Differential Diagnosis for Sciatica
- Single most likely diagnosis
- Lumbar Disc Herniation: This is the most common cause of sciatica, where the herniated disc compresses or irritates the sciatic nerve, leading to pain, numbness, and weakness in the lower back and legs.
- Other Likely diagnoses
- Lumbar Spondylosis: Degenerative changes in the lumbar spine can cause sciatica due to narrowing of the spinal canal or foraminal stenosis, putting pressure on the sciatic nerve.
- Piriformis Syndrome: The piriformis muscle can compress the sciatic nerve, especially if it is tight or inflamed, leading to sciatica symptoms.
- Sacroiliac Joint Dysfunction: Inflammation or dysfunction of the sacroiliac joint can cause sciatica due to referred pain patterns.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- 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 surgical intervention is necessary to prevent permanent damage.
- Spinal Infection (e.g., Abscess or Osteomyelitis): Infections in the spine can cause sciatica, and if left untreated, can lead to serious complications, including paralysis and death.
- Spinal Tumor: Tumors in the spine can compress the sciatic nerve, leading to sciatica symptoms. Early diagnosis and treatment are crucial to prevent neurological deterioration.
- Rare diagnoses
- Diabetic Amyotrophy: A condition that affects people with diabetes, causing damage to the nerves in the thighs, hips, and buttocks, leading to sciatica-like symptoms.
- Arterial Occlusion: Rarely, sciatica can be caused by occlusion of the arteries that supply blood to the lower extremities, leading to ischemic pain and weakness.