Sciatica is a term that refers to the pain caused by irritation of the sciatic nerve. This nerve (also known as ischiatic nerve) is the largest and longest nerve in the human body – it starts in the lower back and runs through the buttocks and the lower limbs. The sciatic nerve provides sensation and motor control to the entire lower leg (except for its inner side), as well as the skin of the foot.
Symptoms of Sciatica
Sciatica is usually caused by a compressed nerve in the lower spine, which results in back and leg pain, ranging from mild to very strong.
Other symptoms of sciatica include:
- difficulty moving of exercising
- numbness and tingling sensation in the limbs
- stiffness in the feet
- throbbing or inflammation in the lower back or thigh area when standing or sitting for a longer period of time
Studies have shown that 10% – 40% of Americans will suffer from sciatica at some point in their lives. Sciatic nerve pain can cause discomfort and prevent you from functioning normally. What’s more, it becomes worse with every bending, twisting, or flexing motion.
Causes of Sciatica
Sciatic nerve pain is not a condition but a symptom of several different medical conditions. In most cases, sciatic nerve pain is caused by a slipped (herniated) disk. The disks in the spine are made of cartilage, which functions as a protective layer between the vertebrae (individual bones in the spine) and makes the spine flexible. When a disk is pushed out of place, it’s jelly-like core leaks out and pressures the sciatic nerve or the lower back nerves.
Other causes of sciatica include:
- Spinal stenosis – a narrowing of the space around the spinal cord, which can compress the spinal nerves.
- Tumors inside the spine which may put pressure on the sciatic nerve’s root.
- Spondylolisthesis – a slipping of vertebrae that occurs at the base of the spine.
- Pelvic fracture or trauma – this kind of injuries affects the nervous tissue.
- An infection that can ultimately affect the spine.
- Injuries in the spine.
There are also several factors that can increase the risk of sciatica, such as:
- Excess body weight puts extra pressure on the spine and contributes to sciatic nerve pain.
- Age – people in their 40s are more likely to develop sciatic nerve pain.
- Certain professions that involve lifting loads for longer periods of time.
- Sedentary behavior – people who sit for long periods of time or those who aren’t physically active are at a higher risk of developing sciatica.
- Sleeping on an inadequate mattress can also contribute to sciatic nerve pain.
- Pregnancy – certain pregnancy hormones can cause the ligaments to stretch and loosen up, which can result in back pain.
When to See a Doctor
If your symptoms are persistent or getting worse, make sure to see a healthcare professional who will confirm a sciatica diagnosis and discuss the most appropriate treatment options.
If you experience any or all of the following, you need to call your doctor right away:
- sciatic nerve pain in both legs
- numbness or tingling between the legs and around your buttocks
- recent loss of bowel or bladder control
Even though it is rare, these can be a sign of cauda equina syndrome. This is a very serious disorder in which something compresses on the spinal nerve roots and it requires urgent medical treatment.
Treatments for Sciatica
The good news is that 80% to 90% of people suffering from sciatica can recover without surgical intervention.
Usually, a combination of some of the following can help reduce the symptoms until the condition improves:
- Exercises and light stretches allow patients to alleviate the symptoms and possibly avoid taking prescription drugs. These can also bring relief during flare-ups.
- Painkillers like ibuprofen, which are sold over-the-counter but are also available online. Note: if you decide to take painkillers for sciatica, make sure to discuss the best option for you with a healthcare professional.
- Hot/cold compresses can help alleviate the pain.
- Sleeping on a good-quality supportive mattress.
- Using ergonomic and supportive chairs
For more persistent cases, further treatment may be recommended, such as:
- Injections of painkilling and anti-inflammatory medication directly into the spine
- Physical therapy
- Taking stronger painkiller tablets, or even steroids
- Cognitive-behavioral therapy
If the sciatica symptoms can’t be relieved by any of these treatments, and they continue getting worse, surgery is also an option. Common surgical options are:
- Discectomy – complete or partial removal of the herniated disk.
- Lumbar laminectomy – widening of the spinal cord in the lower back to decrease the pressure on the nerves.
In most cases, sciatic nerve pain will go away on its own (usually in six weeks) and surgical intervention won’t be necessary.