Sciatica

Definition

Sciatica refers to pain, weakness, numbness, or tingling in the leg. It is caused by injury to or pressure on the sciatic nerve. Sciatica is a symptom of another medical problem, not a medical condition on its own.

Alternative Names

Neuropathy - sciatic nerve; Sciatic nerve dysfunction; Low back pain - sciatica

Causes

Sciatica occurs when there is pressure or damage to the sciatic nerve. This nerve starts in the lower spine and runs down the back of each leg. This nerve controls the muscles of the back of the knee and lower leg. It also provides sensation to the back of the thigh, part of the lower leg, and the sole of the foot.

Common causes of sciatica include:

Symptoms

Sciatica pain can vary widely. It may feel like a mild tingling, dull ache, or burning sensation. In some cases, the pain is severe enough to make a person unable to move.

The pain most often occurs on one side. Some people have sharp pain in one part of the leg or hip and numbness in other parts. The pain or numbness may also be felt on the back of the calf or on the sole of the foot. The affected leg may feel weak.

The pain often starts slowly. It may get worse:

Exams and Tests

The health care provider will perform a physical exam. This may show:

Tests are often not needed unless pain is severe or long-lasting. If tests are ordered, they may include:

Treatment

Because sciatica is a symptom of another medical condition, the underlying cause should be identified and treated.

In some cases, no treatment is required and recovery occurs on its own.

Conservative treatment is best in many cases. Your doctor may recommend the following steps to calm your symptoms and reduce inflammation.

Measures to take care of your back at home:

If these measures do not help, your doctor may recommend injections to reduce inflammation around the nerve. Other medicines may be prescribed to help reduce the stabbing pains of sciatica.

Physical therapy may also be recommended. Additional treatments depend on the condition that is causing the sciatica.

Nerve pain is very difficult to treat. If you have ongoing problems with pain, you may want to see a neurologist or a pain specialist to ensure that you have access to the widest range of treatment options.

Outlook (Prognosis)

Often, sciatica gets better on its own. But it is common for it to return.

More serious complications depend on the cause of sciatica, such as slipped disc or spinal stenosis.   

When to Contact a Medical Professional

Call your doctor right away if you have:

Also call if:

Prevention

Prevention varies, depending on the cause of the nerve damage. Avoid prolonged sitting or lying with pressure on the buttocks.

References

Chou R, Qaseem A, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007;147:478-491.

Chou R, Qaseem A, Owens DK. Diagnostic imaging for low back pain: advice for high-value health care from the American College of Physicians. Ann Intern Med. 2011;154:181-189.

Chou R, Atlas SJ, Stanos SP, Rosenquist RW. Nonsurgical interventional therapies for low back pain: a review of the evidence for an American Pain Society clinical practice guideline. Spine. 2009;34:1078-93.