Patients with sciatica generally feel pain that begins in the lower spine and radiates down to the buttocks and into the back of the legs. Sciatica can affect one or both sides of the lower body. It often feels like a bad leg cramp, but pain may be experienced at any point along the nerve pathway. Sciatica is most likely to be felt in the following patterns:

• Lower back to the knee
  
  
• Middle of the buttock to the outside of the calf, top of the foot and into the space between the last two toes
  
  
• Inside the calf to the inner ankle and sole of the foot

Some patients with sciatica experience only a mild ache, whereas others feel an excruciating sharp, burning sensation. It is not unusual for the pain to begin mildly and to get progressively worse over time. In severe cases, the pain can feel like an electric shock. Pain is most likely to affect just one lower extremity and to worsen when sitting, coughing or sneezing.

Other symptoms that may accompany sciatica include:

• Numbness or muscle weakness along the nerve pathway in the leg or foot. Some patients will experience pain along part of the sciatic nerve and numbness along another part.
  
  
• Tingling. This feeling, sometimes described as a “pins-and-needles” sensation, occurs most often in the toes or part of the foot.
  
  
• Weakness of the knee or foot. Patients may have an inability to move the foot or bend the knee, or may experience difficulty walking. Rarely patients can have footdrop with advanced damage of the nerve.
  
  
• Loss of bladder or bowel control (incontinence). This symptom may indicate the presence of cauda equina syndrome, a rare disorder that affects the bundle of nerve roots (cauda equina) at the lower (lumbar) end of the spinal cord. These nerve roots send messages to and receive messages from the pelvic organs and lower limbs. Cauda equina syndrome sometimes is accompanied by numbness or tingling in the groin or genital area. It is an extremely serious condition that requires emergency medical care.