Your sciatic nerve begins at your spinal cord, runs through your
hips and buttocks, and then branches down each leg. This nerve is your body’s
longest nerve and one of the most important ones. It has a direct effect on
your ability to control and feel your legs. When this nerve is irritated, you’ll
Sciatica is a sensation that can manifest itself as a moderate to
severe pain in your back, buttocks, and legs. You may also feel weakness or
numbness in these areas. Sciatica is a symptom caused by an underlying injury
to your sciatic nerve or an area that impacts the nerve, such as your vertebrae,
which are the bones in your neck and back.
Sciatica is most likely to occur to people between the ages of .
Symptoms of Sciatica
Sciatica is a very distinct type of symptom. If you’re
experiencing pain that flows from your lower back through your buttock area and
into your lower limbs, it’s typically sciatica.
Sciatica is the result of damage or injury to your sciatic nerve,
so other symptoms of nerve damage are usually present with the pain. Other symptoms
may include the following:
- You may
have pain that gets worse with movement.
- You may
have numbness or weakness in your legs or feet, which is usually felt
along your sciatic nerve pathway. In severe cases, you may
experience a loss of feeling or movement.
- You may
feel the sensation of pins and needles, which involves a painful
tingling in your toes or feet.
- You may
experience incontinence, which is the inability to control your bladder
or bowels. This is a rare symptom of cauda equina syndrome, which is described
below, and it calls for immediate emergency attention.
What Causes Sciatica?
Sciatica can be caused by a number of conditions that involve your
spine and can affect the nerves running along your back. It can also be caused
by an injury, for example from falling, or spinal or sciatic nerve tumors.
Common conditions that can cause sciatica are described below.
Your vertebrae, or spinal bones, are separated by pieces of
cartilage. Cartilage is filled with a thick, clear material to ensure
flexibility and cushioning while you move around. Herniated disks occur when
the first layer of the cartilage rips. The substance inside can compress your
sciatic nerve, resulting in lower limb pain and numbness. It’s estimated that
one in every 50 people will experience a herniated disk in their lifetime,
according to the .
Spinal stenosis is also called lumbar spinal stenosis. It’s
characterized by the abnormal narrowing of your lower spinal canal. This
narrowing puts pressure on your spinal cord and your sciatic nerve roots.
Spondylolisthesis is one of the associated conditions of
degenerative disk disorder. When one spinal bone, or vertebra, extends forward
over another, the extended spinal bone can pinch your sciatic nerve.
Piriformis syndrome is a rare neuromuscular disorder, in which your
piriformis muscle involuntarily contracts or tightens, causing sciatica. Your
piriformis muscle is the muscle that connects the lower portion of your spine
to your thighbones. When it tightens, it can put pressure on your sciatic
nerve, leading to sciatica. Piriformis syndrome can worsen if you sit for long
periods, fall, or experience a car crash.
Risk Factors for Developing Sciatica
Certain behaviors or factors can raise your risk of developing
sciatica. The most common factors for developing sciatica include the following
- As your body ages, it becomes more likely that
parts will wear out or break down.
- Certain careers place a lot of strain on your
back, especially those that involve lifting heavy objects, sitting for extended
periods, or twisting movements.
diabetes can increase your risk of nerve damage.
- Smoking can cause the outer layer of your spinal
disks to break down.
When to Seek Medical Attention
Seek immediate medical attention if you experience the following
- Your pain comes after a severe injury or
- You have sudden, excruciating pain in your lower
back or leg that’s coupled with numbness or muscle weakness in that same leg.
- You’re unable to control your bladder or bowels,
which are the symptoms of cauda equina syndrome.
Cauda Equina Syndrome
In rare cases, a herniated disk can press on nerves that cause
you to lose control of your bowel or bladder. This condition is known as cauda
equina syndrome. It can also cause numbness or tingling in your groin area,
decreased sexual sensation, and paralysis if left untreated.
This disorder often develops slowly. It’s important to go to your
doctor or an emergency room immediately if the symptoms appear.
The symptoms of this disorder can include:
- an inability to control your bladder or bowels,
which can result in incontinence or retention of waste
- pain in one or both of your legs
- numbness in one or both of your legs
- weakness in one or both of your legs, making it
hard to get up after sitting
- stumbling when you try to get up
- a noticeable progression or sudden severe loss
of feeling in your lower body, which includes the area between your legs,
buttocks, inner thighs, heels, and entire foot
Sciatica is a symptom that varies from one person to another and
depends on the condition that’s causing it. To diagnose sciatica, your doctor
will first want to get your full medical history. This includes whether or not
you have had any recent injuries, where you feel the pain, and how the pain
feels. They will want to know what makes it better and what makes it worse and
how and when it started.
The next step is a physical exam that will include testing your
muscle strength and reflexes. Your doctor might also ask you to do some
stretching and moving exercises to determine which activities cause more pain.
The next round of diagnosis is for people who have dealt with
sciatica for longer than a month or have a major illness, such as cancer. Nerve
tests will allow your doctor to examine how nerve impulses are being conducted
by your sciatic nerve and learn if there are any abnormalities. Imaging tests
will allow your doctor to get a look at your spine, which will help them
determine the cause of your sciatica.
The most common imaging tests used to diagnose sciatica and find
its cause are spinal X-rays, MRI, and
CT scans. Normal X-rays will not be able to provide a view of sciatic
nerve damage. An MRI uses magnets and radio waves to create detailed images of
your back. A CT scan uses radiation to create detailed images of your body.
Your doctor will more than likely conduct a CT myelogram in which they inject a
special dye into your spine to help produce clearer pictures of your spinal
cord and nerves.
Treatment Options for Sciatica
Upon first diagnosis of sciatica, your doctor will likely give
you tips for treating your sciatica pain. You should continue your daily
activities as much as possible. Lying in bed or avoiding activity can worsen
Some commonly suggested at-home treatments are described below.
You can purchase ice packs or even use a package of frozen
vegetables. Wrap the ice pack or frozen vegetables in a towel and apply it to
the affected area for 20 minutes per day, several times per day, during the
first few days of pain. This will help to reduce swelling and ease pain.
You can also purchase hot packs or a heating pad. It’s
recommended that you use ice during the first couple of days to reduce swelling.
After two or three days, switch to heat. If you continue to have pain, try
alternating between ice and heat therapy.
Gently stretching your lower back can also be helpful. To learn
how to stretch properly, get personal, one-on-one physical therapy or even yoga
instruction from a physical therapist or instructor trained to deal with your
Over-the-counter medications, such as aspirin and ibuprofen, can
also help with pain, inflammation, and swelling. Be careful about using aspirin
excessively, since it can cause complications, such as stomach bleeding and
The more you stay active, the more endorphins your body releases.
Endorphins are painkillers made by your body. Stick to low-impact activities at
first, such as swimming and stationary bicycling. As your pain decreases and
your endurance improves, create an exercise regimen that includes aerobics,
core stability, and strength training. A regimen with these components can
decrease your risk of future back problems.
If at-home treatments fail to treat your pain effectively, your
doctor might suggest that you take further measures.
Exercises in physical
therapy can help to improve your posture and strengthen your back
Your doctor might prescribe muscle relaxers, narcotic pain
relief, or antidepressants. Antidepressants can increase your body’s endorphin
Epidural Steroid Medication
Corticosteroid medications are injected into an area called the
epidural space, which is the canal that surrounds your spinal cord. Because of
side effects, these injections are given on a limited basis.
Surgery may be needed for severe pain or situations in which you
have lost control of your bowel and bladder or have developed weakness in
certain muscle groups of the lower extremity. The two most common types of
surgery are discectomy, in which part of the disk that’s pressing on your
sciatic nerve is removed, and microdiscectomy, in which the disk removal is done
through a small cut while your doctor uses a microscope.
Alternative medicine is growing in popularity. There are a number
of alternative remedies for sciatica. These include the following:
acupuncturist can insert sterilized needles at key points to affect the
flow of energy in your body. This procedure is virtually painless.
- A chiropractor can manipulate your spine to
achieve maximum spinal mobility.
- A trained professional can induce hypnosis,
which is intended to put you in a very relaxed, focused state of mind, allowing
you to best receive healthy suggestions and instructions. In the case of
sciatic pain, the messages might involve pain relief.
massage therapist can apply motion, pressure, tension, or vibration to your
body to relieve pressure and pain.
How to Prevent Sciatica
The following steps can help you prevent sciatica or keep it from
often. Strengthening your back muscles and your stomach or core
muscles is the key to maintaining a healthy back.
your posture. Make sure your chairs offer proper support for your
back, place your feet on the floor while sitting, and use your armrests.
- Mind how
you move. Lift heavy objects in the proper way, by bending at your
knees and keeping your back straight.