Sciatica is a troublesome condition that causes pain due to damage, pressure, or inflammation of the sciatic nerve. The sciatic nerve is the largest in the body, starting from the lower back and extending down each leg to the heels. It plays a crucial role in motor and sensory functions, helping you move your muscles and feel sensations in your legs.
When the sciatic nerve gets hurt or disturbed, it can lead to pain, a burning feeling, or tingling sensations, sometimes described as “pins and needles,” beginning in the buttocks and moving down the leg. Occasionally, some individuals might notice weakness in the affected leg.
Even though sciatica is painful, it often improves on its own within four to six weeks. If it persists, various medical, surgical, and complementary therapies can help ease the discomfort. It’s important to note that people often misuse the term sciatica for any lower back pain or leg pain, but it specifically refers to symptoms caused by compression or irritation of the sciatic nerve.
The classic sign of sciatica is pain on one side of the lower back that shoots down the leg on the same side. Some people may also feel pain or burning in the affected buttock. Actions like sneezing, coughing, or certain movements can make the pain worse. Many people experience changes in sensation in the leg, including the foot, which can sometimes be difficult to describe. In rare cases, there might be one-sided leg weakness or a sensation of heaviness.
Sciatica occurs when something irritates the sciatic nerve at its origin in the spine. In older adults, bone spurs and arthritis in the spine are common causes. For those under 40, herniated discs, where the gel-like inner material of the spinal discs pushes out due to damage, are a leading cause. Other conditions can also result in similar sciatica symptoms.
Sciatica is pretty common, affecting 10-40% of people at some point. Some factors can increase your risk of developing it. When diagnosing sciatica, healthcare providers typically start by discussing your symptoms and medical history. They may ask you to perform exercises to assess your mobility and pain level, like squatting and walking on your heels and toes. A straight-leg test might be conducted, where your leg is slowly raised while you’re lying down to pinpoint when and where the pain starts.
Initial imaging like X-rays or MRIs isn’t usually recommended, as it often doesn’t affect treatment plans. Spinal changes can appear in scans even in people without sciatica. Imaging is used in cases where symptoms continue, to identify an underlying cause that might require more aggressive treatment.
Most sciatica cases resolve on their own in four to six months without needing medical intervention. For pain management or if symptoms don’t improve naturally, starting with “conservative management” like light exercise is common. From there, treatments may escalate to prescription medications or surgery. Over-the-counter drugs like NSAIDs (Advil, Tylenol) aren’t recommended. Instead, using hot and cold packs and staying mildly active can help alleviate symptoms. If necessary, pain medications like corticosteroid shots, anticonvulsants, muscle relaxants, and opioids may be prescribed, but their effectiveness varies.
Acupuncture, spinal manipulation, and deep tissue massage are other therapies that may work for some, depending on the cause. Talking to your healthcare provider is advisable if you’re considering these treatments. In some situations, surgery might be an option, though studies indicate similar outcomes over time between surgical and non-surgical interventions.
Genetics can increase the likelihood of developing sciatica, but lifestyle changes can also reduce risk. Consult your healthcare provider if your sciatica isn’t improving to prevent complications. Prolonged sciatic nerve compression can lead to nerve damage, potentially causing cauda equina syndrome. This is a medical emergency where nerve damage affects bladder and sexual function control, leading to permanent loss of function.
The good news is sciatica often resolves on its own within four to six weeks, although it can recur or persist. Talking with your healthcare provider about treatment and lifestyle changes is vital for long-term management and prevention. Walking is beneficial for both treatment and prevention of sciatica. However, avoid staying in one position for too long, and if you have numbness, steer clear of hot packs to prevent burns.
