignore. If you’ve felt it, you’re probably nodding your head.

But the twist here is that even when it’s painful and limiting, it may not be that serious. That’s why it’s important to understand when you should and shouldn’t worry about sciatica pain – and how to recognize the serious signs.

What is sciatica and why does it spread?

The feeling is typically described as a sharp burning sensation – like an electric shock in one side of the body. It gets worse with extended sitting or bending, and is even affected by coughs and sneezes.

The sciatic nerve is the body’s largest nerve – starting in the low back and running down the entirety of each leg – and that helps explain why sciatica spreads. So while the pain may originate from the back, hips, or buttocks, it travels downward, spreading painful signals everywhere along its path.

Sciatica is a symptom of an underlying condition rather than a standalone ailment. It has four main causes: herniated discs, bone spurs, spinal stenosis, and piriformis syndrome.

When sciatica IS NOT serious

The good news: There is such a thing as “mild sciatica”, and these cases typically are less severe and can lessen or disappear within weeks. These cases can be painful, yes, but not dangerous.

Here’s how to know your sciatica doesn’t require attention.

The pain comes and goes. It’s not consistent or all-encompassing.

You’re not losing strength. Progressive weakness is a sign of serious sciatica, and it involves a gradual weakening of the muscles.

You can still walk and function. The worst cases of sciatica strip people of these basic abilities.

You see improvement. With time comes relief. Even slow and gradual progress is a positive sign.

Treatment works. If your condition responds (even somewhat) to movement, physical therapy, or medication, you appear to be on the upswing.

When sciatica IS serious

There are certain red flags to look out for. If any of these signs are present in your case, we regret to inform you that it may be serious.

🚩Progressive leg weakness You’re having a hard time lifting your foot or toes, and the strength in the area is worsening over time. This suggests you’re dealing with nerve compression.

🚩Loss of bladder/bowel control The inability to control those two functions (often in conjunction with groin numbness) is an emergency that requires immediate medical attention.

🚩Severe and worsening pain If your pain is strong enough that it affects walking or your ability to sleep, lasts longer than two weeks, and persists beyond conservative treatment, you’re likely dealing with nerve damage.

🚩Increasing numbness If your leg or foot has lost all sensation or feels “dead”. If the numbness is expanding, that’s a sign nerve function is impacted.

Why sciatica gets worse

Oftentimes sciatica heals slowly and gradually, and that’s because inflammation takes time to decrease and irritated nerves have a slow recovery process. But it can go the other way too. Why? As mentioned earlier, sciatica is a symptom, not a condition. If the underlying issue causing your sciatica has not been addressed, then the affected nerve will continue to send pain signals to the brain.

There are a handful of symptoms that indicate your condition may worsen over time. A herniated disc providing ongoing pressure. Inflammation that won’t subside. A nerve that’s become especially sensitive. Sometimes, a person dealing with sciatica pain simply moves less than before, and that creates its own problems.

What to do about it

Start by consulting your doctor. A physical exam, MRI or CT imaging, or an EMG can help diagnose the true issue.

If treatment is deemed necessary, you may start with conservative care and then get progressively more aggressive if your body doesn’t respond. Physical therapy typically comes first. If that doesn’t work, we try epidural steroid injections. Still no improvement? Advanced interventions include nerve blocks, radiofrequency ablations, and minimally invasive decompressions.

The final frontier after moving through that treatment pathway would be surgery. That happens when pain is severe and lasting and it limits your basic function, we can identify severe compression through imaging, there is progressive weakness over time with no apparent path to improvement, and conservative and interventional care have both failed.

For a closer look at the full pathway, see our guide to sciatica treatment options.

How Hudson Pain and Spine can help

Folks in the Englewood, New Jersey area that are experiencing symptoms resembling our description of sciatica should contact Hudson Pain and Spine. Dr. Saurabh Dang, a double board-certified pain management specialist and an expert in sciatica. He can help determine the best care plan for you.

If your pain lasts more than two weeks, includes radiating pain, numbness, tingling, or weakness, and limits your ability to work, sleep, or do normal activities, contact Hudson Pain and Spine to schedule a consultation.

Hudson Pain and Spine 25 Rockwood Place, Suite 335, Englewood, NJ 07631 Phone: (201) 605-9000