Do you feel a sharp, knifelike pain radiating down your leg or an ache in your lower back? It may be sciatica. Learn what may be causing the pain and what you can do about it.
Make no mistake — when sciatica strikes, the symptoms can be unbearable. Its hallmarks are pain, numbness, tingling or even weakness in your leg. It’s not a medical condition in itself, though; it’s symptomatic of an issue in your back that’s putting pressure on or damaging your sciatic nerve.
“Sciatica is the medical term for a pinched nerve in the back, which causes pain to radiate down the buttocks, leg and foot,” says Raymond J. Hah, MD, a spine surgeon at Keck Medicine of USC and assistant professor of clinical orthopedic surgery at the Keck School of Medicine of USC.
Several things can cause sciatica, like a herniated (slipped) disc, pelvic injury, spinal stenosis or a tumor.
“Arthritic changes, such as a collapsed disc, bone spurs or buildup of arthritic tissue, can also cause sciatica, along with slippage of one vertebral bone over another, which is called spondylolisthesis,” Dr. Hah adds.
What kinds of symptoms does it cause?
The sciatic nerve is the largest nerve in our bodies, stretching from the lower back down to the feet, so there’s a lot of ground to cover. It controls the muscles in the back of the knee and lower leg and delivers sensation from the backs of the thighs to the soles of the feet.
Since the nerve covers such a substantial area, your symptoms and where you experience them can vary widely, from pain in your hip to numbness in the back of your leg.
“You may feel pain only, or it may be accompanied by other symptoms, such as weakness, numbness or tingling,” Dr. Hah says.
Sciatica typically occurs on only one side, and the intensity of your symptoms may increase under certain conditions, such as if you’ve been standing or sitting for a while, when you laugh, sneeze or cough or at particular times of the day.
How can I find relief?
Since it may hurt to walk or exercise, you might want to rest, but sciatica is not a free pass to spend quality time on the couch. Keep moving, even if it’s at a slower pace. Movement is essential to your recovery.
“Ice or heat can help with some of the muscular back pain that accompanies sciatica but is not likely to address the nerve pain itself,” Dr. Hah says. “For that, gentle stretches and nonimpact exercise can be helpful. As with all things, however, your pain should be your guide. If your symptoms worsen at all, then your exercise regimen should be supervised by a physician or physical therapist.”
The primary solution to sciatica is to figure out what’s causing it. A herniated disc is a common culprit; this is when part of the cushiony disc between two vertebrae protrudes from the spine and presses on the sciatic nerve.
The good news? Sciatica may resolve itself in a matter of weeks — no intervention needed. In fact, according to the American Academy of Orthopaedic Surgeons, 80% to 90% of people who have sciatica get better within that time frame, without surgery.
“Sciatica is typically treated with a short period of activity modification and rest, anti-inflammatory medications or steroids, and physical therapy,” Dr. Hah says. “If the pain is severe or continues to persist, then sometimes epidural injections of steroids are used to further decrease inflammation. If these don’t succeed in relieving the pressure from the compressed nerve, surgery may be necessary.”
If your symptoms are severe, recur often, are accompanied by neurologic deficits, such as loss of balance or vision changes, or do not resolve with appropriate care, “have an evaluation by a specialist,” Dr. Hah advises. “Timely diagnosis and treatment can bring relief.”