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Sciatica Pain

Sciatica refers to pain in the lower back that radiates through your hip, buttock, and leg. One possible cause of sciatica pain is irritation to the sciatic nerve, a large nerve that branches off the spinal cord in the lower back and courses through the buttock and down the back of the leg and into the foot. Inflammation of the sciatic nerve can occur for many reasons. When there is injury or pressure on the nerve, the nerve becomes swollen, inflamed, and painful. Herniated discs are the most common cause of sciatic nerve irritation.

Pain from sciatica can range from moderate, feeling like a cramp; to severe, shock-like sensations. Most people can recover through physical therapy and pain management techniques. Surgical repair is not often necessary.

Symptoms

  • Pain anywhere along the course of the sciatic nerve running from the lower back, through the hip, buttock, leg, and foot. Pain is often described as radiating. 
  • Pain patterns vary widely from a mild, dull ache or cramp; to severe, shock-like sensations
  • Pain may become worse with coughing, sneezing, sitting or bending
  • Numbness, tingling, or burning may also be felt in the affected area
  • Weakness in the muscles along the sciatic nerve may also be noticed

Causes

  • Herniated discs
  • Overgrowth of bones in the spine, such as bone spurs, typically caused by arthritis
  • Narrowing of the spinal cord, also known as spinal stenosis
  • Tumors near the sciatic nerve
  • Damage to the nerve from underlying medical conditions such as with diabetes or multiple sclerosis
  • Piriformis syndrome - spasm of the piriformis muscle which runs directly adjacent to the sciatic nerve
  • Pregnancy

Risk Factors

  • Occupations requiring repetitive twisting, heavy lifting, or long periods of sitting
  • Injuries such as a fall
  • Arthritis
  • Pregnancy
  • Excess weight

Diagnosis

  • Physical examination to evaluate pain, reflexes, strength, and sensation
  • X-ray to show bone health and the presence of arthritis
  • MRI or ultrasound to show muscle and soft tissue health
  • Electromyography to evaluate potential nerve damage

Treatment Options

  • RICE therapy: Rest, Ice, Compression, Elevation
  • Nonsteroidal anti-inflammatory medications for pain relief
  • Injections to alleviate pain
  • Physical therapy
  • Exercise regimen or alternative therapies such as yoga, massage, chiropractic manipulation, or acupuncture
  • Surgical repair may be recommended in severe cases to relieve irritation or pressure of the nerve