The sciatica nerve is the longest single nerve in the body, running from each side of the spine through the buttock, into the back of each thigh and down to the foot. The nerve plays a critical role in connecting the spinal cord to the leg and foot muscles.
Any type of pain felt along this nerve is called sciatica.
What is Sciatica Pain?
Sciatica pain refers to pain or neurological symptoms that affect the sciatica nerve. While pain is the most common symptoms, some people may also experience weakness, numbness and tingling.
Most people call this sciatica, although this is not technically a medical diagnosis. Sciatica pain is really just a symptom of an underlying medical condition.
An estimated 40% of people will experience sciatica pain in their lifetime, and the risk grows as you age.
Sciatica is rare in people under the age of 20 and is more likely to affect middle-aged adults between the ages of 40 and 50.
What Causes Sciatica?
Sciatica is usually caused by compression of a spinal nerve in the lower back. A number of back issues can cause sciatica pain, but it most commonly occurs when the L5 or S1 nerve in the lower spine becomes irritated by a herniated disc.
The nerve roots that form the sciatica nerve are extremely sensitive. The inner portion of a herniated or extruding disc contains a protein that can easily irritate or inflame the nerve.
Sciatica is also more common in:
- Obese adults
- People over the age of 20
- Sedentary adults
- People with piriformis syndrome
- People with osteoarthritis
Certain medical conditions, primarily back issues, can cause sciatica, including:
- Isthmic spondylolisthesis
- Degenerative disc disease
- Piriformis syndrome
- Lumbar spinal stenosis
- Sacroiliac joint dysfunction
Other less-common conditions that can cause sciatica include:
- Spinal tumors
- Ankylosing spondylitis
- Muscle strain
- Scar tissue
What are the Symptoms of Sciatica?
Sciatica pain can be debilitating, but for some, the symptoms are infrequent and irritating. Typically, the condition only affects one side of the body, where pain radiates from the lower back down through the thigh and leg.
Sciatica can cause the following symptoms:
- Pain that radiates from the lower back or buttock down through the leg and foot.
- Constant pain on one side of the leg or buttock (rarely in both sides).
- Pain the toes, which makes it difficult to stand up or walk.
- Pain that feels better when walking or laying down and worsens when standing or sitting.
- Weakness or numbness when moving the foot or leg.
- Numbness, weakness, or a “pins and needles” sensation along the leg.
- Sharp or searing pain.
Symptoms may become more intense during sudden movements, such as coughing, sneezing or changing positions (e.g. standing to sitting).
Sciatica sounds painful (and it is), but here’s the good news: the majority of people will feel better within a few weeks or months. Most people experience relief without surgical treatment.
For some people, the pain from a pinched nerve in the leg can be debilitating. In this case, surgery may be required.
But most people start to feel better after making lifestyle changes.
Over-the-counter pain medications are often very effective at relieving sciatica pain. NSAIDs can reduce inflammation, which is usually partly to blame for the pain.
A doctor may also prescribe narcotic medications or muscle relaxants if the pain does not subside with NSAIDs. These are typically prescribed for the short-term (up to two weeks).
For acute pain, heat and ice packs can provide some relief. Heat or ice should be applied for 20 minutes at a time and repeated every two hours. Heat or ice can be used, or you can alternate between the two.
For those who experience pain while sitting, specially-designed sciatica cushions can help provide relief.
These cushions are designed to take pressure off of the coccyx, which can cause spinal disc compression. Alleviating pressure on the discs can provide pain relief and minimize inflammation, one of the root causes of the condition.
Acupuncture is an alternative form of treatment that is designed to improve the flow of energy (or qi) through the body. Thin, small needles are placed along certain energy points on the body, typically near the area of the pain.
The U.S. FDA has approved acupuncture as a treatment for back pain. The National Institutes of Health also recognizes acupuncture as an effective treatment for back pain.
Massage therapy can help improve sciatica pain by improving blood flow and relaxing the body. It also helps the body release endorphins, which are natural pain relievers.
Physical Therapy and Exercise
In cases where sciatica pain is ongoing, exercise and physical therapy may be recommended. Sciatica exercises focus on a few important areas:
For strength training, the focus is not only on the lower back but also on the buttock, hip and abdominal muscles. Strong core muscles can automatically provide relief, as they support the spine and keep it in proper alignment.
Stretching in and of itself can provide pain relief while improving flexibility and reducing the changes of a future flare-up. Hamstring stretches are great for alleviating sciatica pain, as this is often the area that is most painful.
Low-impact cardiovascular exercise, such as swimming, walking and pool therapy, will help improve blood flow and allow the body to release endorphins (natural pain killers).
Sciatica sufferers have a number of treatment options available to them. A doctor can help determine the most effective course of action to alleviate pain.