Differential Diagnosis for Sciatic Pain
- Single Most Likely Diagnosis
- Lumbar Disc Herniation: This is the most common cause of sciatic pain, resulting from the compression of the sciatic nerve by a herniated disc in the lumbar spine. The pain typically radiates down the back of the leg and can be accompanied by numbness, tingling, or weakness.
- Other Likely Diagnoses
- Lumbar Spondylosis: This condition involves wear and tear on the spine, leading to narrowing of the spinal canal and compression of the sciatic nerve. It's common in older adults and can cause sciatic pain, stiffness, and limited mobility.
- Piriformis Syndrome: The piriformis muscle runs from the base of the spine to the thighbone, and when it compresses or irritates the sciatic nerve, it can cause pain, numbness, and tingling in the buttocks and legs.
- Sacroiliac Joint Dysfunction: The sacroiliac joints connect the sacrum to the ilium bones, and dysfunction in these joints can cause sciatic pain due to inflammation or irritation of the surrounding nerves.
- Do Not Miss Diagnoses
- Cauda Equina Syndrome: A serious condition where the nerves in the spinal canal are compressed, leading to severe pain, numbness, and weakness in the legs, as well as bladder and bowel dysfunction. Prompt medical attention is necessary to prevent permanent damage.
- Spinal Infection or Abscess: Infections like osteomyelitis or epidural abscess can cause sciatic pain, fever, and other systemic symptoms. Early diagnosis and treatment are crucial to prevent serious complications.
- Tumor: Spinal tumors, whether benign or malignant, can compress the sciatic nerve and cause pain, numbness, and weakness. A thorough evaluation is necessary to rule out this potentially life-threatening condition.
- Rare Diagnoses
- Tarlov Cyst: A rare condition where fluid-filled cysts form in the spine, compressing the sciatic nerve and causing pain, numbness, and weakness.
- Arteriovenous Malformation (AVM): An abnormal connection between arteries and veins can cause sciatic pain, numbness, and weakness due to compression or damage to the surrounding nerves.