Sciatica

Overview

Sciatica is a painful nerve condition that affects one side of the body. Typically, pain originates in the sciatic nerve within the lower back and radiates down through the leg.

Common causes of sciatica pain include:

• Disc herniation
• Spinal stenosis
• Bone spurs on the spine

Most cases of sciatica resolve within a few weeks with conservative self-care. More severe cases may require surgery.

Sciatica causes

Most cases of sciatica are caused by a disc herniation that puts pressure on the sciatic nerve.

Other conditions that may irritate the sciatic nerve in the spine and cause pain include:

• Excess weight on the spine
• Poor posture
• A benign or malignant tumor on the spine
• Spinal stenosis
• Spondylolisthesis
• Piriformis syndrome
• Lyme disease
• Diabetes

Sciatica symptoms

Symptoms of sciatica often develop on only one side of the body. Typically, the pain will originate in the lower back and radiate down the back into the thigh and down the leg, potentially into the toes.

Signs or symptoms include:

• Pain in the lower back, hip, or on one side of the buttocks.
• Inability to move your legs or feet
• Shooting pain down the leg
• Burning, tingling numbness or weakness in the legs or feet

Sciatica complications

If left untreated, complications can develop due to the continuous pressure on the nerves in the spine. Possible complications include:

• Intense pain
• Herniated disc
• Loss of bladder or bowel control
• Loss of sensation in the affected leg

Sciatica risk factors

There are a variety of factors that can increase your chances of developing sciatica, including:

• As a person ages, the spine can wear down or change over time, causing issues in the spine, such as bone spurs or radiculopathy. People between the ages of 30 and 50 years old are most likely to develop sciatica.
• People who are overweight or obese place extra pressure on their spine, which may lead to sciatica.
• Sitting for extended periods.
• People with diabetes are more likely to develop nerve damage over time.
• Careers that require manual labor such as twisting, carrying heavy items, or driving long distances.

Sciatica prevention

Some cases of sciatica cannot be prevented. For example, sciatica that occurs as a result of trauma or degenerative disc disease may not be avoided. In other cases, you can take action to prevent sciatica by living a healthy lifestyle. Some lifestyle modifications you can make to prevent sciatica include:

• Stop smoking or avoid second-hand smoke
• Exercise regularly
• Avoid extended periods of sitting
• Use proper posture when sitting
• Use proper techniques when lifting heavy objects

Sciatica diagnosis

Your doctor can diagnose sciatica. During a clinic visit, your doctor will perform a physical exam and take a full medical history. In some cases, your doctor will order imaging tests such as:

• MRI scan
• CT scan
• X-ray
• Electromyogram

These tests may be able to pinpoint what is causing your pain.

Sciatica treatment

Sciatica can generally be treated with nonsurgical treatments. Many people experience symptom relief within six weeks, with rest and medication.

If your pain is impacting your ability to perform your daily activities, your doctor may recommend a nonsurgical treatment such as:

• Rest
• Alternate hot and cold therapy.
• Physical therapy — Improve your strength, posture, and flexibility with gentle exercises
• Exercise
• OTC medications — Over-the-counter pain relievers such as ibuprofen or naproxen can relieve pain caused by sciatica
• Prescription pain relievers and muscle relaxants
• Corticosteroid injection directly into the affected spot

When to seek care

If your pain lasts more than a week, is severe, or is progressively worsening, call your doctor to schedule an appointment.

Go to the emergency room if you have severe numbness or muscle weakness in the leg, if you were in an accident that caused the pain or if you are not able to control your bladder or bowels.

Next Steps

Your doctor will develop a treatment plan customized to your case. Carefully follow your doctor’s treatment instructions.

If your pain intensifies, call your doctor right away to discuss the next steps. You may need a more advanced treatment option if a first-line conservative treatment is not effective.