Sciatica: Symptoms, diagnosis and 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 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:
- Pain in the buttock or leg that is worse when sitting
- Burning or tingling down the leg
- Weakness, numbness, or difficulty moving the leg or foot
- A constant pain on one side of the buttock
- A shooting pain that makes it difficult to stand up
Sciatica usually affects only one side of the lower body. Often, the pain extends from the lower back all the way through the back of the thigh and down through the leg. Depending on where the sciatic nerve is affected, the pain may also extend to the foot or toes.
For some people, the pain from sciatica can be severe and debilitating. For others, the pain from sciatica might be infrequent and irritating, but has the potential to get worse.
Seek immediate medical attention with any symptoms of progressive lower extremity weakness and/or loss of bladder or bowel control.
What causes sciatica?
Sciatica is caused by irritation of the sciatic nerve. A 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)
- Spondylolisthesis (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 warranted if the sciatic nerve pain is severe and has not been relieved with appropriate manual or medical 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.