The sciatic nerve begins from the lower spine on either side. It travels deep in the pelvis to the lower buttocks. From there, it passes along the back of each upper leg and divides at the knee into branches that go to the feet. Sciatica is an irritation of the sciatic nerve.
Sciatic Nerve Pain
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Sciatica is caused by irritation or pressure on the sciatic nerve. This can be the result of: Herniated disc
—the cushions between the bones of your spine bulge and press on the nerve as it exits the spinal column
in the lower back
—narrowing of the spinal canal in the lumbar area
—slippage of a bone in the lower back
Cauda equina syndrome
—nerve roots at the base of the spinal cord are compressed
Piriformis syndrome— spasm of piriformis muscle
Sciatica is more common in men. Other factors that may increase your chance of sciatica include:
Lifestyle and personal health factors, such as: ObesitySmokingHistory of low back problemsAnxiety
Occupational factors, such as: Heavy manual laborHeavy liftingExposure to vibrationsA job that requires standing for long periods of time and forward bending
Health conditions, such as: Fractures in the backTumorsInfections
Metabolic problems, such as
Sciatica causes symptoms that can range from mild to severe. Symptoms may include: Burning, tingling, or a shooting pain down the back of one leg
Pain in one leg or buttock may get worse with:
SittingStanding upCoughingSneezingStrainingWeakness or numbness in a leg or foot
More serious symptoms associated with sciatica that may require immediate medical attention include: Continuing weakness in a leg or footNumbness in groin or the buttocksDifficulty walking, standing, or movingLoss of bowel or bladder controlFever, unexplained weight loss, or other signs of illness
You will be asked about your symptoms and medical history. A physical exam will be done. Your doctor will pay particular attention to your back, hips, and legs. The physical exam will include tests for strength, flexibility, sensation, and reflexes.
Imaging tests are used to evaluate the affected area: X-rayMRI scanCT scan
Your doctor may also need to test your nerves. This can be done with a
nerve conduction study
The goal of treatment is to reduce sciatic nerve irritation.
Treatment options include:
Bed rest is not generally recommended. It may be suggested for no more than 1-2 days in those with severe pain. Your doctor may recommend that you restrict certain activities for a period of time and then resume them as soon as possible. You may be able to shorten your recovery time by staying active and exercising.
Medications used to treat sciatica include: Over-the-counter or prescription pain relieversMuscle relaxers for muscle spasmsCorticosteroid injections in the backAntidepressants or antiseizure medications for chronic pain
Physical therapy may include: Cold packs or heat therapyStretching
MassageUltrasound treatments or electrical stimulationPosture education and appropriate lifting instructions
These therapies have not been proven by scientific studies to have an effect on sciatica. However, some people may find some pain relief from: BiofeedbackAcupuncture
Surgery may be done
to relieve pressure on the sciatic nerve. This is performed in emergency situations or if other treatments fail. Common surgical procedures are
Sciatica tends to happen more than one time. To help reduce your chance of sciatica: Use proper body movement when playing sports, exercising, or lifting heavy objects.Practice good posture to reduce pressure on your spine.
Begin a safe
with the advice of your doctor.
If possible, avoid sitting or standing in one position for long periods.Consider job retraining if your work requires a lot of heavy lifting or sitting.
Allen C, Glasziou P, et al. Bed rest: A potentially harmful treatment
needing more careful evaluation.
Sciatica. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at:
http://orthoinfo.aaos.org/topic.cfm?topic=A00351. Updated December 2013. Accessed December 1, 2015.
Waddell G, Feder G, Lewis M. Systematic reviews of bed rest and advice to
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6/7/2007 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Peul WC, van Houwelingen HC, et al. Surgery versus prolonged conservative treatment for sciatica.
N Engl J Med.
Last reviewed December 2015 by Teresa Briedwell, PT, DPT, OCS, CSCS
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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