Condition 101 About Sciatica

What is the definition of Sciatica?

Sciatica refers to pain, weakness, numbness, or tingling in the leg. It is caused by injury to or pressure on the sciatic nerve. Sciatica is a symptom of a medical problem. It is not a medical condition on its own.

What are the alternative names for Sciatica?

Neuropathy - sciatic nerve; Sciatic nerve dysfunction; Low back pain - sciatica; LBP - sciatica; Lumbar radiculopathy - sciatica

What are the causes for Sciatica?

Sciatica occurs when there is pressure or damage to the sciatic nerve. This nerve starts in the lower back and runs down the back of each leg. This nerve controls the muscles of the back of the knee and lower leg. It also provides sensation to the back of the thigh, the outer and back part of the lower leg, and the sole of the foot.

Common causes of sciatica include:

  • Slipped herniated disk
  • Spinal stenosis
  • Piriformis syndrome (a pain disorder involving the narrow muscle in the buttocks)
  • Pelvic injury or fracture
  • Tumors

Men between 30 and 50 years of age are more likely to have sciatica.

What are the symptoms for Sciatica?

Sciatica pain can vary widely. It may feel like a mild tingling, dull ache, or burning sensation. In some cases, the pain is severe enough to make a person unable to move.

The pain most often occurs on one side. Some people have sharp pain in one part of the leg or hip and numbness in other parts. The pain or numbness may also be felt on the back of the calf or on the sole of the foot. The affected leg may feel weak. Sometimes, your foot gets caught on the ground when walking.

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The pain may start slowly. It may get worse:

  • After standing or sitting
  • During certain times of the day, such as at night
  • When sneezing, coughing, or laughing
  • When bending backward or walking more than a few yards or meters, especially if caused by spinal stenosis
  • When straining or holding your breath, such as during a bowel movement

What are the current treatments for Sciatica?

As sciatica is a symptom of another medical condition, the underlying cause should be identified and treated.

In some cases, no treatment is required and recovery occurs on its own.

Conservative (non-surgical) treatment is best in many cases. Your provider may recommend the following steps to calm your symptoms and reduce inflammation:

  • Take over-the-counter pain relievers such as ibuprofen (Advil, Motrin IB) or acetaminophen (Tylenol).
  • Apply heat or ice to the painful area. Try ice for the first 48 to 72 hours, then use heat.

Measures to take care of your back at home may include:

  • Bed rest is not recommended.
  • Back exercises are recommended early on to strengthen your back.
  • Start exercising again after 2 to 3 weeks. Include exercises to strengthen your abdominal (core) muscles and improve the flexibility of your spine.
  • Reduce your activity for the first couple of days. Then, slowly start your usual activities.
  • Do not do heavy lifting or twisting of your back for the first 6 weeks after the pain begins.

Your provider may also suggest physical therapy. Additional treatments depend on the condition that is causing the sciatica.

If these measures do not help, your provider may recommend injections of certain medicines to reduce swelling around the nerve. Other medicines may be prescribed to help reduce the stabbing pains due to nerve irritation.

Nerve pain is very difficult to treat. If you have ongoing problems with pain, you may want to see a neurologist or a pain specialist to ensure that you have access to the widest range of treatment options.

Surgery can be performed to relieve the compression of your spinal nerves, however, it is usually the last resort for treatment.

What is the outlook (prognosis) for Sciatica?

Often, sciatica gets better on its own. But it is common for it to return.

What are the possible complications for Sciatica?

More serious complications depend on the cause of sciatica, such as slipped disk or spinal stenosis. Sciatica can lead to permanent numbness or weakness of your leg.

When should I contact a medical professional for Sciatica?

Call your provider right away if you have:

  • Unexplained fever with back pain
  • Back pain after a severe blow or fall
  • Redness or swelling on the back or spine
  • Pain traveling down your legs below the knee
  • Weakness or numbness in your buttocks, thigh, leg, or pelvis
  • Burning with urination or blood in your urine
  • Pain that is worse when you lie down, or awakens you at night
  • Severe pain and you cannot get comfortable
  • Loss of control of urine or stool (incontinence)

Also call if:

  • You have been losing weight unintentionally (not on purpose)
  • You use steroids or intravenous drugs
  • You have had back pain before, but this episode is different and feels worse
  • This episode of back pain has lasted longer than 4 weeks

How do I prevent Sciatica?

Prevention varies, depending on the cause of the nerve damage. Avoid prolonged sitting or lying with pressure on the buttocks.

Having strong back and abdominal muscles is important to avoid sciatica. As you get older, it's a good idea to do exercises to strengthen your core.

Cauda
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REFERENCES

Marques DR, Carroll WE. Neurology. In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 41.

Ropper AH, Zafonte RD. Sciatica. N Engl J Med. 2015;372(13):1240-1248. PMID: 25806916 pubmed.ncbi.nlm.nih.gov/25806916/.

Yavin D, Hurlbert RJ. Nonsurgical and postsurgical management of low back pain. In: Winn HR, ed. Youmans and Winn Neurological Surgery. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 281.

Top Global Doctors For Sciatica

KK
Elite
Kika Konstantinou
Haywood, SCT, GB
MA
Elite
Mark P. Arts
Westeind, ZH, NL
Wilco C. Peul
WP
Elite
Wilco C. Peul
NL
AE
Elite
Abdelilah El Barzouhi
Leiden, ZH, NL

Latest Advances On Sciatica

  • Condition: Piriformis Syndrome (PS)
  • Journal: Journal of long-term effects of medical implants
  • Treatment Used: Computed Tomography (CT)-Guided Percutaneous Infiltrations
  • Number of Patients: 20
  • Published —
This study evaluated the effectiveness of computed tomography (CT)-guided percutaneous (through the skin) infiltration in patients with piriformis syndrome (compression of the sciatic nerve by the piriformis muscle; PS).
  • Condition: Sciatic Posttraumatic Neuropathy
  • Journal: Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko
  • Treatment Used: Chronic Neuromodulation and Endoscopic Technics
  • Number of Patients: 3
  • Published —
This study offered a new endoscopic approach for the treatment of sciatic posttraumatic neuropathy with chronic neuromodulation and endoscopic technics.

Clinical Trials For Sciatica

Clinical Trial
  • Status: Not yet recruiting
  • Phase: N/A
  • Intervention Type: Procedure
  • Participants: 1400
  • Start Date: January 2021
Return to Work After Early Intervention for Lumbar Disc Herniation Versus Usual Care
Clinical Trial
  • Status: Recruiting
  • Phase: N/A
  • Intervention Type: Drug, Other
  • Participants: 300
  • Start Date: December 2020
EuroPainClinics® Study II (Prospective Randomized Double Blinded Trial)