Sciatica is a symptom of a problem with the sciatic nerve, a large nerve
that runs from the lower back down the back of each leg. It controls
muscles in the back of your knee and lower leg and provides feeling to
the back of your thigh, part of your lower leg and the sole of your
foot. When you have sciatica, you have pain, weakness, numbness or
tingling. It can start in the lower back and extend down your leg to
your calf, foot, or even your toes. It's usually on only one side of
your body.
Sciatica may be due to a ruptured intervertebral disk, narrowing of the
spinal canal that puts pressure on the nerve, or an injury such as a
pelvic fracture. In many cases no cause can be found. Sometimes sciatica
goes away on its own. Treatment, if needed, depends on the cause of the
problem. It may include exercises, medicines and surgery. Introduction
Sciatica is pain, weakness, numbness or tingling that begins in the
lower back and extends down the leg. It’s usually on only one side of
the body.
Sciatica is a symptom of a problem with the sciatic nerve, a large nerve
that runs from the lower back down the back of each leg. Sciatica is
common. Most people who experience sciatica are 30 to 50 years old.
This program will help you understand sciatica. It covers the causes,
symptoms, diagnosis and treatment of sciatica.
Anatomy
The spine protects the spinal cord and nerves that go to different parts
of the body.
The spine is formed of solid sections of bone called vertebrae. The
vertebrae are joined together by the facet joints.
Softer disks separate the vertebrae. These disks allow the spine to bend
and flex. The disks act as cushions in between the vertebrae and absorb
shock and vibration produced by walking and running.
Nerves branch off from the spinal cord to various organs and muscles
including those in the arms and legs. The nerves carry instructions from
the brain to the muscles, organs, and limbs.
When the brain orders body parts to move, or if it gives other orders to
body parts, the orders are carried through the nerves. These orders
travel by electrical impulses in the nerves.
The nerves also carry sensations, such as pain, from different parts of
the body to the brain.
Many of the nerves of the lower spine join together to form the sciatic
nerve. The sciatic nerve runs through the hips and buttocks and down the
back of each leg.
The sciatic nerve controls muscles in the back of your knee and lower
leg. It provides feeling to the back of your thigh, part of your lower
leg and the sole of your foot.
Causes
Sciatica happens when there is a problem with the sciatic nerve itself,
but more commonly with one of the lower spinal nerves that ends up
forming the sciatic nerve. There are many conditions that may cause the
sciatic nerve to become irritated or inflamed.
Sciatica may be caused by a herniated disk. This is also called a
ruptured or slipped disk. A herniated disk is when part or all of the
center of the disk pushes into the disk’s outer lining.
The disk can then push on one of the nerves in the lower spine
that end up joining with other nerves to form the sciatic nerve. This
can cause pain, numbness, tingling and/or weakness down the leg.
Spinal stenosis is a narrowing of the spinal canal that puts
pressure on the nerves in the lower spine. This pressure can cause
sciatica.
Piriformis syndrome is a rare disorder that happens when the
piriformis muscle compresses or irritates the sciatic nerve. The
piriformis muscle is a narrow muscle in the buttocks.
Injury to the pelvis or sciatic nerve may cause sciatica.
Tumors are abnormal growths. Tumors that grow near the sciatic nerve may compress the nerve and cause pain.
Sciatica may also result from the sciatic nerve being damaged
over time due to aging. In many cases no cause can be found for
sciatica.
Symptoms
When you have sciatica, you have pain, weakness, numbness or tingling.
It can start in the lower back and extend down your leg to your calf,
foot, or even your toes. It's usually on only one side of your body but
can affect both sides, especially in cases of spinal stenosis.
Sciatica may begin suddenly but often starts slowly. It also may last
weeks. It can feel like a bad muscle cramp or even a burning or tingling
sensation. You may have pain in one area and numbness in others.
Certain activities may make sciatica worse. This depends on what causes
the sciatica pain. Standing or sitting may make the pain worse, as well
as coughing or laughing. Sometimes the pain may be worse at night.
Diagnosis
Your healthcare provider will ask you about your symptoms in order to
make a diagnosis of sciatica. You will also have a physical exam to look
for signs of weakness and pain.
Tests may be used to rule out other causes. These tests include blood
tests, x-rays, and MRIs or other imaging tests. Other tests are usually not needed unless the pain is severe or lasts for a long time.
Treatment
In some cases, sciatica will get better over time without any treatment.
But, there are some options to help manage the pain.
Treatments for sciatica aim at reducing irritation and inflammation of
the sciatic nerve. These include at-home treatment such as:
- Resting and reducing your level of activity
- Applying ice for the first 48-72 hours, then heat
- Taking over-the-counter pain medicines like acetaminophen or ibuprofen
Your healthcare provider may also suggest other treatments if at-home
treatments don’t work. These include injections around the nerve to
reduce inflammation. Prescription medicines may also be prescribed.
Physical therapy is another possible treatment for sciatica. A physical
therapist can teach you exercises that may help with sciatica.
About 80-90% of people with sciatica get better without surgery. Surgery
may be an option if the pain is severe and other treatments haven’t
worked.
Summary
Sciatica is pain, weakness, numbness or tingling that begins in the
lower back and extends down the leg. It’s usually on only one side of
the body. It is a symptom of a problem with the sciatic nerve.
Sciatica is common. Most people who experience sciatica are 30 to 50
years old. About 80-90% of people with sciatica get better without
surgery. At home treatments include rest and over-the-counter pain
medicines.
Surgery may be an option if the pain is severe and other treatments
haven’t worked.
