What Is Sciatica?

Sciatic pain (sciatica) is a pain in the lower back, buttock, leg and/or foot, usually on one side at a time, caused by one of disorders affecting the sciatic nerve:

  • Pinched nerve due to:
    • Bulging or herniated disc 
    • Degeneration disc disease (DDD)
    • Spinal stenosis (narrow spinal canal)
    • Fracture of one or more of spinal vertebra or direct injury of the nerve
    • Tumor of the spinal cord or spine
    • Spondylolysthesis (slipping disc – from several reasons)
    • Piriformis syndrome (pressure from piriformis muscle that extends from the sacrum to the outer hip bone)
    • Spondylosis – degeneration due to wear and tear of spinal vertebra
    • Spondylitis – inflammation of spine
    • Osteoporosis
    • Tuberculosis or osteomyelitis of spinal vertebra
  • Peripheral neuropathy e.g. from diabetes or alcoholism  

Symptoms

Sciatic pain characteristics:

  • Sciatic pain usually starts in the lower back and radiates through the buttock, back thigh, calf and (not always) foot and toes, usually on one side only. Lower back pain may be present on the start and then vanish completely or it may appear later. Sometimes there is no back pain at all.
  • Numbness, tingling or burning sensation may be present on the same or additional areas as the pain.
  • Muscle weakness, having a “heavy leg”, “falling foot” (trouble to bend foot upwards)
  • Pain may be triggered or aggravated by lifting, bending, standing, turning the upper part of the body along its axis, sitting, and often by lying down on the back. Sneezing, coughing, laughing and having a bowel movement may also trigger sciatic pain.
  • Pain is often relieved by walking or swimming.
  • Intensity, location and the nature of sciatic pain may change through the time from no apparent reasons.

Diagnosis

1. Neurological Examination

Pinched sciatic nerve  is strongly suspected if  you feel pain at a certain spot in your leg when a doctor moves your fully extended leg upward.

2. Imaging Investigations

CT or MRI of the lumbar spine may reveal a disorder in spinal vertebra (bone) disc (cartilage), spinal cord or diameter of the spinal canal.

Treatment Options

Mild sciatica often heals on its own in some days/weeks. Rest, avoiding certain physical movements and having regular walk may help.

Painkillers like aspirin, paracetamol, or ibuprofen may relieve the pain. In strong pain, epidural injections of analgesics and/or steroids may be required. This may provide a short or long term relief.

Neurologist, orthopedist, “back doctor”, physiotherapist or chiropractor (specially educated for manual treatment of spinal disorders) may show you exercises to release pressure caused by a pinched nerve.

Severe or long term sciatica may require “decompression surgery” – a part of bone, disc or other tissue is removed. Surgery is generally safe and effective treatment of sciatica.  

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Article reviewed by Dr. Greg. Last updated on December 22, 2009