Conditions Mimicking Sciatica: 10 Differential Diagnoses

True sciatica involves sciatic nerve compression/irritation causing radiating leg pain, numbness, tingling, weakness. Many conditions produce similar symptoms:

1. Lumbar herniated disc – most common true sciatica cause.
2. Spinal stenosis – central canal narrowing compresses nerve roots.
3. Piriformis syndrome – piriformis muscle compresses sciatic nerve.
4. Sacroiliac joint dysfunction – SI joint irritation refers pain down leg.
5. Muscle strains/sprains – local injury mimics radicular pain.
6. Compression fractures – osteoporotic/traumatic vertebral collapse.
7. Bone spurs (osteophytes) – encroach on neural foramina.
8. Infections – shingles, Lyme, viral meningitis inflame nerve roots.
9. Peripheral neuropathy – diabetic/chemo/autoimmune nerve damage.
10. Pregnancy – uterine pressure on sciatic nerve.

Accurate diagnosis (history, exam, imaging, EMG) is essential for targeted treatment.