Sciatica (sciatic nerve pain) - Symptoms, causes, diagnosis, treatment
Sciatica is a common type of pain caused by compression or irritation of the sciatic nerve.
The sciatic nerve is the longest nerve in the body, going from the pelvis, through the buttocks, down the legs to the feet.
Having a prolapsed disc (also known as a 'slipped disc') in the back is a most common cause of sciatica, but sometimes doctors do not find an obvious cause of the pain.
What are the symptoms of sciatica?
Common symptoms of sciatica include:
The pain may be very painful and debilitating for some people or mild in others. Usually only one side of the body is affected.
What makes sciatica pain worse?
The pain can be worsened or aggravated by:
- Sitting for long periods of time
- Forceful coughing
Seek urgent medical attention if the symptoms worsen causing more weakness, or bladder or bowel control problems.
What causes sciatica?
Sciatica is caused by irritation of the sciatic nerve. A prolapsed disc (‘ slipped disc’) is the most common cause of sciatica.
Additional common causes of sciatica include:
- Lumbar spinal stenosis (narrowing of the spinal canal in the lower back)
- Degenerative disc disease (breakdown of discs, which act as cushions between the vertebrae)
- Spondylolisthesi (a condition in which one vertebra slips forward over another one)
Other things that may make your back pain worse include being overweight, not exercising regularly, wearing high heels, or sleeping on a mattress that is too soft.
In diagnosing sciatica, a doctor will take your medical history and perform an examination of the back, hips, and legs in order to test for strength, flexibility, sensation, and reflexes.
Other tests may include:
- MRI scans
- CT scans
- Nerve conduction studies to determine the health or disease of a nerve
Treatment for sciatica focuses on relieving pressure and inflammation. Typical sciatica treatments include:
- Medical treatments. Anti-inflammatory drugs such as nonsteroidal anti-inflammatory drugs ( NSAIDs) like ibuprofen, or oral steroids, to relieve inflammation.
- Epidural steroid injections. Steroids, with their strong anti-inflammatory effects, are delivered at the origin of the inflamed sciatic nerve roots.
- Physiotherapy. This treatment helps to prevent further episodes of sciatica.
- Surgery. Surgery may be recommended if the sciatic nerve pain is severe and has not been relieved with appropriate non-surgical treatments.
Although sciatica can be very painful, it is rare for the disorder to cause permanent nerve damage. Most sciatica pain syndromes result from inflammation and will usually get better within a few weeks.