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Must Know Distinctions Between Sciatica and Spinal Stenosis

Must Know Distinctions Between Sciatica and Spinal Stenosis

Dr. Michael Derry, DPT, PT, OCS Jacksonville, Florida
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While spinal stenosis and sciatica can both cause discomfort they are different in a few key ways. It's important to review the symptoms of each as well as the impact they can have on your life to better understand how to treat them. Before you consider surgery and other invasive measures let's look at ways to feel better today.

Sciatica versus Spinal Stenosis: Differing Symptoms and Impact on Spinal Health 


Understanding the differences between sciatica and spinal stenosis is essential to maintaining your spinal health. So, what's the difference between spinal stenosis and sciatica? Well, while both conditions may lead to back pain, their symptoms and effects vary significantly. Sciatica typically causes pain along the sciatic nerve, traveling from the lower back into the leg. Conversely, spinal stenosis - a narrowing of the spinal canal, can trigger pain anywhere within the spine or leg. It can impact multiple nerve roots and can occur on both sides of the body. Moreover, these differing symptoms have distinct impacts on spinal health.

I have had patients that have stenosis in their lower back causing both feet to go numb when they walk.

While scary, this can be managed over time.

Sciatica Symptoms Down The Leg
Symptoms of Sciatica

You might wonder, "How can I differentiate between the two conditions?" The signs of sciatica versus spinal stenosis can often be distinguished by where your discomfort is primarily felt. Sciatica usually leads to radiating leg discomfort down one leg, while spinal stenosis often results in more localized back pain and pain down both legs. Stenosis often makes bending backwards very painful where sciatica bending forwards is often much harder.

With proper care and tailored treatment plans offered by Revision Health Services in Nocatee, St. Johns, Ponte Vedra, you can confidently navigate these distinctions and take important steps towards better back health.

Understanding the role of sciatica in lumbar spinal pain - it's central to getting the right treatment.

The experience of sciatica delivers pain along the sciatic nerve, which often travels down through the lumbar spine. This pain can be intense, and understanding its source in the lumbar region of your spine is a key step towards relief. In examining the differences and interaction between sciatica and spinal stenosis, lumbar spine health is a crucial focus. Both conditions hinge upon the health and functionality of this key area in the spine, making lumbar spine care essential to resolving sciatic nerve pain.

There are key differences between pain caused by stenosis vs sciatica. Here are some questions that I would expect a trained professional may ask you to help differentiate the two. 

  1. Does it feel better when you sit or stand?
  2. Does walking bring on your symptoms?
  3. Do you have symptoms that go down both legs or just one?
  4. If present, how far down do the symptoms go? 
  5. Do you feel like it is easier to walk when you have a shopping cart?

In the clinic, we use these questions to help guide our treatment and to determine what the patient may be dealing with. With stenosis, we often find that pain or numbness will go down both legs rather than just one. The pain will typically go further down the legs, into the calves or feet. Those dealing with lumbar stenosis will report that leaning forward is a position of relief. They will be able to walk further while using a shopping cart or walker due to the flexed posture reducing the stress on the nerves. Standing tends to be difficult due to the pressure it applies to the spine with stenosis. 

Symptoms associated with sciatica present differently than those with stenosis. Standing doesn’t typically cause symptoms to increase, where sitting can be uncomfortable. Walking doesn’t provoke pain like it does with stenosis. Sciatica will present one side rather than both in most cases. The symptoms will vary in how far they go down the leg. There are instances where it can go all the way down to the foot. Other times it can terminate at the knee or even the hip or glute. There won’t be much difference in symptoms with using a shopping cart or walker. People with sciatica will likely have an increase in pain if they bend over at the waist. Bending over will put more tension on the sciatic nerve causing irritation. 

The cause of the pain associated with stenosis is rather cut and dry. The space where the nerves exit the spine start to narrow. This causes the pressure on the nerves to increase and leads to symptoms down the legs. Typically, the pressure is less when bending over and more when leaning back. With sciatica, the causes can be more diverse in nature. 

With sciatica there could be a disc that is herniated and pushing on a nerve, leading to symptoms further down the legs. This compression can cause symptoms that may only go to the hips or buttocks, and in some cases all the way down to the calf or feet. Other causes of sciatica include compression of the sciatic nerve further away from the lumbar spine. The sciatic nerve is very large and either passes around or directly through a muscle called the piriformis. If this muscle is aggravated it can literally be a pain in the butt. This tight or shortened muscle can cause the sciatic nerve to be irritated.  It is important to differentiate between stenosis and sciatica because the treatments are very different. 

Stenosis and sciatica are great examples of the uniqueness that back pain presents. They differ in their mechanism for pain and subsequently how they are treated. Although they are different, the end goal remains the same. We want our patients to achieve the highest level of function that they can so they can live life to the fullest. The interventions for both stenosis and sciatica address the pain and potential numbness that may run down one leg or both. 

Goal setting is extremely important when it comes to rehabilitation. Take some time to figure out what it is you want to be able to do and how the back pain is getting in the way. Remember that a 1000 mile journey begins with one step, and the road to managing low back pain is a process. 

Understanding Spinal Stenosis: Symptoms and Role in Chronic Leg Pain

When getting to grips with the root cause of chronic leg pain, it's crucial to understand a condition known as spinal stenosis. Spinal stenosis is a health concern characterized by the narrowing of the spaces within your spine, which can put pressure on the nerves that travel through the spine. It's a common cause of leg pain and can often be mistaken for sciatica due to the similarity in symptoms. However, clear differences separate spinal stenosis from other disorders.

It's crucial to recognize these distinctions and symptoms, so you can intervene early. Common symptoms of spinal stenosis may include numbness or tingling in the foot or leg. You could be dealing with spinal stenosis if you're also enduring weakness in your limbs or trouble with balance. Remember, it’s crucial to seek early treatment for spinal stenosis. Maintaining a positive attitude and seeking help from experts in the field, such as those at Revision Health Services makes a difference. Best evidence for the treatment of spinal stenosis included conservative measures first. That includes physical therapy and even massage or chiropractic work.

The Impact of Lumbar Spinal Stenosis on the Spine 

Lumbar stenosis, a type of spinal stenosis, can have a significant impact on the spine and overall health. Focusing on the lumbar spine, lumbar stenosis is a condition occurring in the lower back as a result of narrowing the spinal canal. This can be central stenosis or foramina. The impact of lumbar stenosis creates pressure on the nerves housed in the spine, potentially causing immense discomfort, including burning and "hot poker" feelings in the leg. But don't lose heart, you're not alone in this! At Revision Health our professional team understands the toll spinal stenosis takes on your body and are equipped to present solutions that may alleviate your symptoms quickly.

Despite how daunting spinal stenosis may seem, with the right care, its effects on the spine can be managed. In the midst of all this, it’s vital to remember the human body's incredible resilience. Though it's a long journey, the path to improving your spinal health isn't in the realm of impossibility. With the right help in the right place, the impact of lumbar stenosis can become a hurdle you successfully clear. Reach out to us and let's discuss the next steps to turning your spinal health around. We’re in this together! 

Your Spine Surgeon's Take on the Lumbar Spine: Spinal Stenosis versus Sciatica

When dealing with chronic lumbar spine pain, don't overlook the role of your spine surgeon. They'll thoroughly evaluate your situation to provide a diagnosis, whether that be lumbar spinal stenosis or sciatica. Both lumbar spinal stenosis and sciatica have different symptoms and impacts on spinal health. Learning your surgeon's take on the lumbar spine can shed light on these differences. That said, you want to equip yourself with the best evidence and a team that can you make the best decisions for your body.

For instance, spinal stenosis typically leads to mild swelling around the nerve and chronic leg pain, while sciatica is primarily associated with nerve pain radiating along the sciatic nerve. Remember, it's not a contest between spinal stenosis and sciatica, but rather an opportunity to understand your unique spine health. So lean on the expertise of your lumbar spine surgeon who understands your spine and can provide treatments tailored for you.

The Role of Spinal Surgery in Treating Spinal Stenosis and Sciatica 

When you're dealing with these conditions, it's important to understand your spine surgeon's take. In treating spinal stenosis and sciatica, lumbar spine care has evolved greatly, with spinal surgery being a key player. Treating spinal stenosis involves alleviating pressure on your spinal cord, crucially restoring your comfort.

Conversely, sciatica typically arises from lumbar spinal pain, with pinching of the sciatic nerve sparking the discomfort. This is where spinal surgery may play a key role in its management after conservative care such as physical therapy, as failed.

It's all about targeting the root cause and improving how you feel. Now, many fear the word 'surgery', but it's essential to underscore that today's advancements in surgery have made it safer and more efficient. But there are risks for everything and not to mention very costly.

Your path back to a pain-free life may just be through spinal surgery for your spinal stenosis or sciatica. I have seen many individuals improve with surgery but I have also seen folks undergo surgery and didn't actually need it.

Opting for Lumbar Spine Surgery: Risks and Benefits for Sciatica and Spinal Stenosis 

When you're dealing with sciatic pain, it's hard to ignore. And if you've been diagnosed with lumbar spinal stenosis, choices about how to manage your condition can feel overwhelming. This is why opting for lumbar spine surgery may be considered. Here is an example of a neurosurgeon appointment I went on with a client before they had surgery.

The risks and benefits must be weighed carefully, but for sciatica and spinal stenosis patients, it can offer much-needed relief. There's no denying that lumbar spine surgery carries risks, as any surgery does. However, by choosing a skilled surgeon well-versed in both sciatica and spinal stenosis, you're taking the greatest possible step to ensure your surgery is successful.

Dealing with lumbar spine pain on a daily basis is not easy, and it's a significant reason many patients consider surgery. Though the risks shouldn't be overlooked, the benefits are indeed attractive. The potential for immediate relief from sciatic pain and significant improvements in mobility and quality of life makes the option for lumbar spine surgery an appealing choice for many struggling with sciatica and spinal stenosis.

Surgery for lumbar stenosis typically uses a technique called “decompression.” This involves relieving some of the pressure that is placed on the nerves. Success rates vary among individuals depending on the severity and co-morbidities. It is usually safe to start with noninvasive interventions such as physical therapy as they have been shown to have success. It is important to know that there are other options such as surgery when therapy is unsuccessful.  

In my experience the better your body prior to surgery the less intense the symptoms the the easier recovery. There are many ways to improve yourself despite the pain or limitations you may be feeling. It takes a team so build your team to help you be successful.

Surgical interventions for sciatica typically involve a “microdiscectomy.” This procedure involves cutting away a piece of a herniated disc that is protruding into a nerve and causing it to be irritated. Success rates vary with this surgery. Other than severe cases of disc herniation, most people’s symptoms will resolve on their own. When symptoms are so severe that they cause weakness down the leg making walking difficult, then surgery may be an option. 


Q: What is spinal stenosis?

A: Spinal stenosis is a health condition characterized by the narrowing of the spaces within your spine, which can put pressure on the nerves that travel through the spine. It's a very common cause of leg pain and often mistaken for sciatica due to similar symptoms. This can include numbness or tingling in a hand, arm, foot or leg, weakness in your limbs, or trouble with balance. Of course, it depends on where the stenosis is occurring.

Q: What is lumbar stenosis?

A: Lumbar stenosis, a type of spinal stenosis, is a condition that occurs in the lower back as a result of a narrowing spinal canal. This narrowing can put pressure on the nerves housed in the spine, potentially causing discomfort or more serious effects on overall health.

Q: What's the difference between spinal stenosis and sciatica?

A: While both conditions may lead to back pain, their symptoms and effects vary. Sciatica typically causes pain along the sciatic nerve, travelling from the lower back into the leg. Conversely, spinal stenosis, characterized by a narrowing of the spinal canal, can trigger pain anywhere within the spine. Moreover, these differing symptoms have distinct impacts on spinal health.

Q: How can I manage my sciatic nerve pain?

A: Understanding the source of sciatic nerve pain, which often travels down through the lumbar spine, is a key step towards relief. Both conditions, sciatica and spinal stenosis, hinge upon the health and functionality of the lumbar spine and nerves. Management is a key role of physical therapists in these conditions. At Revision Health Services, we focus on maintaining and correcting the conditions that create sciatica in the lumbar, providing prompt diagnosis and expert care for your sciatica, lumbar spine issues, and more.

Q: Should I consider spinal surgery for my spinal stenosis or sciatica?

A: Treating spinal stenosis and sciatica often involves alleviating pressure on your spinal cord or the sciatic nerve. Spinal surgery could play a key role in this management. There are many in which they don't need surgery for either of these conditions. Also consider, any surgery carries risks, even with today's advancements you need to weigh your options. Weighing the risks and benefits carefully with an experienced lumbar spine surgeon can help you take the first step towards a pain-free life. It's important to remember, your path back to a comfortable life may very well be through the right spinal surgery.

In conclusion, low back pain is rarely just one thing. There are several factors that come into play and symptoms that need to be recognized in order to guide treatment. In the instances of stenosis and sciatica we see different mechanisms for the cause as well as varying interventions to address pain. Regardless of what origin of your pain or discomfort may be, it is important to remember that there are options out there to deal with the pain and even relieve it completely. Physical therapy and exercise have helped countless people return to their normal function. The experts at Revision Health Services can help guide you on your path to recovery.

Revision Health Services offers physical therapy and wellness in Jacksonville, Nocatee, and St. Johns, Florida. To find out if our services could be the best fit for you, reach out and let's chat!


1. Katz, J. N., Zimmerman, Z. E., Mass, H., & Makhni, M. C. (2022). Diagnosis and Management of Lumbar Spinal Stenosis: A Review. JAMA, 327(17), 1688–1699.

2. Koes, B. W., van Tulder, M. W., & Peul, W. C. (2007). Diagnosis and treatment of sciatica. BMJ (Clinical research ed.), 334(7607), 1313–1317.

Dr. Michael Derry is a Doctor of Physical Therapy and board certified in orthopedics. He is very passionate about treating lower back pain and helping people build their resiliency. He has spent time assisting at universities as well as managing large clinics before starting his own practice in Jacksonville, FL.

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