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Sciatic Nerve Pain (Sciatica) Overview: Symptoms, Treatment, Outlook

Published February 26, 2021
| Written By SpineNation Editorial Staff   | Medically Reviewed by Theresa Marko, PT, DPT, MS

What is Sciatic Nerve Pain?

Sciatica is the umbrella term used to describe various conditions related to pain, numbness, tingling, burning, or weakness along the path of the sciatic nerve. This nerve runs from the lower back to the hips and down the legs. While sciatica is not a disorder itself, it refers to the symptoms caused by a problem with the sciatic nerve.

Sciatic nerve pain can be caused by many conditions, such as a herniated disc or degenerative disc disease. Sciatic nerve pain often goes away by itself in four to eight weeks, but in some cases may require treatment.

Sciatica_Illiustration_web.jpgSymptoms of Sciatic Nerve Pain

Symptoms of sciatic nerve pain include:
  • Pain, numbness, tingling, burning, or weakness along the path of the sciatic nerve—from the lower (lumbar) back to the hips and buttocks, and along the back of the leg.
  • Pain ranges from mild and achy, to sharp and burning, to severe.
  • Symptoms usually occur only on one side of the body.
  • Symptoms may also occur in the toes or part of the foot.
  • Certain activities can worsen the symptoms, such as walking, sitting for a long time, bending at the waist, sneezing, or coughing.
  • Severe sciatic nerve pain can lead to difficulty walking.

What Causes Sciatic Nerve Pain

Several conditions can cause sciatic nerve pain, including:
  • Herniated (bulging) discs. Spinal discs separate and cushion the bones of the spine (vertebrae). The discs have a jelly-like interior with a tough outer layer. If the outer layer weakens, the inner layer can push outward and press on the sciatic nerve.
  • Osteoarthritis, or degenerative arthritis. This chronic disorder damages the cartilage and tissues surrounding a joint. When this occurs in the joints of the spine, where the nerves exit the spinal column, it can cause irritation or inflammation of the nerves.
  • Spinal stenosis. This condition involves a narrowing of the spaces within the spine, which can put pressure on the nerves that exit the spine.[TM2] 

Less common causes of lower extremity nerve pain include compression of the nerve by:
  • Muscles
  • Bleeding
  • Infections
  • Injuries, such as to the bones of the pelvis.
  • Tumors

Can Sciatic Nerve Pain Happen in Both Legs?

Sciatic nerve pain usually occurs in only one leg at a time. It can happen in both legs, but this is less common. If symptoms occur in both legs, it may be due to another condition, such as degenerative disc disease or a severe condition called cauda equina syndrome.

Risk Factors

Several factors can increase the chance of developing sciatic nerve pain, including:
  • Age. Degenerative, or age-related, spine conditions such as herniated disc, osteoarthritis, and spinal stenosis are more common in older people.
  • Occupation. Jobs that involve sitting for long periods, or repetitive bending or lifting can increase the risk of sciatic nerve pain.
  • Prolonged sitting outside of work.
  • Obesity. Carrying extra weight can put pressure on the spine and the sciatic nerve.
  • History of back injury or surgery.
  • Playing sports that put extra stress on the spine. People who are out of shape may be more likely to develop sciatic nerve pain because of these activities.

Is Sciatic Nerve Pain Common?

Some studies have found that 3.7 percent of women and 5.3 percent of men will have sciatic nerve pain at some point during their life. Other studies, though, suggest as many as 40 percent of people will have sciatic nerve pain at some point. Part of the reason for this variation is because studies may use different definitions of Sciatic nerve pain.


How Sciatic Nerve Pain is Diagnosed

Diagnosis is based on these conditions:
  • Symptoms, physical exam, and medical history.
  • Blood tests may be done if your doctor suspects that you have an infection or a tumor.
  • Imaging tests may be needed if the sciatic nerve pain doesn’t go away on its own. These include X-ray, computed tomography (CT), or magnetic resonance imaging (MRI) of the spine.

Treatment

Treatment depends on its cause and how severe the symptoms are. It may involve:
  • Changing or reducing physical activity. Bed rest, though, is not recommended
  • Physical therapy.
  • Exercises and stretching.
  • Ice and/or cold therapy. Heat or cold should be applied only for 20 minutes or less at a time, with a towel between the skin and the ice or heat pad.
  • Medicines to relieve pain and inflammation, such as nonsteroidal anti-inflammatory drugs (NSAIDs). This category of drugs includes ibuprofen, naproxen, and aspirin.
  • Medicines to relax your muscles. 
  • Steroid injections to reduce inflammation around the sciatic nerve which is causing pain and irritation.
  • Surgery, usually only if other treatments don’t help. This involves treating the underlying cause of sciatic nerve pain, such as a herniated disc or spinal stenosis.

Complications

If the pressure on the sciatic nerve doesn’t decrease or actually increases, complications can occur, such as:
  • Increase in pain
  • Weakness or a loss of feeling in the leg
  • Loss of control over the bladder or bowel
  • Permanent damage to the nerve

Prevention

While sciatic nerve pain is still present, you can take steps to keep it from worsening, such as:
  • Ask your health care provider when you can return to your normal activities or begin an exercise or stretching program.
  • Avoid activities that worsen your symptoms.
  • Take frequent breaks from repetitive activities or prolonged sitting, both at work and during your leisure time. If resting for longer, break up this period with gentle stretching or other activities.
  • Do not lift anything heavier than 10 pounds. When lifting objects from the floor, bend your knees, keep from curling your back forward, and avoid twisting.

Sciatic nerve pain does not usually recur, but you can take steps to keep your spine and sciatic nerve healthy, such as:
  • Maintain a healthy weight.
  • Wear comfortable shoes. Avoid wearing high heels if they bother your back or cause your sciatic nerve pain to return.
  • Sleep on a mattress that supports your back but is not too hard.
  • Follow-up with your health care provider with any concerns. Also, be sure to go to your scheduled appointments.

Outlook

In most cases, lower extremity nerve pain goes away on its own in four to eight weeks. However, sometimes treatments such as physical therapy, pain relief medications, or heat or ice therapy may be needed.

If your pain or other symptoms worsen, keeps you awake at night, or lasts longer than four weeks, contact your health care provider. You should also contact them if you have unexplained weight loss.

Seek medical help right away if you have any of the following symptoms:
  • Loss of control over urination or bowel movements.
  • Increased weakness in your lower back, pelvis, buttocks, or legs.
  • Redness or swelling on your back.
  • A burning sensation while you urinate.

Conclusion

Sciatic nerve pain is pain, numbness, tingling, burning, or weakness along the path of the sciatic nerve. These symptoms can occur from the lower (lumbar) back to the hips and buttocks, and along the back of the leg. Sometimes the foot is also involved.

Sciatic nerve pain isn’t a disorder itself but is caused by other conditions that compress or irritate the sciatic nerve, such as a herniated disc or osteoarthritis. Treatment depends on the severity of the symptoms, but often involves rest, exercise, stretching, pain-relieving or other medications, and heat or ice therapy.
Updated: March 3, 2021
Disclaimer

Information provided within this article is for educational purposes and is not a substitute for medical advice. Those seeking specific medical advice should consult his or her doctor or surgeon. If you need to consult with a specialist, you may be able find a health care provider in our Specialist Finder. SpineNation does not endorse treatments, procedures, products or physicians.


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Contributors and Experts

Theresa Marko, PT, DPT, MS, is a board-certified orthopaedic physical therapist & certified early intervention specialist with over 20 years of experience. She is the owner of Marko Physical Therapy.
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