What Is Sciatica?

Sciatica is a common type of pain that affects the sciatic nerve, a large nerve that runs from your lower back down the back of each leg.

Sciatica Symptoms

The following are some of the most common sciatica symptoms:

  • Lower back pain
  • Back or leg pain that worsens when sitting
  • Hip pain
  • Tingling or burning down the leg
  • Weakness, numbness, or difficulty moving a leg or foot
  • A constant ache on one side of the back
  • A shooting pain that makes it difficult to stand.

Typically, sciatica affects only one side of the lower body. Often, the pain radiates from the lower back down your thigh and your leg. The pain may also extend to the foot or toes, depending on where the sciatic nerve is affected.

Sciatica pain can be excruciating and incapacitating for some people. For others, sciatica pain may be infrequent and irritating, but it has the potential to worsen.

Seek medical attention as soon as possible if you have:

  • Fever and back pain
  • Back or spine swelling or redness
  • Pain that travels down your legs
  • Upper thighs, hips, pelvis, or bottom numbness or weakness
  • Peeing with a burning sensation or pee with blood
  • Serious pain
  • Inability to regulate one’s bladder or bowels (leaking or not being able to make it to the toilet in time)

Sciatica Causes and Risk Factors

Sciatica is caused by inflammation of the lower lumbar and lumbosacral spine roots.

The following are some other important causes of sciatica:

  • A lumbar spinal stenosis is a form of spinal stenosis (narrowing of the spinal canal in your lower back)
  • A degenerative disk disease is a form of disk disease (breakdown of discs, which act as cushions between the vertebrae)
  • Spondylolisthesis is a form of spondylolisthesis (a condition in which one vertebra slips forward over another one)
  • Pregnancy
  • Back or buttocks muscle spasm

Other factors that can increase the chances of developing sciatica include:

  • The process of aging (which can cause changes in the spine, like bone spurs or herniated disks)
  • Diabetes
  • Being overweight
  • Not exercising regularly
  • Wearing high heels
  • Sleeping on an overly firm or overly soft mattress
  • Smoking
  • Your work, mainly if it requires you to drive for long periods, twist your back, or carry heavy items.

Sciatica Diagnosis

If your doctor suspects you have sciatica, you will be given a physical test to assess your reflexes and muscle strength. They can ask you to perform certain tasks, such as walking on your heels or toes, to determine what is causing your pain.

Your doctor can recommend imaging tests to look for bone spurs and herniated disks if your pain is serious. You may obtain tests such as:

  • X-ray, which creates images of the inside of the body, is used to look for bone spurs.
  • CT scan, which combines a series of X-rays to provide a more detailed view of the spinal cord and spinal nerves.
  • MRI, which uses radio waves and magnets to create images of your insides to get a detailed look at your back and spine
  • Electromyography (EMG) which uses radio waves and magnets to create images of your insides to get a detailed look at your back and spine

Sciatica Treatment

Most people with sciatica feel better after engaging in self-care activities or using at-home remedies such as:

  • Using cold or hot packs
  • Stretching
  • Using over-the-counter pain relievers

However, if your pain does not improve, your doctor may suggest other options.

Medication

Your doctor may advise you to take a variety of medications, including:

  • Anti-inflammatories
  • Anti-seizure medications
  • Muscle relaxants
  • Narcotics
  • Tricyclic antidepressants

Physical therapy

A physical therapist can show you how to perform exercises that will improve your posture and flexibility. They will also strengthen the muscles that support your back.

Steroid injections

Your doctor may advise you to get steroid injections, such as a cortisone shot. They’ll give you a shot containing medicine to reduce inflammation around the nerve, which will help you feel better. The effects typically last a few months, but they will fade over time.

Surgery

If you have severe pain that does not go away, weakness, or loss of bladder or bowel control, your doctor may advise surgery. They’ll remove the bone spur or herniated disk that’s putting pressure on your nerves and causing pain.

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