What is Sciatica?

Sciatica usually affects one side of the body and it is a kind of pain that follows the path of the sciatic nerve.  The sciatic nerve starts at the lower back and branches out down the hips and past the buttocks and down each leg.  It is usually the result of a herniated disk, narrowing of the spine that compresses the nerve, or bone spurs on the spine.

It can usually be resolved without surgery over the course of a few weeks.

What are the Symptoms of Sciatica?

The most common symptom of sciatica is pain that starts in the spine and goes down the back of the legs and down as far as the calves.  The pain level varies from mild to very sharp.  Some describe it as a burning pain while others say it feels like an electric shock.  Other symptoms include weakness in the muscles, numbness, or tingling.  Different symptoms may be felt in different parts of the leg.

Sciatica Causes

  • Herniated or ruptured disc in the lower back — when a spinal disc becomes damaged and bulges (herniates) or breaks open (ruptures).
  • Degenerative disc disease — associated with aging.
  • Spondylolisthesis — a spinal bone moves out of place, over the bone below it.
  • Radiculopathy — pinched nerve.
  • Spinal osteophytes — bone spurs.
  • Spinal stenosis — narrowing of the spine.
  • Sacroiliac joint dysfunction — impairment of the joint between the tailbone (coccyx) and the lumbar spine.
  • Piriformis Syndrome — the piriformis buttock muscle compresses a nerve.
  • Osteoarthritis — deterioration of the protective cartilage on spinal bones.
  • Pregnancy — additional body weight causes downward pressure on the sciatic nerve.
  • Epidural fibrosis — scar tissue.
  • Inflammation — caused by muscle strain or spasm in the lower back.
  • Spinal fracture — particularly in the lumbar region.
  • Tobacco use — including all types of nicotine intake.
  • Obesity — increases stress on the lumbar region.

Strategies that may help prevent sciatica include strengthening lower back muscles or preventing excessive pressure on the muscles. Specific exercise programs should be at the recommendation of a physician.

How is Sciatica Treated?

Sometimes medications are prescribed for sciatica including tricyclic antidepressants, muscle relaxants, anti-seizure medications, narcotics, and anti-inflammatories.

If pain is not too bad or has been minimized through medications, physical therapy is helpful for some.  In other case corticosteroid medication may be injected into the root of the nerve to reduce pain and suppress inflammation.

This is not a permanent solution and several injections may be needed over time.  The last resort is surgery.  This course of treatment is usually saved for when the compressed nerve causes severe problems like weakness or loss of control of the bladder or bowels.  It may also be suggested if other treatments do not work.

Sciatica Prevention

  • Maintaining a healthy weight.
  • Low-impact exercise, such as riding a bicycle.
  • Yoga.
  • Daily stretching exercises.
  • Performing exercises that strengthen core muscles in the abdomen and lower back.
  • Using proper posture while sitting, particularly for occupations that require sitting for long periods of time.
  • Sitting in an ergonomic chair that has a lumbar support and arm rests. (For chairs with no lumbar support, place a rolled towel or small pillow between the natural curvature of your lower back and the chair.)
  • In occupations that require standing for long periods at a time, alternate lifting one leg and resting the foot on a low stool or box.
  • Lifting an object by lowering your body straight down and bending only at the knees, keeping the object close to your body. Raise straight up without twisting.
  • Back massages may improve circulation and increase movement in the lower back.