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Sciatica

Medically reviewed by Drugs.com. Last updated on Jan 31, 2024.

Overview

Sciatica refers to pain that travels along the path of the sciatic nerve. The sciatic nerve travels from the buttocks and down each leg.

Sciatica most often happens when a herniated disk or an overgrowth of bone puts pressure on the lumbar spine nerve roots. This happens "upstream" from the sciatic nerve. This causes inflammation, pain and often some numbness in the affected leg.

Although the pain associated with sciatica can be serious, those cases that are caused by a herniated disk can clear up with treatment in a few weeks to months. People who have severe sciatica and serious leg weakness or bowel or bladder changes might need surgery.

Sciatic nerve

The sciatic nerve is the confluence of nerve roots from the lower back. The sciatic nerve extends from the buttocks down each leg.

Symptoms

Sciatica pain can be almost anywhere along the nerve pathway. It's especially likely to follow a path from the low back to the buttock and the back of a thigh and calf.

The pain can vary from a mild ache to a sharp, burning pain. Sometimes it feels like a jolt or electric shock. It can be worse when coughing or sneezing or sitting a long time. Usually, sciatica affects only one side of the body.

Some people also have numbness, tingling, or muscle weakness in the leg or foot. One part of the leg can be in pain, while another part can feel numb.

When to see a doctor

Mild sciatica usually goes away over time. Call your primary care professional if self-care measures don't ease symptoms. Also call if pain lasts longer than a week, is severe or gets worse. Get immediate medical care for:

Causes

Sciatica occurs when the nerve roots to the sciatic nerve become pinched. The cause is usually a herniated disk in the spine or an overgrowth of bone, sometimes called bone spurs, on the spinal bones. More rarely, a tumor can put pressure on the nerve.

Herniated disk

The disks that lie between the vertebrae in the spine consist of a soft center (nucleus) surrounded by a tougher exterior (annulus). A herniated disk occurs when a portion of the nucleus pushes through a crack in the annulus. Symptoms may occur if the herniation compresses a nerve.

Risk factors

Risk factors for sciatica include:

Complications

Most people recover fully from sciatica caused by herniated disks, often without treatment. But sciatica can damage nerves. Seek immediate medical attention for:

Prevention

It's not always possible to prevent sciatica, and the condition can come back. To protect your back:

Diagnosis

During the physical exam, a healthcare professional might check muscle strength and reflexes. For example, you may be asked to walk on your toes or heels, rise from a squatting position, and lift your legs one at a time while lying on your back.

Tests

People with severe pain or pain that doesn't improve within a few weeks may need:

Treatment

For pain that doesn't improve with self-care measures, some of the following treatments might help.

Medications

The types of medicines that might be used to treat sciatica pain include:

Physical therapy

Once the pain improves, a healthcare professional can design a program to help prevent future injuries. This typically includes exercises to correct posture, strengthen the core and improve range of motion.

Steroid injections

In some cases, a shot of a corticosteroid medication into the area around the nerve root that's causing pain can help. Often, one injection helps reduce pain. Up to three can be given in one year.

Surgery

Surgeons can remove the bone spur or the portion of the herniated disk that's pressing on the nerve. But surgery is usually done only when sciatica causes severe weakness, loss of bowel or bladder control, or pain that doesn't improve with other treatments.

Lifestyle and home remedies

For most people, sciatica responds to self-care measures. Although resting for a day or so may provide relief, staying inactive will make symptoms worse.

Other self-care treatments that might help include:

Alternative medicine

Alternative therapies often used for low back pain include:

Preparing for an appointment

Not everyone who has sciatica needs medical care. If your symptoms are serious or last for more than a month, make an appointment with your healthcare professional.

What you can do

For radiating low back pain, some basic questions to ask include:

Don't hesitate to ask other questions.

What to expect from your doctor

Examples of questions your doctor may ask, include:

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