I'm a Spine Surgeon. Here Is the One Question I Ask Patients to Separate Sciatica From Back Pain
Sciatica is a growing problem, with up to 40 percent of people experiencing it at some point in their lives. While it's often lumped in with general back pain, sciatic nerve pain goes a bit further. In fact, about 5 to 10 percent of people dealing with low back pain actually have sciatica. The condition causes a sharp, radiating pain that starts in the lower back and travels down the leg, making it difficult to sit, stand, or walk comfortably.
"The terms low back pain and sciatica are often used as interchangeable terms, but they describe different problems," says Paul Gause, M.D., an orthopedic spine surgeon at Spine Institute of Arizona. "There are a multitude of conditions that can cause compression or irritation of nerves in the spine, but the result is the same: pain radiating down your leg."
We tapped Gause to learn more about what causes sciatica, symptoms to watch for, and when it's time to seek medical attention. If you're dealing with such pain, understanding the source of your symptoms could be the first actionable step towards finding relief.
What is Sciatica?
Sciatica is nerve pain from an injury or irritation to your sciatic nerve, which is the longest nerve in the body. Many conditions can result in sciatic nerve pain, but the most common is a herniated disc, which occurs when the soft inner portion of a spinal disc pushes through its outer layer and presses on a nerve.
Spinal stenosis is another common cause of sciatic nerve pain, which is a degenerative narrowing of the spinal canal that puts pressure on nerves. Spondylolisthesis is another condition where one vertebra slips out of place and pinches nearby nerves. A less common cause is piriformis syndrome, where a muscle in the buttock compresses the sciatic nerve as it travels down the leg.
Sciatica Symptoms
The main symptom of sciatica, Gause says, is leg pain. Because the sciatic nerve is irritated or compressed, people may also experience numbness, tingling, or muscle weakness along the affected side. Above all, duration of symptoms should be paid close attention to. Often, the causes of sciatic nerve pain heal themselves, but symptoms lasting longer than a month without improvement should be evaluated by a healthcare professional.
"I generally worry more about nerve dysfunction and particularly, weakness," he adds. "It's not that pain is unimportant to treat, but weakness, particularly if severe or progressive, can lead to a permanent loss of function in the affected leg."
Low Back Pain vs. Sciatica
Low back pain is a common experience for many, with a multitude of underlying conditions, including muscle soreness, injuries, and even degenerative changes of ligaments, joints, or discs. Low back pain is usually an achy, stiff, or tight feeling that is isolated to the lower back area. It may radiate slightly to the buttock, but it doesn't radiate down the leg.
Sciatica, on the other hand, is when someone experiences pain along the distribution of the sciatic nerve, which runs from the buttocks down the posterior thigh and into the lower leg, usually affecting one side. Back pain can be a component of sciatic nerve pain, but the main symptom is usually a sharp, burning, or shooting sensation down the leg, often down to the foot.
"A useful question to ask yourself is: 'Is the pain staying in my back or is it traveling down my leg?' If it's radiating down the leg, particularly below the knee, then you're likely experiencing sciatica," Gause says.
Sciatica Treatment
Sciatic nerve pain can be intense, but treatment with medications and physical therapy can help diminish the severity of pain while the back tries to heal. The time to seek immediate medical care, however, is if the pain is accompanied by significant or progressive leg weakness, loss of bowel or bladder control, or numbness in the groin or saddle area. A new loss of bowel or bladder control can be permanent if not treated right away.
"Associated symptoms can also be an important red flag to seek urgent care," Gause adds. "Sciatic nerve pain in someone with a history of cancer, with significant fevers or chills, or with unexplained weight loss should be evaluated right away. If the pain is a result of a significant fall or trauma, it's best to seek more urgent care."
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This story was originally published by Men's Journal on Jun 2, 2026, where it first appeared in the Health & Fitness section. Add Men's Journal as a Preferred Source by clicking here.
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This story was originally published June 2, 2026 at 1:47 PM.