Sciatica

What Is Sciatica?

Sciatica is a common type of pain affecting the sciatic nerve, a large nerve extending from your lower back down the back of each leg.

Sciatica Symptoms

Common symptoms of sciatica include:

• Lower back pain
• Pain in the rear or leg that is worse when sitting
• Hip pain
• Burning or tingling down the leg
• Weakness, numbness, or a hard time moving the leg or foot
• A constant pain on one side of the rear
• A shooting pain that makes it hard to stand up

Sciatica usually affects only one side of the lower body. Often, the pain extends from the lower back all the way through the back of your thigh and down through your leg. Depending on where the sciatic nerve is affected, the pain may also extend to the foot or toes.

For some people, the pain from sciatica can be severe and disabling. For others, the sciatica pain might be infrequent and irritating, but has the potential to get worse.

Seek medical attention right away if you have:

• Fever and back pain
• Swelling or redness in your back or spine
• Pain that moves down your legs
• Numbness or weakness in the upper thighs, legs, pelvis, or bottom
• Burning when you pee or blood in your pee
• Serious pain
• Loss of bladder or bowel control (leaking or not being able to make it to the toilet in time)

Sciatica Causes and Risk Factors

Sciatica results from irritation of the root(s) of your lower lumbar and lumbosacral spine.

Additional common causes of sciatica include:

• Lumbar spinal stenosis (narrowing of the spinal canal in your lower back)
• Degenerative disk disease (breakdown of disks, which act as cushions between the vertebrae)
• Spondylolisthesis (a condition in which one vertebra slips forward over another one)
• Pregnancy
• Muscle spasm in the back or buttocks

Other things that may make you more likely to have sciatica include:

• Aging (which can cause changes in the spine, like bone spurs or herniated disks)
• Diabetes
• Being overweight
• Not exercising regularly
• Wearing high heels
• Sleeping on a mattress that is too hard or too soft
• Smoking
• Your job, especially if it involves driving for long periods of time, twisting your back, or carrying heavy things

Sciatica Diagnosis

If your doctor thinks you have sciatica, you’ll get a physical exam so they can check your reflexes and see how strong your muscles are. They might have you do certain activities, like walking on your heels or toes, to see what’s causing your pain.

If your pain is severe, the doctor might order imaging tests to check for bone spurs and herniated disks. You could get tests like:

• X-ray, which makes pictures of the inside of your body, to check for bone spurs
• CT scan, which combines a series of X-rays to get a better look at your spinal cord and spinal nerves
• MRI, which uses radio waves and magnets to create pictures of your insides to get a detailed look at your back and spine
• Electromyography (EMG), which measures how fast nerve signals travel through your body, to check for things like a herniated disk

Sciatica Treatment

Most people with sciatica feel better after self-care activities or at-home remedies like:

• Using cold or hot packs
• Stretching
• Taking over-the-counter pain medication

But if your pain isn’t getting better, your doctor might suggest other options.

Medication

Your doctor might recommend a few different types of medication, including:

• Anti-inflammatories
• Anti-seizure medications
• Muscle relaxants
• Narcotics
• Tricyclic antidepressants

Physical therapy

A physical therapist can show you how to do exercises that will improve your posture and make you more flexible. They’ll also make the muscles that support your back stronger.

Steroid injections

Your doctor might recommend you get steroid injections, like a cortisone shot. They’ll give you a shot that has medicine to help with inflammation around the nerve, which can help reduce your pain. The effects usually last a few months, but they’ll wear off over time.

Surgery

If you have extreme pain that doesn’t get better, weakness, or a loss of bladder or bowel control, your doctor might recommend surgery. They’ll take out the bone spur or herniated disk that’s pressing on your nerves and causing your pain.

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