Sciatica is best described as a symptom of an underlying condition more than a disorder in and of itself. It's usually the result of pressure placed on the sciatic nerve, causing the sensation of pain or discomfort to radiate from the back and into the leg. However, this pain can sometimes be felt all the way down into the big toe, which can often indicate the exact location of the problem.
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The most likely cause of sciatica is a herniated disk. Small tears in the pads of cartilage separating one vertebra from the next allow a gel-like substance to seep out, explains the American Academy of Orthopaedic Surgeons. This gel can compress the sciatic nerve and lead to pain along any area of the body below the pressure point where the nerve is located, including the lower back, buttocks, leg and foot.
If the sciatic pain radiates down into the big toe, the herniation has probably occurred in the L4 or L5 level of your lower back and has pinched the sciatic nerve. This pain is often accompanied by a numbness or tingling sensation along the top of the foot and into the big toe. It may also cause something known as foot drop.
Food drop is marked by difficulty lifting the front part of the foot. This can change the gate of your stride, causing you to drag the affected foot as you walk. Like sciatica, this isn't a medical condition, but rather a symptom of an underlying disorder. Treating the cause of the sciatica should treat foot drop.
Most people suffering from sciatica respond favorably to self-care measures, even when this pain permeates down into the big toe. Icing the back with cold packs for 20 minutes at a time on the first day and then alternating this with heat packs the following two days can help lessen inflammation and reduce compression of the sciatic nerve, which should help improve symptoms of the condition. Taking non-steroidal anti-inflammatory drugs, such as ibuprofen or aspirin, can also be of benefit. The same can be said for regular, low-impact exercises. As time goes by, the herniated disk should correct itself and ease symptoms.
If sciatic pain that radiates down into the big toe fails to improve with self-care, your doctor may then recommend starting physical therapy. Not only do you take part in exercises to strengthen the back and improve flexibility, but you also learn ways to correct movements and postures that may be contributing to the herniated disk.
You may also experience sciatica down into the big toe as a result of lumbar spinal stenosis, piriformis syndrome, tumors and trauma, according to MayoClinic.com. Consult your doctor to determine the exact cause of your sciatica before treating the condition as a herniated disk.