Sciatica: Causes, Symptoms and Treatments

Sciatica is when a nerve in your lower spine gets squeezed, causing pain in your back and legs. It’s not a condition on its own; it’s a sign of a problem with the sciatic nerve.

The sciatic nerve is the biggest nerve in your body. It starts in your lower back, goes through your buttocks, and down your legs, ending just below your knee. It controls many leg muscles and gives feeling to your foot and most of your lower leg.

In this article, we’ll look at sciatica symptoms and causes, talk about how doctors diagnose it, and go over treatment options.

What is Sciatica?

Sciatica is when you have nerve pain due to an injury or irritation in your sciatic nerve. This pain can feel like aching, tingling, or numbness in your lower back or buttocks, and it might even travel down your leg. Sometimes, it can be quite severe.

The sciatic nerve is the biggest nerve in your body, about the width of a penny or a UK 1 pence coin. Despite its name, it’s not just one nerve; it’s a bundle of nerves that come from five nerve roots branching off your spinal cord.

You actually have two sciatic nerves, one on each side of your body. These nerves go through your hip and buttock, down your leg, and stop just below your knee. After that, they split into smaller branches that connect to different parts of your lower leg, foot, and toes.

If you have sciatica, you might feel pain in various areas where nerves connect to the sciatic nerve. It can affect your lower back, hips, buttocks, or legs, and sometimes even go down to your feet and toes, depending on which nerves are involved.

Types of Sciatica

There are two main types of sciatica, and even though they cause similar problems, they have different reasons behind them:

1. True Sciatica: This type happens when there are issues or injuries directly affecting the sciatic nerve.

2. Sciatica-Like Conditions: These conditions imitate sciatica symptoms but stem from other problems involving the sciatic nerve or its component nerves.

In everyday medical talk, both types are usually just called “sciatica.” The key is to differentiate between them when deciding on the right treatment with your healthcare provider.

What are the symptoms of sciatica?

Sciatica usually starts with pain in the lower back or buttocks and then travels down one leg. This pain is often mistaken for coming from the sciatic nerve in the buttocks, but it usually begins in a nerve in the lower spine.

Common sciatica symptoms include:

1. Pain that can be dull, aching, shooting, or even a “burning” feeling. It starts in your lower back or buttock and goes down one leg. If you have both back and leg pain, it’s likely sciatica rather than other back issues.

2. Numbness or a tingling sensation, often described as “pins and needles.”

3. Muscle weakness or changes in reflexes.

Your symptoms may worsen when you bend, lift things, twist your body, sit, cough, or sneeze, depending on where the compressed nerve is.

What Causes Sciatica?

The main reason for sciatica is often a herniated or bulging disk. To understand this, let’s break down the three important parts of your spine:

1. Vertebrae: These are the bones that make up your spine and protect the nerves.

2. Nerves: Delicate pathways that send signals throughout your body.

3. Disks: These act as cushions between each vertebra, allowing your spine to move comfortably. When a disk shifts out of place, it can press on the nerves that make up the sciatic nerve, causing sciatica.

Other factors that can lead to sciatica include:

• Lumbar Spinal Stenosis: This is when the spinal cord in your lower back narrows.

• Cauda Equina Syndrome: A rare and severe form of spinal stenosis.

• Spondylolisthesis: This is when a disk slips forward over the vertebra below it.

• Back Injuries: Any trauma to the back area.

• General Wear and Tear: Gradual degeneration over time.

What Makes You More Likely to Have Sciatic Nerve Pain?

There are a few common factors that can increase your risk of getting sciatica:

1. Age: Sciatica is more common in people between 30 and 50 years old.

2. Job: If your work involves lifting heavy things for long periods, you might have a higher chance of getting sciatica.

3. Back Troubles: If you’ve had lower back pain or issues with your back before, you’re more likely to develop sciatic nerve pain.

What are the Possible Complications of Sciatica?

Most people with sciatica can recover fully, but there are some potential issues to know about:

1. Chronic Pain: Some may experience long-lasting pain.

2. Muscle Weakness: In severe cases, it can cause chronic muscle weakness, making walking difficult or impossible (known as “drop foot”).

3. Permanent Nerve Damage: In severe instances, sciatica can cause lasting numbness and sensation loss in the legs.

How Do Doctors Diagnose Sciatica?

Doctors use a few steps to diagnose sciatica accurately:

1. Physical Examination: Doctors start by examining you and asking about your medical history and symptoms.

2. Movements: They might ask you to do some simple movements to gently stretch the sciatic nerve. If you feel sharp leg pain during these movements, it could indicate sciatica.

3. Imaging Tests: If symptoms last more than 6–8 weeks or if there’s a suspicion of a serious issue, doctors may suggest X-rays or MRI scans. These tests reveal any pressure on the sciatic nerve and provide insights into the cause of your symptoms.

What Are the Treatment Options for Sciatica?

Sciatica treatment varies depending on how bad it is. There are different ways to deal with it. In some cases, it can get better on its own in 4-6 weeks, but there are treatments to help speed up healing and ease the pain.

1. Home Remedies

You can try these self-care treatments for sciatica pain at home:

• Cold packs: Put a cold pack or something frozen in a cloth on your lower back for up to 20 minutes several times a day. Your doctor or physical therapist can tell you the right way to do it.

• Hot packs: If cold packs don’t help, you can switch to using heat after a few days. Just make sure to use the lowest heat setting to avoid burning your skin with a heating pad.

• Stretching and moving: Rest is important when you have severe pain, but gentle stretching and easy movements like walking can help. These activities improve blood flow, distract from the pain, make you more flexible, and increase your range of motion. If moving around too much makes the pain worse, talk to your doctor for advice.

2. Sciatica Exercises

Ask your doctor or physical therapist for exercises tailored to relieve sciatica pain. Here are some examples:

• Glute bridges
• Lying knee-to-chest stretches
• Clamshells
• Bird dogs
• Child’s pose stretch
• Hamstring stretches
• Pelvic tilts

Your healthcare provider may also suggest general stretches and exercises to strengthen the muscles around your spine and buttocks, which can press on the sciatic nerve.

3. Medications

Medical treatment may involve medications like:

• Gabapentin: It targets nerve pain.
• Muscle relaxants: These help ease muscle tension.
• Anticonvulsant drugs: Sometimes used for nerve-related pain.
• Corticosteroid injections: Given for persistent sciatica.

4. Surgery

Surgery is usually the last option, and most people with sciatica don’t need it. Surgical choices for sciatica include:

• Lumbar laminectomy: This involves removing part or all of the lamina (a part of the vertebrae) to relieve pressure on the spinal nerve.
• Discectomy: This surgery removes part or all of a herniated disk.

If other treatments haven’t worked, talk to a surgeon who can explain the risks and benefits of surgery and recommend the right surgical option based on the cause of your sciatica.

Can You Prevent Sciatica?

Yes, you can reduce the risk of getting sciatica. Here are some simple tips:

1. Stay active: Regular exercise is important and can help prevent sciatica.

2. Watch your posture: Maintain good posture while sitting or standing to lower your risk of sciatica.

3. Maintain a healthy weight: Keeping your weight in check can also help prevent sciatica.

4. Quit smoking: Giving up smoking is good for many reasons, including reducing the risk of sciatica.

5. Lift properly: When lifting heavy objects, always use the right techniques to protect your back.

If you need more guidance, you may make an appointment with our online pain management consultation. 

Frequently Asked Questions About Sciatica

1. How long does sciatica last?

In most cases, sciatica gets better within 4–6 weeks.

2. Will sciatica pain go away on its own?

For many people with mild sciatica, symptoms usually improve within 3 to 6 weeks without any medical treatment. However, more severe or injury-related sciatica can take months or longer to heal. In some cases, surgery may be necessary to prevent nerve damage.

3. What triggers sciatica?

Sciatica symptoms can occur when conditions like disk herniation, arthritis, or bone spurs compress or put pressure on the sciatic nerve.

4. What relaxes the sciatic nerve?

Nerves themselves cannot tense or relax, but they can become irritated. Sciatic nerve irritation typically subsides with time and rest. Using heat or cold compression pads and engaging in gentle stretching exercises may also help.

5. What should someone avoid doing with sciatica?

Activities like bending, twisting, or coughing can worsen sciatica pain. Prolonged bed rest can also contribute to discomfort, so it’s advisable to incorporate gentle stretches into your daily routine.

6. How do I know if I have sciatic nerve pain?

The best way to diagnose sciatica is by consulting a doctor. However, common signs of sciatica include lower back pain accompanied by numbness or tingling in the buttocks or down the back of the leg. Muscle weakness in the affected leg and, in severe cases, loss of bowel or bladder control may also be indicators.

7. What is the straight leg test for sciatica?

The straight leg test involves lying down while a healthcare professional raises your leg by flexing the hip. If you experience pain along the lower limb when your knee is extended, it could indicate sciatica.

8. What is the fastest way to cure sciatica?

The speed of recovery depends on the severity of your symptoms and the underlying cause of your sciatica pain. Surgery to address issues like herniated disks may provide faster relief than physical therapy alone. However, a full recovery often takes time, ranging from weeks to months. Collaborate with your doctor to determine the most suitable treatment plan for your situation.

9. Where is the sciatic nerve located, left or right?

You have two sciatic nerves, each running from your spine down the back of both legs. These nerves form a larger bundle that extends from your buttocks to your knee and then branches into smaller nerves that reach your lower leg, foot, and toes.