Pressure on the sciatic nerve can cause pain and often numbness down a leg. Self-care measures might help.
Sciatica refers to pain that travels along the path of the sciatic nerve. The sciatic nerve travels from the lower back through the hips and buttocks and down each leg.
Sciatica most often occurs when a herniated disk or an overgrowth of bone puts pressure on part of the nerve. This causes inflammation, pain and often some numbness in the affected leg.
Although the pain associated with sciatica can be severe, most cases clear up with treatment in a few weeks. People who have severe sciatica and serious leg weakness or bowel or bladder changes might need surgery.
Sciatica pain can be almost anywhere along the nerve pathway. It's especially likely to follow a path from the low back to the buttock and the back of a thigh and calf.
The pain can vary from a mild ache to a sharp, burning pain. Sometimes it can feel like a jolt or electric shock. It can be worse when coughing or sneezing or sitting a long time. Usually, sciatica affects only one side of the body.
Some people also have numbness, tingling or muscle weakness in the leg or foot. One part of the leg can be in pain, while another part can feel numb.
Mild sciatica usually goes away over time. Call your primary care provider if self-care measures don't ease symptoms. Also call if pain lasts longer than a week, is severe or gets worse. Get immediate medical care for:
Sciatica occurs when the sciatic nerve becomes pinched. The cause is usually a herniated disk in the spine or an overgrowth of bone, sometimes called bone spurs, form on the spinal bones. More rarely, a tumor can put pressure on the nerve. Or a disease such as diabetes can damage the nerve.
The rubbery disks that lie between the vertebrae in the spine consist of a soft center (nucleus) surrounded by a tougher exterior (annulus). A herniated disk occurs when a portion of the nucleus pushes through a crack in the annulus. Symptoms may occur if the herniation compresses a nerve.
Risk factors for sciatica include:
Most people recover fully from sciatica, often without treatment. But sciatica can damage nerves. Seek immediate medical attention for:
It's not always possible to prevent sciatica, and the condition can come back. To protect your back:
During the physical exam, a health care provider might check muscle strength and reflexes. For example, you may be asked to walk on your toes or heels, rise from a squatting position, and lift your legs one at a time while lying on your back. Pain from sciatica will usually get worse while doing these moves.
People with severe pain or pain that doesn't improve within a few weeks may need:
For pain that doesn't improve with self-care measures, some of the following treatments might help.
The types of drugs that might be used to treat sciatica pain include:
Once the pain improves, a health care provider can design a program to help prevent future injuries. This typically includes exercises to correct posture, strengthen the core and improve range of motion.
In some cases, a shot of a corticosteroid medication into the area around the nerve root that's causing pain can help. Often, one injection helps reduce pain. Up to three can be given in one year.
Surgeons can remove the bone spur or the portion of the herniated disk that's pressing on the nerve. But surgery is usually done only when sciatica causes severe weakness, loss of bowel or bladder control, or pain that doesn't improve with other treatments.
For most people, sciatica responds to self-care measures. Although resting for a day or so may provide relief, staying inactive will make symptoms worse.
Other self-care treatments that might help include:
Alternative therapies often used for low back pain include:
Not everyone who has sciatica needs medical care. If your symptoms are severe or last for more than a month, make an appointment with your primary care provider.
For radiating low back pain, some basic questions to ask include:
Don't hesitate to ask other questions.
Your doctor is likely to ask you a number of questions, such as: