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Anatomy of Sciatica
The sciatic nerve is the longest and largest nerve in your body. Five sets of paired nerve roots combine to create it, and it’s about the diameter of a finger. The sciatic nerve starts in your low back, which is called your lumbar spine. The nerve roots are at the L4 and L5 vertebrae (the ‘L’ means lumbar, and the numbers indicate the level of the vertebra — where it is in your back). The sciatic nerve also travels through your pelvic region (sacrum).

Anatomy of Sciatica
The sciatic nerve is the longest and largest nerve in your body. Five sets of paired nerve roots combine to create it, and it’s about the diameter of a finger. The sciatic nerve starts in your low back, which is called your lumbar spine. The nerve roots are at the L4 and L5 vertebrae (the ‘L’ means lumbar, and the numbers indicate the level of the vertebra — where it is in your back). The sciatic nerve also travels through your pelvic region (sacrum).

In most people, the sciatic nerve runs under the piriformis muscle, which moves your thigh side to side. From there, the sciatic nerve descends through the buttocks and the back of the thighs. Behind your knee, smaller nerves branch out from the sciatic nerve and travel down to your feet.

Your sciatic nerve is part of a complex structure: your body’s nervous system. That system is responsible for transmitting pain and sensation to other parts of your body. So, when something presses on a nerve, you’ll feel it, and it won’t feel good. With sciatica, something in your low back — a herniated disc, for example — compresses the sciatic nerve, which then transmits pain down your legs.

Symptoms of Sciatica
To get the best treatment for sciatica, it’s important to recognize and understand the symptoms. You can feel sciatica in different ways, including:

• Pain that travels from the low back, through the buttocks, downward into the leg, and sometimes into the foot.
• Shooting pain down your leg — sometimes described as like electricity.
• Burning and tingling sensations in your leg.
• Partial leg numbness or weakness.
• Pain, burning, tingling, numbness, or weakness on only one side of your lower body.
• Pain and other symptoms may be constant and vary from mild to severe.
• Sitting, trying to stand up, and walking may be painful and difficult.
• Coughing, sneezing, and other sudden movements can intensify pain.

You can experience sciatica in different ways and in different parts of your leg — it all depends on where your sciatic nerve is affected in your low back. When you’re describing your symptoms to your doctor, it’s helpful to be as exact as possible. This will help him or her more accurately diagnose the cause.

So when you feel pain, is it…

• Especially intense above your knee? Instead of originating in your low back (lumbar spine), your pain possibly starts in your buttocks. With these symptoms, it’s likely that your sciatic nerve is being pinched by the piriformis muscle, which moves your thigh side to side.
• Below your knee and into your foot? You may also not react as quickly when the doctor tests your knee-jerk reflex (that’s when he or she taps your knee with a tiny mallet). You may have trouble bringing your foot up. With these symptoms, it’s likely that your sciatic nerve is being pinched at the L3-L4 level of your low back (lumbar spine).
• On the side of your foot? Your ankle reflexes may not be very quick, either. It could be difficult for you to lift your heel off the ground or walk on your tiptoes (should you ever need to do that). With these symptoms, it’s likely that your sciatic nerve is being pinched at the L5-S1 level of your low back (lumbar spine) and pelvic region (sacrum).
• In your big toe and maybe in your ankle, too? This is also known as foot drop. You may have numbness and/or pain on the top of your foot, but you really feel it in your big toe. With these symptoms, it’s likely that your sciatic nerve is being pinched at the L4-L5 level of your low back (lumbar spine).