Sciatic Nerve Pain – Causes and Symptoms

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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  • Caroline

    My mum has lost use of her right leg and the foot is drooping. She can lift the leg when she bends it at the knee but can’t lift it up when the leg is straight.She also has pain around her tummy. She has been told to lie flat and that she will need a brace for her back & spine.
    Will she be able to walk again?

  • Jan Modric

    Caroline,

    what was said to be an exact cause of her problems, and when did these start?

  • Vanusha

    mrs.y was went to the shop,and she was lifting heavy objects around 40kg.One day,she having low back pain and its radiated to left foot.
    Can i know what is the name for this condition?

  • Hi Vanusha. It sounds like a slipped disc, also known as a herniated disc. This causes pressure on the nerve root emerging at the affected spinal level which can present with back pain radiating all the way down to the foot. The herniation is most likely at the level of the low back pain. However, you have provided very limited information and instead you should seek the advice of a doctor.

  • Hi! My girlfriend had a accident 10 years ago, she was pushed and hit an outer corner of a wall (back first). since then she has pain that starts in her lower back and down buttock and back thigh sometimes the right, and sometimes the left side. Never both sides at the same time. She has a mild pain all the time and something triggers the pain to get really nasty. then all she can do is to lay down as still as she can, sometimes for days… Swedish doctors has nothing to offer it seems, except painkillers in different shapes. She has tried epidural injections but the last time ( a couple of years ago) it had no effect. Are there any good tips on how to treat this in any way ?

  • Hi Johnny. It is difficult to advise on an specific treatment without knowing the exact diagnosis. 10 years is a very long period of time. Depending on the severity of the injury and even the way it was initially managed, there could have been complications which may have even led to permanent structural changes at this point that may require surgery to be corrected. But there are many possibilities that need to be considered.

    She should be consulting with a neurologist on a frequent basis at this point. If necessary there may be a referral to a neurosurgeon. However, it is important to remember that surgery is only considered if it is indicated and a viable option for treating the condition. If not, the regular use of painkillers may sometimes be the only option when there are flare ups.

    Hopefully she had also been consulting with a physical therapist at the time of injury and is continuing to do so on a frequent basis. Depending on the underlying problem, a physical therapist could help advise her on exercises and other conservative measures that may assist in managing the pain.