Bilateral Sciatica

Bilateral sciatica, although not a common occurrence, can pose serious and permanent harm if not recognized early and treated promptly. But, first we must recognize what sciatica really is.

What Is Sciatica

Sciatica is a condition where the sciatica nerve or one or more of it's roots are compressed resulting in symptoms such as: 

  • Pain.
  • Numbness.
  • Pins and needles sensations.
  • Muscle weakness.
  • Loss of reflexes.

The symptoms and signs of sciatica are typically one-sided and of varying degrees of intensity and involvement.

It may present as just some mild paresthesia or it can express severe radiating pain (radiculopathy) that travels from the buttocks and into the foot.

Lower back pain may also exist but typically it is relatively mild compared to the radicular pain. The back pain may be directly related to the sciatica but more commonly it is the result of other conditions that may co-exist, i.e., myofascial pain, facet syndrome.

What Causes Bilateral Sciatica

Rarely, will sciatica occur on both sides. When it does occur it is often due to a large central disc herniation that compresses the nerve roots between the disc and the posterior arch a vertebra.

There may also be multiple disc herniation at separate levels of the lumbar spine that will compress different sciatic nerve roots. When bilateral sciatica is present the symptoms will be noticed in both legs with varying degrees of intensity or character.

If the sciatica is extremely severe on one side the sciatica on the opposite side may go unnoticed if it is relatively mild in nature.

Beware Of Cauda Equina Syndrome

A serious form of sciatic nerve root compression, named cauda equina syndrome, occurs when the roots are compressed that innervate the bowel, bladder and muscles of the perineum. Early recognition of this condition is important so that treatment can be performed to relieve the pressure before any permanent damage ensues.

Cuada equina can occur with or without sciatica pain and other symptoms.

If you notice any of the signs and symptoms of cauda equina syndrome you should consult your healthcare provider as soon as possible. They are:

  • Loss of bowel control.
  • Loss of bladder control or incontinence.
  • Numbness or loss of feeling in the perineum or saddle area (anal area, reproductive organs, and the skin and muscle of those areas).

The treatment will most likely be emergency surgical decompression.

A person with cauda equine syndrome, identified and treated early, has a better chance of full recovery.

If treatment is delayed because you put off seeing a healthcare provider some degree of permanency may remain and include any or all of the above signs and symptoms.

Key To Successful Treatment

Bilateral sciatica, just like sciatica that occurs on one side, can be treated conservatively with success.

The key to all successful treatment for conditions that cause lower back pain and sciatica is to be sure you are truly dealing with sciatica, address and correct any and all contributing and associated problems that may exist, and allow enough time for your treatment to take effect.

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