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What Is Sciatica and How Does It Cause Lower Back Pain?
Sciatica is an inflammation of the sciatic nerve, the longest nerve in the body, which runs from the spinal cord across the buttock and hip area and down the back of each leg. Sciatica is actually a secondary symptom of another problem placing pressure upon the nerve, most often a herniated disk. Most prominent among the symptoms of sciatica is pain along the area of the nerve, which may cause considerable discomfort in acute cases. While this pain generally goes away on its own in four to eight weeks or so, it can recur if the underlying problem isn't addressed. In most cases, treatment involves self-help measures to ease the pain. However, in severe cases, doctors may suggest more aggressive treatment.
Sciatica Pain Symptoms
Sciatica is most commonly associated with pain radiating from the lower (lumbar) spine to the buttock and down the back of the leg. Discomfort can occur anywhere along the pathway, though it may be localized to a certain area along the pathway, for example, the back, buttock or calf.
The pain can vary greatly, from mild aches to sharp, burning sensations, or excruciating discomfort. It may feel like a jolt or electric shock. This discomfort can be aggravated by lack of exercise, prolonged sitting, bad posture, improper lifting techniques, or coughing or sneezing. Usually, only one lower extremity is affected.
Complications of the Pain
In more severe cases, sciatica can cause additional symptoms including numbness or muscle weakness along the nerve pathway in the leg or foot. Pain may appear in one part of your leg with numbness in another. Tingling or a pins-and-needles feeling in the toes or part of the foot can also occur.
Although such complications are rare, sciatica can potentially lead to permanent nerve damage including loss of feeling and/or movement in the affected leg. Additionally, extremely rare instances result in a loss of bladder or bowel control: a sign of cauda equina syndrome, a serious condition that requires immediate medical care. Untreated, this syndrome can lead to paralysis of the legs.
Sciatic Nerve Pain Causes
Sciatica pain in the back most frequently occurs as a result of a compressed nerve due to a herniated disk in the lower (lumbar) spine. These disks—pads of cartilage that separate the spinal bones (vertebrae)—keep the spine flexible, acting as shock absorbers to cushion the vertebrae during movement. They consist of a tough, fibrous outer covering with a jelly-like substance in the center.
However, the disks can deteriorate as we age, becoming drier, flatter and more brittle. Eventually, the outer portion of the disk may develop tiny tears, causing the inner material to protrude out (herniate or rupture). The herniated disk may then press on a sciatic nerve, causing pain in your back or leg or both. If the damaged disk is in the middle or lower part of your back, you may also experience numbness, tingling or weakness in your buttock, leg or foot.
In addition to herniated disks, several other conditions can lead to sciatica pain, including:
- Lumbar spinal stenosis, in which one or more areas in the spinal canal narrow, putting pressure on the spinal cord or on the roots of the branching nerves.
- Spondylolisthesis, often the result of degenerative disk disease, occurs when one vertebra slips slightly forward over another vertebra. The displaced bone may pinch the sciatic nerve where it leaves your spine.
- Piriformis syndrome, which causes the piriformis muscle, that runs directly above the sciatic nerve, to tighten or go into spasms.
- Tumors inside the membranes (meninges) that cover the spinal cord or in the space between the spinal cord and the vertebrae, Which can compress the cord itself or the nerve roots as it grows.
- Trauma from a car accident, fall, or blow to the spine.
Risk factors that make it more likely for a person to develop sciatica-related back pain include:
- Age: most herniated disks develop among people who are in their 30s and 40s.
- Pregnancy: due to pressure from the fetus on the spine.
- Occupations requiring frequent twisting and bending; heavy lifting; or driving for long periods.
- Sitting for prolonged periods or an excessively sedentary lifestyle.
- Diabetes, which affects the way your body uses blood sugar and often leads to nerve damage.
How to Get a Diagnosis
Medical treatment is not required for mild cases of sciatica-related lower back pain, which usually goes away with a little time and patience. However, a doctor should be consulted if self-help measures fail to ease the symptoms, or if the pain gets worse and worse or lasts more than four weeks. In addition, immediate medical attention should be sought in cases that include:
- Sudden, severe pain or numbness
- Muscle weakness in the lower back or leg
- Pain following a violent injury, such as a traffic accident
- Trouble controlling the bowels or bladder
When diagnosing sciatica-related pain, doctors attempt to determine which nerves are affected and how severely. This involves reviewing a patient’s medical history and performing a thorough physical exam, emphasizing the spine and legs. Exams may include basic tests of muscle strength and reflexes, such as asking the patient to walk on their toes or heels, stand from a squatting position, or lift their legs one at a time from a prone position. Pain from sciatica will usually worsen when performing these types of movements.
They may also request one or more imaging tests to help identify what is causing pressure on the sciatic nerve and to rule out other possible conditions. These tests may include:
- Spinal X-rays can't detect herniated disk problems or nerve damage, but can help rule out cancers affecting the bony structures of the spine, narrowed disks, spondylolisthesis and other nerve-root impingement as possible causes.
- Magnetic resonance imaging (MRI) uses a powerful magnet and radio waves to produce cross-sectional images of the back. Probably the most effective test for diagnosing sciatica-related lower back pain, MRI tests can detect damage to spinal disks and ligaments and the presence of tumors. An MRI machine; essentially a large magnet with a movable table that the patient lies on; is a noninvasive procedure without any harmful side effects.
- Computerized tomography (CT) scan produces detailed, cross-sectional images of the spine using a narrow beam of radiation. A contrast dye is injected into the spinal canal before the X-rays are taken, causing the spinal cord and spinal nerves to appear white when scanned.
Traditional Treatments for Sciatica Pain
In most cases, sciatica can be treated with self-help measures. Continuing usual activities, while avoiding what may have triggered the pain, may ease symptoms. Resting may also prove beneficial, though excessive inactivity could actually worsen symptoms. Some self-help measures that may help:
- Cold packs may help reduce inflammation and relieve discomfort when applied to the painful areas for at least 15 to 20 minutes.
- Hot packs should be applied to painful areas or alternated with cold packs.
- Stretching the low back for at least 30 seconds can help alleviate pain and relieve nerve-root compression.
- Over-the-counter medications, such as aspirin and ibuprofen, and acetaminophen (Tylenol, others) can be helpful for sciatica-related lower back pain. However, there's a limit to how much pain they can control, and they can cause side effects, including nausea, stomach bleeding, and ulcers.
- Regular exercise. Low-impact exercises such as a stationary bicycle or water exercise can help patients stay active without aggravating the symptoms. Also, once the pain lessens, start aerobic activity with strength training and core exercises to strengthen the back muscles and limit spinal disk degeneration.
In severe cases, doctors may recommend more aggressive treatment.
- Physical therapy typically involves exercises to correct bad posture, strengthen the back muscles and improve flexibility. It can play a vital role in recovery for a herniated disk and help prevent recurrent injuries.
- Prescription drugs such as anti-inflammatory medication or muscle relaxers may be used for short-term pain relief. Tricyclic antidepressants and anticonvulsant drugs may also ease chronic pain, by blocking pain messages to the brain, or enhancing the production of endorphins, which act as natural painkillers.
- Epidural steroid injections suppress inflammation around the irritated nerve and help relieve pain. However, the number of injections you can receive is limited (usually to three per year) by the potential side effects, and therefore injections are only a short-term solution.
- Surgery is usually reserved for cases involving extreme weakness, bowel or bladder incontinence, or pain that gets progressively worse or doesn't improve with other therapies. Lumbar laminectomy and microdiskectomy involve removing the portion of a herniated disk that's pressing on a nerve while leaving as much of the disk intact as possible.
Health care systems, practices, and products outside conventional medicine, known as complementary and alternative medicine (CAM), have proved to be very effective in treating sciatica-related lower back pain.
- Acupuncture is based on the theory that health can be affected by a vital energy called qi (pronounced "chee") which flows throughout the body. It's believed that inserting fine needles into specific points will unblock energy flow and restore qi balance.
- Chiropractic is based on the philosophy that restricted spinal mobility causes pain and loss of function. Chiropractors employ spinal adjustment (manipulation), from different positions; using varying degrees of force, to restore spinal movement and relax muscles.
- Massage can have varying effectiveness depending on the skill of the masseuse, but studies have suggested it can help alleviate sciatica-related lower back pain.
- Hypnosis creates a state of deep relaxation, in which a patient's mind is narrowly focused and open to suggestions that decrease pain sensitivity and increase coping abilities.
An Ounce of Prevention
Some suggestions to help protect your back and prevent sciatica-related pain:
Regular exercise. Pay special attention to your core muscles; muscles in your abdomen and lower back that aid in maintaining proper posture.
Proper posture. Use a comfortable chair that supports your hips, with a seat that doesn't cause pressure on the back of your thighs or knees. When working, adjust your chair so that your feet are flat on the floor and your arms rest on your desk or the chair's arms, with your elbows bent at a right angle. While driving, adjust your seat so your knees are level with your hips and you don't need to stretch your legs out to reach the pedals. Choose a comfortable mattress and pillows that support your head without bending your neck up excessively. When standing for long intervals, try to rest one foot on a raised object or platform, if possible.
Lift properly. When lifting something heavy, bend at your knees, not your back, and lift with your legs. Carry objects close to your body at about waist level. Don't twist at your waist. Instead, turn by pivoting your feet.
Abitbol, Jean-Jacques. “Six Leading Causes of Sciatica.” SpineUniverse.com.
Eidelson, Stewart G. “Sciatica: Treatment Options.” SpineUniverse.com.
U. S. National Library of Medicine, National Institutes of Health. “Sciatica.”
“What You Need to Know About Sciatica.” Spine-health.com.
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
Tracie Jordan on March 30, 2018:
I fell down flight of stairs 4weeks ago I have shooting numbness in legs, hands red can't feel, feet the same now arms numb to elbows legs week jolts of numbness shoot through them, also through middle of body when coughing, breath heavy walk certain ways, can't hold things hands, falling out off balance allot fall when walking allot can't get up inn morning there more
Robert Phillips on November 05, 2017:
This information is the very best I have every read. I took the information to my doctor for him to see. The pictures and information was very helpful for bought me and my doctor.
Thank you Heal Dove for all your help.. for my sciatica has been hurting me for years..
Hassan on August 11, 2017:
Hi, I had sciatica pain since one month but now I m batter then before with some madicen including pain killer I have little numbness my left small portions feet I m worry
Someone advice how it's will complete finish with the time or some more treatment??
Mukhtar Ahmad anjum on January 17, 2017:
Very very helful
Eileen from Western Cape , South Africa on June 29, 2015:
Insightful hub! This is indeed a very painful condition. I had it sorted out with my chiropractor and never had a problem again.
Mary Norton from Ontario, Canada on June 28, 2015:
I will definitely be better at regular exercise as I know that age will make this problem of sciatica even more painful.
Fatahillah from Indonesia on June 28, 2015:
Nice , Post
Medical Centre on June 28, 2015:
The article is very useful, thank you. Good job.
Payal N Naik from Mumbai on June 28, 2015:
Emily Heise on May 11, 2015:
These are all good for the back and body in general. However, I would also recommend to take into consideration the seats you are using. Especially if you are sitting for long hours. Nowadays, there are gel seats that improves back pain and prevent it. Seats like that should be used if you are suffering from chronic back pain.
Roberta Kyle from Central New Jersey on February 09, 2015:
Great article on sciatica. I've struggled with sciatic pain for years and recently tried chiropractic once again not expecting much, but this chiropractor performed miracles and I have been pain free now for months,.... my posture is better and I'm able to exercise more which is just wonderful. A big thumbs up for this one... good job!
Mel on January 04, 2015:
Non traditional treatments are a money grab but to each there own. I tried them all
if you've suffered with true pain that's a burning knife in your knee hip and foot for months on end and praying a surgeon will finally say yes let's do surgery this time you'd go for it.
I'm 135 pd female who had an injury two years ago. Who was told your young. You will heal. Get on with your life. I never made it back to who I was before my injury. I tried to get on with my life as instructed. I ended up not being able to dress myself. To not being able to care for myself. To having my children care for me and not the other way around. I'm 35. All it took was trying to be me again but less then half of what I was before to do this to me. I did physio for a year. I built up core. I did everything they said to do. The fact is that discs don't just go back on there own. You are only prolonging the inevitable. They talked me into spinal decompression. Saying this should work. 20+ sessions later they are all stunned it has not changed one bit.
Don't wait. If they will do surgery grab at it.
I saw two who denied me and it only got worse. Now I'm on a waiting list again. You tell me who is telling my children. The ones who witnessed me passing out from the intense 24hr pain that they won't get the mom back they had two years ago? That if I'm denied again I have lost everything.
stella vadakin from 3460NW 50 St Bell, Fl32619 on October 09, 2014:
Hi, my husband has chronic back pain so I stopped by to read this hub. We are going for a shot of steroids on Monday, but always looking for new treatments.
Angie Shearer from Whangarei, Northland on September 16, 2014:
Wow very informative great read
LADBRN on August 23, 2014:
Great Post. I'm a nurse & have been searching for information on sciatica. I, also have a left total hip replacement. Over the years my right side has been abused by over compensation. 3 weeks ago I started having severe pain in my R lower back, buttock, leg & calf. Wow!
I had my SI joint injected but continue with the sciatica pain. I do have a very stressful, desk job where I am up & down, twist side to side, don't have a chair/desk that fits properly (I'm short & petite). So finding your article has made my day & it all makes sense. Will discuss with doc at my f/u appt. TY
robertdking on October 02, 2012:
good article. lots of useful information
Samuel on May 28, 2012:
I suffered from backpain for last 10 years and advised by doctors for surgery, Just day before surgery I met founder of anandabodh shivchittam. In just 4 sittings he changed my life. Now I am fully cured. Thanks. I will suggest everybody to avoid the surgery. Regards See my experience at www.sciaticacurehub.blogspot.in
SUSANJK from Florida on February 13, 2012:
Exercise has really worked for me. I find that regular exercise is the best cure.
DePuy Pinnacle recall on April 26, 2011:
Knowing about symptoms and treatments for sciatica is important, especially for those with defective Pinnacle hip replacements that are in close proximity to the sciatic nerve and are experiencing chronic pain. Thanks for sharing this information!
Kelly W. Patterson (author) from Las Vegas, NV. on September 23, 2010:
You're very welcome electricsky. I'm glad I could be helpful.
electricsky from North Georgia on September 20, 2010:
Thanks for the information. I will commit it to my memory and maybe see a doctor next time my low back pain flares up and suggest he check me for sciatica.
Kelly W. Patterson (author) from Las Vegas, NV. on September 16, 2010:
I'm glad you enjoyed the hub. I don't know if this quite qualifies for med. school credits, but I'm glad that it is simple and understandable, so that someone who might be suffering from sciatica can find it useful, even if they haven't graduated medical school.
msms on September 15, 2010:
EYEAM4ANARCHY ... This looks like a Medical College Class, yeah, medical knowledge in simple understandable presentation Thanks Mr.YEAM4ANARCHY, sure there was no ANARCHY UMAYBE4 :-)
Kelly W. Patterson (author) from Las Vegas, NV. on July 12, 2010:
You are very welcome wander1!
wander1 on July 12, 2010:
Thanks for a great, informative article!
Kelly W. Patterson (author) from Las Vegas, NV. on July 04, 2010:
Thank you very, very much Mukesh.
Mukesh on July 04, 2010:
Thanks very much for such a useful information for the patients with sciatica.
its really very very useful
Kelly W. Patterson (author) from Las Vegas, NV. on June 08, 2010:
Sounds great, thanks a lot for the complement PC.
Pure Chiropractic from Nanaimo on June 02, 2010:
Wow, very thorough Hub. All the information is spot on. If you don't mind, I'd like to link it to one of mine. We've also put together some educational video on the subject on http://www.purechiro.ca Thanks again!
Kelly W. Patterson (author) from Las Vegas, NV. on July 17, 2009:
There certainly are many different potential causes of back pain and sciatica itself. That first section goes over some of the symptoms that differentiate sciatica from other forms of back pain.
Rob on July 17, 2009:
Actually true sciatica is pretty rare. Everything that is low back and leg pain gets tagged with that diagnosis. The location of the symptoms tells you what nerve levels are involved.
Kelly W. Patterson (author) from Las Vegas, NV. on June 09, 2009:
I'm not a doctor, this article is based on research not any sort of medical training. So, I would rather not advise you on any specifics regarding surgery, but my personal opinion is that surgery should very much be a last resort. In regards to whether surgery would be an option to relieve leg pain, it is a possible option since the sciatic nerve can create pain in the legs.
Moroccan_Hitman on June 09, 2009:
Very Good Information really helping.
I would like to ask what you opinion of surgery as am thinking to go for one in the next few months as I tried just about everything including the latest treatment in england of spine decompression and with no hope in the end.
Please advise what do you thing I should do next and if surgery is an option for getting leg pain I would appriciate if you can advice the best way to go about it
Kelly W. Patterson (author) from Las Vegas, NV. on March 06, 2009:
I appreciate someone who has experience with sciatica treatments saying that.
Tim on March 06, 2009:
One of the best pages on sciatica I've seen. Very informative.
Kelly W. Patterson (author) from Las Vegas, NV. on February 27, 2009:
Thanks a lot Iphi,
I really enjoyed reading your hubs; I appreciate you becoming a fan; and I especially appreciate you linking to this hub on your blog. I'm glad that you enjoyed this hub and, while I'm sorry that your mom is having such trouble, I'm very glad that I was able to provide some helpful information for you.
One bit of advice, when you link to hubs, either in your own hubs or on your blog, you should use the "link to this page" button at the very bottom of the hub. What that does is allow you to insert your tracker into the url. So you actually get 5% of any revenue generated by people clicking the link (page views, sign-ups, etc.). And it comes out of HubPages' cut, so the author still gets their 60%.
Good luck with your writing!
Iphigenia on February 27, 2009:
hello again - just to let you know that I linked to this page on my blog today : http://iphigenia.synthasite.com/
Iphigenia on February 26, 2009:
Hi EYEAM4ANARCHY - first of all thank you for visiting my hubs and commenting - that is a great way for a newbie like me to meet people. So I visited your profile, joined as a fan and voila - found this great hub about sciatica. My mother who is 76 has been diagnosed with sciatica following a fall last August. i never really understood what it was. Because of her age, other health issues and associated medication it has taken a while for the doctors to find appropriate pain relief. The pain has been bad enough - but the combination of having a fall and the on-going long-term pain which has kept her indoors has sapped her confidence. Fortunately, where she lives there is a 'Falls Clinic' for the elderly which offers physiotherapy, counselling about the emotional problems after having a fall, a visit to the home to assess what equipment is needed (mum now has a frame around her toilet, a 'perching stool' for when working at kitchen surfaces etc and a trolley on wheels for transferring hot things safely (drinks, food from over etc) and there a general sociable atmosphere. It is one day a week for 6 weeks and the participants morning coffee, lunch, afternoon tea and biscuits tere are two sessions of one hour each where they play games like scrabble or knit or just chat together. They also get transported there and back in an ambulance/bus. All this is free on the UK's National Health Service.
Anyway, at least I know what sciatica is and I can explain a bit more to her.
Kelly W. Patterson (author) from Las Vegas, NV. on February 05, 2009:
Many thanks Earnest!
earnestshub from Melbourne Australia on February 04, 2009:
Very instructive with clear information. I really like this hub.
Kelly W. Patterson (author) from Las Vegas, NV. on January 21, 2009:
TJ on January 21, 2009: