Sciatica in the ankles is a relatively common patient complaint, but not as common as sciatica in the back of the legs or sides of the legs. The ankles are generally served by the L4 and L5 nerve roots in front and the S1 and sometimes S2 nerve roots in the rear. Pain which occurs only in the ankle is not likely to be from a spinal source, but radiating pain which shoots into the ankle may. There are alternative explanations for ankle symptoms not related to sciatica. Other common sources of suspected ankle sciatica include injury to the joints or soft tissues of the ankle itself, localized nerve dysfunction or regional ischemia.
This treatise focuses on neurological symptoms that are expressed in the ankle unilaterally or bilaterally.
Spinal Causes of Sciatica in the Ankles
A herniated disc, abnormal spinal curvature, osteoarthritis bone spur complex or vertebral misalignment condition can all impinge upon the lumbar or sacral nerve roots, creating the ideal circumstances for sciatica to occur. While this is the most common diagnostic theory offered to explain sciatic nerve symptoms, the occurrence of actual pinched nerves is actually quite rare.
In actual chronic nerve compression scenarios, the patient is likely to suffer ongoing weakness and numbness, including possible foot drop, but is not likely to endure continual pain. This is because actual pinched nerves cease signaling altogether in a relatively short time frame. This is why chronic pain may be one of many possible indicators of a mistaken causative theory, if the working diagnosis is single level nerve compression.
Non-Spinal Causes of Ankle Sciatica
Non-spinal issues leading to sciatica in the lower legs can include simple misdiagnosis of a localized injury, such as a sprained ankle, ligament tear or joint concern. These injuries can be very painful and the symptoms may radiate upwards or into the foot, making them resemble sciatica concerns. This is particularly true in patients with histories of lower back and leg pain.
Likewise, pseudo-sciatica sourced from ischemia, piriformis syndrome or sacroiliac joint problems may affect the ankles, although in the case of the latter 2, this is rare.
Oxygen deprivation can strike anywhere in the anatomy and can provide one of the most treatment-resistant of all sciatic nerve syndromes, mostly due to the anonymity of the actual source process.
Guidance on Sciatica in the Ankles
Sciatica can affect virtually any area of the lower body and the symptoms can be debilitating. Most ankle pain alone will not be diagnosed as sciatica and this is correct in most cases.
Ankle pain, in association with a known lower back pain or leg pain condition, is likely to be covered by the umbrella theory of all symptoms, usually relating to a lumbar or lumbosacral bulging disc. In the vast majority of cases, this diagnostic conclusion is ridiculous, since symptoms often do not correlate exactly, and sometimes not at all, or the scapegoat disc issue is minor and unlikely to be enacting any pain whatsoever.
If your ankle pain has not responded well to treatment time and time again, I suggest considering misdiagnosis as the likely culprit for your ordeal of eternal suffering. Remember to look for other clues about the actual source process involved. These may include positionally and activity-related symptoms, expressions which worsen when the legs are elevated and pain which occurs when in bed or first thing in the morning. These are not likely to be caused by the usual sciatica scapegoats, although some may.
