This is known as radiculopathy, and sciatica is its most familiar form. Finding which nerve is affected and why is key to relief. At Mir Neurology, our board-certified neurologists diagnose the cause of nerve pain using in-house nerve testing and build a treatment plan, for patients across Western Maryland, the Eastern Panhandle of West Virginia, and South-Central Pennsylvania.
Request an Appointment or call (301) 797-7600.
Seek emergency care: Call 911 or go to the ER for cauda equina syndrome symptoms: new loss of bladder or bowel control, numbness in the groin or inner thighs, or severe weakness in both legs. These are red flags of a serious spinal emergency that requires immediate treatment.
What Is Radiculopathy?
Radiculopathy is the medical term for symptoms caused by a pinched or compressed nerve root where it exits the spine. When a nerve root is irritated, it can cause pain, numbness, tingling, and weakness that travels along the path of that nerve β often into an arm or leg.
It is named for where it occurs:
Lumbar Radiculopathy
Occurs in the lower back. Sciatica is the most common form.
Cervical Radiculopathy
Occurs in the neck, causing symptoms down the arm.
Thoracic Radiculopathy
Occurs in the mid-back and is less common.
Radiating Nerve Pain
Pain, numbness, tingling, or weakness follows the path of the affected nerve.
What Is Sciatica?
Sciatica is radiculopathy affecting the sciatic nerve β the large nerve that runs from the lower back through the hips and down each leg. When a nerve root in the lower spine is compressed, pain radiates along this path. Sciatica typically affects one side of the body.
What Does Sciatica Feel Like?
Sciatica and radiculopathy have a distinctive pattern. You may notice:
- Pain that radiates from the lower back or buttock down the leg, or from the neck down the arm
- Sharp, burning, or electric shock-like pain
- Numbness or tingling along the nerve's path
- Weakness in the affected leg or arm
- Pain that worsens with sitting, coughing, sneezing, or certain movements
- Symptoms usually on one side
The pain often follows a specific line down the limb, which helps a neurologist identify exactly which nerve root is involved.
What Causes Sciatica and Radiculopathy?
Nerve-root compression can have several causes:
- Herniated or slipped disc β the most common cause; disc material presses on a nerve root
- Spinal stenosis β narrowing of the spinal canal, more common with age
- Bone spurs and degenerative changes β from arthritis of the spine
- Piriformis syndrome β a sciatica mimic in which the piriformis muscle in the buttock irritates the sciatic nerve
- Injury or, less often, a tumor or infection
Piriformis Syndrome: A Common Sciatica Mimic
Not all sciatic-type pain comes from the spine. In piriformis syndrome, the piriformis muscle deep in the buttock tightens or spasms and compresses the sciatic nerve, producing very similar symptoms β pain and tingling in the buttock and down the leg.
Because the treatment differs from spine-related sciatica, distinguishing the two matters, and it is part of a thorough evaluation.
How Sciatica and Radiculopathy Are Diagnosed
Pinpointing the affected nerve and the underlying cause is where a neurologist's expertise is especially valuable. Evaluation may include:
- A detailed history and neurological exam β mapping the pain, testing strength, reflexes, and sensation to identify the involved nerve
- EMG and nerve conduction studies β to confirm which nerve root is affected and how severely, and to distinguish radiculopathy from other nerve problems
- Imaging, such as MRI, to look at the discs, nerve roots, and spinal canal when needed
This precise diagnosis is what allows treatment to target the actual source of the pain.
Sciatica and Radiculopathy Treatment
The good news: most sciatica and radiculopathy improves with conservative, non-surgical care. Treatment is tailored to the cause and severity, and may include:
- Medications to manage nerve pain and inflammation
- Physical therapy with targeted exercises to relieve pressure and strengthen supporting muscles
- Activity modification to adjust movements that aggravate the nerve
- Treating the underlying cause, such as a herniated disc or stenosis
- Referral for injections or surgery when conservative care is not enough
- Ongoing follow-up to track recovery
Can sciatica be cured? Many cases improve within a few weeks with conservative treatment, and most people recover fully. When symptoms persist, are severe, or come with weakness, a neurological evaluation helps identify why and what to do next.
When to See a Neurologist
See a neurologist if you have:
- Radiating pain, numbness, or tingling down an arm or leg
- Weakness in a limb
- Pain that is not improving with initial treatment, or keeps returning
- Symptoms that interfere with daily life
Seek emergency care for the cauda equina red flags listed above.
At Mir Neurology, our board-certified neurologists diagnose sciatica and radiculopathy β pinpointing the affected nerve with in-house testing β and build a plan for relief.
Serving Western Maryland & the Tri-State Area
With offices in Cumberland and Hagerstown, expert sciatica and radiculopathy care is close to home.
Maryland
Cumberland, Hagerstown, LaVale, Frostburg, Cresaptown, Hancock, Williamsport, Smithsburg, Boonsboro
West Virginia
Martinsburg, Keyser, Romney, Berkeley Springs, Paw Paw
Pennsylvania
Waynesboro, Greencastle, Chambersburg, Mercersburg
Cumberland office: 924 Seton Dr Suite C, Cumberland, MD 21502 β MonβSat, 7:30 AM β 4:30 PM
Hagerstown office: 11110 Medical Campus Rd Unit 151, Hagerstown, MD 21742 β MonβFri, 7:30 AM β 5:00 PM
Frequently Asked Questions
What's the difference between sciatica and radiculopathy?
Radiculopathy is the general term for symptoms from a pinched spinal nerve root. Sciatica is the most common type β radiculopathy affecting the sciatic nerve, causing pain that radiates from the lower back down the leg.
What does sciatica feel like?
Sharp, burning, or electric shock-like pain that radiates from the lower back or buttock down one leg, often with numbness, tingling, or weakness, and worse with sitting, coughing, or sneezing.
What causes sciatica?
Most often a herniated disc pressing on a nerve root. Other causes include spinal stenosis, bone spurs, and piriformis syndrome, a muscle-related mimic.
How long does sciatica last?
Many cases improve within a few weeks with conservative treatment, and most people recover. Persistent, severe, or worsening symptoms should be evaluated.
When is sciatica an emergency?
Seek emergency care for new loss of bladder or bowel control, saddle numbness in the groin or inner thighs, or severe weakness in both legs β possible signs of cauda equina syndrome.
Nerve Pain Shooting Down Your Leg or Arm?
Mir Neurology pinpoints the cause of sciatica and radiculopathy and builds a plan for relief in Cumberland and Hagerstown.