Sciatica

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Sciatica is a symptom of a disorder that compresses the sciatic nerve.  The sciatic nerve is one of the largest nerves in your body.  This nerve starts in the lower back and travels downward behind the hip joint, through the buttocks, and along the back of each leg into the feet.

Symptoms

Classic sciatica is low back pain that radiates (travels) through the buttock(s) and down into one or both legs (back of thigh and calf), and sometimes into the foot (or feet).  Common symptoms:

• Pain: mild, ache, sharp, or excruciating
• Electric shock-like pain
• Pain is aggravated by a cough or sneeze
• Sitting increases pain
• Sensations: burning, numbness, tingling, or pins-and-needles
• Muscle weakness
• Loss of bowel and/or bladder control* (rare)

Loss of bowel and/or bladder control may be a symptom of cauda equina syndrome, a serious medical condition.  Seek medical care immediately if you experience a loss of bowel or bladder control.

Video: Lumbar Radiculopathy (Sciatica)
Click below to view a video from our library about this condition.

Causes

• Nerve damage associated with diabetes
• Degenerative spinal disorders
• Spinal trauma
• Poor biomechanics
• Prolonged sitting
• Unhealthy lifestyle: sedentary, tobacco use, poor diet, alcohol abuse

Diagnosis

The diagnosis of sciatica should be made by an expert physician and may include the following.

• Medical History 
  The doctor asks you about symptoms, their severity, when sciatica started, and treatments you tried and results.

• Physical Examination
  The physician examines you for movement limitations, problems with balance, pain.  He tests your reflexes, muscle strength, sensation, and signs of neurologic dysfunction.

• Diagnostic Tests
  An x-ray may be ordered to rule out a serious diagnosis, such as herniated disc or spinal fracture.

Non-operative Treatment

Sciatica often resolves without any treatment.  Therapies that can help resolve sciatica include:

• Short-term rest
• Cold, heat therapy
• Physical therapy
• Medications for pain, inflammation, muscle spasms
• Spinal injections
• Acupuncture
• Massage

Surgical Treatment

Depending on the cause of sciatica, presence of neurological deficit, cauda equina syndrome (e.g., loss of bowel and/or bladder control), or other problem, surgery may be recommended.  Sciatica rarely requires surgical intervention.

Conclusion

Sciatica is a painful condition that can be treated if it is properly diagnosed. Treatment may include learning about biomechanics, lifestyle changes, and prevention.