Sciatica

What is sciatica?

Sciatica is a condition that causes pain along the sciatic nerve, which is the longest nerve in your body. This is most commonly due to lumbosacral radiculopathy (when nerve roots are compressed). The sciatic nerve runs from your lower back through the nerves in your legs. Sometimes, the nerve roots in your lower back can get compressed or injured by something. This can result in pain in your leg, where the sciatic nerve travels. This pain is often referred to as sciatica. Sometimes, the sciatic nerve itself can get compressed or injured, but this is rare.

What causes sciatica nerve pain?

There are many spinal conditions that can cause you to experience sciatica nerve pain or discomfort. Some of the most common are:

• Herniated disc – A herniated disc occurs when the gel-like core of a spinal disc bulges out through its outer layer and presses against the nerve roots. The pain, which radiates all the way from your lower back down the back of your legs, is from the nerve being irritated or compressed by the disc.
• Degenerative disc disease – Over time, spinal discs can wear down, losing their height and leading to the formation of bone spurs. These bone spurs can compress the nerve roots as they exit the spine contributing to leg pain. This condition is largely the same as osteoarthritis and spinal arthritis.
• Piriformis syndrome – This occurs when the piriformis muscle, located in the buttocks, starts to spasm or become tight and compresses the sciatic nerve.
• Spinal stenosis – This occurs when the central portion of the spinal canal starts to narrow. This can put painful pressure on the nerve roots that make up the sciatic nerve.
• Spondylolisthesis – This condition occurs when one of the vertebrae in your spine slips out of place and begins to put pressure on the vertebra below it. This also narrows the space through which the nerve passes and pinches nerve roots that make up the sciatic nerve.
• Tumors or infections – While rare, tumors or infections in the spinal region can exert pressure on the nerve roots in the spine
• Injuries from an accident or a fall

Call your doctor or our team of specialists

Schedule an appointment with your primary care physician or a specialist such as a neurologist, orthopedist or pain management doctor. They can help identify the underlying cause of your sciatica through imaging tests like X-rays, magnetic resonance imaging (MRI) or computed tomography (CT) scans.

At Ohio State Spine Care, our team of sciatica experts regularly provides people just like you with nonsurgical and, if needed, surgical treatment options.

What does sciatica nerve pain feel like?

Sciatica typically feels like a sharp, shooting pain that radiates from the lower back through the buttock and down the back of the leg. It can also cause numbness, tingling or a burning sensation along the nerve path, and can sometimes feel like an electric shock. The pain can vary in intensity, from a mild ache to severe discomfort. You may experience the pain worsening with prolonged sitting, standing or sudden movements. The pain may be felt anywhere along the sciatic nerve.

What are the symptoms of sciatica?

This condition can present itself in a wide variety of symptoms. Some of the most common symptoms of sciatica include:

• Pain – A sharp, shooting pain that radiates from the lower back through the buttock and down the back of the leg. The pain is often described as burning, buzzing or something similar to an electric shock.
• Numbness – A feeling of numbness or reduced sensation along the nerve path, typically in the leg or foot.
• Tingling – A sensation of tingling or “pins and needles” in the leg or foot.
• Muscle weakness – A lack of strength affecting your leg or foot, which can impact mobility and strength.
• Movement – Pain that intensifies with certain movements, such as sitting for long periods, standing up or sudden actions like coughing or sneezing.
• Limited motion – Challenges in moving the affected leg or foot due to pain or muscle weakness.

Does sciatica affect some people more than others?

Lumbosacral radiculopathy is a fairly common condition, as it’s estimated that 10%-40% of all people will experience sciatica symptoms at some point in their lives. However, there are several key factors (such as age, occupation and lifestyle) that may put you more at risk.

Sciatica is most common in people between the ages of 30 and 50. Additionally, the condition is most often associated with activities like heavy lifting, prolonged sitting or frequent bending and twisting of the spine.

Risk factors include a sedentary lifestyle, obesity or a general lack of physical activity.

What are at-home treatments to relieve sciatica nerve pain?

There are several different self-care techniques that can help alleviate your sciatica nerve pain and inflammation:

• Heat and cold therapy – Applying ice packs to the affected area for 15-20 minutes several times a day can help reduce inflammation and numb the pain. Then, after the first few days, switching to heat therapy (by using heating pads or warm baths) can relax tight muscles and improve overall blood flow to the area.
• Stretching – Gentle stretching exercises that target the lower back, hips and hamstrings, such as the knee-to-chest stretch, piriformis stretch and seated hamstring stretch, can help relieve pressure on the sciatic nerve.
• Medication – Over-the-counter medications like acetaminophen and ibuprofen can help manage sciatic nerve pain and inflammation.
• Self-care activities – Avoid activities that exacerbate the pain. You should strive to maintain good posture throughout the day, both while sitting and standing, to prevent further irritation of the sciatic nerve.

Read our Health & Discovery story on “The dos and don’ts of sciatica”

When should you see a doctor?

• If your sciatica doesn’t get better with self-care measures
• If it persists for more than a couple of weeks
• If your pain gets worse
• If your pain is accompanied by weakness

If any of the four statements above are true, call your doctor and our team will help you explore one or more of the following treatment options:

Physical therapy

A physical therapist can develop a personalized exercise and stretching program aimed at strengthening the muscles supporting your spine, improving flexibility and reducing pressure on the sciatic nerve.

Medications

Your doctor may prescribe pain relievers, anti-inflammatory drugs, muscle relaxants or even antidepressants or anticonvulsants to help manage pain and inflammation.

Steroid injections

In patients for whom physical therapy and injections are not helping symptoms, corticosteroid injections can be administered near the affected nerve root to reduce inflammation and provide temporary pain relief.

Alternative therapies

Techniques such as acupuncture, chiropractic adjustments or massage therapy can offer relief for some individuals.

Surgical options

If nonsurgical treatments fail to provide relief, or if your symptoms are worsening or accompanied by significant weakness (like foot drop), surgery may be the best option. Procedures like a microdiscectomy or laminectomy can help relieve pressure on the nerve.

How can you prevent sciatica?

In order to prevent this condition from happening, you might need to adopt all-new lifestyle habits and practices that reduce the risk of nerve compression or injuries to your lower back.

Here are some strategies to help prevent sciatica:

• Practice good posture.
• Stay active and engage in exercise that strengthens the muscles that support your spine, including the core, back and legs.
• Be careful when lifting heavy objects. Bend at the knees and keep your back straight. Avoid twisting motions while lifting.
• Take regular breaks at work to stretch and move around.
• Maintain a healthy weight.
• Avoid prolonged sitting.
• Quit smoking to improve blood flow to your spinal discs.