Pain radiating from the buttock area and traveling down the back of the thigh and into the leg is often referred to in layman’s terms as sciatica. This term covers a wide variety of conditions which will be discussed below.
This is caused when one of several things happens.
It can either be irritation of the large sciatic nerve in the inside buttock area or irritation from a herniated disc of the roots that form that nerve higher above.
The pain is often described as sharp, stabbing, and sometimes electrical radiation into the back of the thigh and the leg.
Patients with this condition often have difficulty sitting and bending forward.
Their examination will reveal tenderness in that area, and if this is due to a herniated disc in the lumbar spine, raising of that leg while lying down or seated causes the reproduction of symptoms.
Treatment options depend on the cause. For example, if the cause is a herniated disc, treatments such as epidural steroid injections, transforaminal injections, or surgical options may be required in severe cases.
On some occasions, these symptoms are caused by irritation of the overlying muscle, called the piriformis, or even due to inflammation of the sacroiliac joint, which is located near this nerve.
In each case, treatment options will target the piriformis muscle or the sacroiliac joint.
An accurate, detailed history and examination are crucial to understanding the problem. Imaging of the sacroiliac joint and the MRI of the lumbosacral spine can help differentiate the cause of sciatica.
