Sciatica

What is sciatica?

Sciatica is a form of low back pain that runs down your leg, causing pain, numbness, or tingling in the leg.

How does it occur?

The sciatic nerve is formed by a group of nerves that run from the lower spine down the leg to the foot. Anything that causes irritation along the course of the nerve can cause sciatica. The most common causes are:

overuse of your back (lifting something that is too heavy or doing work that uses your back much more than you are used to)
injury to your back (slipping and falling, or having something hit your back).

Overuse or injury can cause muscle tension or spasm, back sprains, ligament or muscle tears, or joint problems, all of which can irritate the sciatic nerve.

Low back pain and sciatica can also be caused by infections, tumors, a ruptured disk in your back, osteoporosis, spondylosis (hardening and stiffening of the spine), or spinal stenosis (narrowing of the spinal canal from bone or soft tissue).

What are the symptoms?

The main symptom is pain that shoots down from the lower back and buttocks to your leg.
You may also have numbness or tingling in your leg.
Sometimes your leg muscles are weak.

How is it diagnosed?

Your health care provider will ask about your symptoms and examine your back. If your provider thinks you might have an infection or a bone disease, you may have some lab tests or x-rays, a CT scan, or an MRI. Most people do not need x-rays or other types of scans in the early part of their treatment. If the pain does not get better in a few weeks, or if the symptoms get worse, then special tests may be needed

How is it treated?

Most people with low back pain and sciatica get better no matter what they do.

Often, nonprescription medicines for pain and inflammation, such as aspirin, ibuprofen, or naproxen, can ease the pain. Talk to your health care provider about whether you should take these medicines.

Your provider may prescribe stronger pain medicine or other types of medicines. Your provider may prescribe oral steroids or you may be given a steroid shot into your spine to control pain and inflammation.

Ice packs or a heating pad may help reduce pain. (Do not sleep on a heating pad because it could cause burns.) Your provider may also suggest physical therapy. A program of gentle exercise may speed your recovery.

If you continue to have symptoms, you may need to have surgery. However, most people who have herniated disks do not need surgery.

How long will the effects last?

People who have sciatica with back pain recover more slowly than people with other kinds of back pain. However, you will probably begin feeling better within a few days of a back strain or injury if you don't strain your back again and if you take some medicine for pain and inflammation. Often the pain is gone in a week or two.

Contact your provider right away if:

You have numbness or tingling in the inner part of your thighs (in a saddle distribution).
You have any new or increasing weakness in your legs.

Call your health care provider for a follow-up appointment if:

The pain is not getting better.
You have new symptoms.

How can I take care of myself?

If you have low back pain and sciatica, make sure you do not overuse your back. Strict bed rest is no longer recommended. It is better to do your usual activities but:

Avoid lifting more than 5 pounds.
Avoid frequent bending or other activities that make the pain worse.

How can I help prevent sciatica?

If you have had back pain and sciatica, you are likely to get it again. To help prevent it in the long term:

Lose weight if you are overweight.
Do regular aerobic exercise to keep your back and abdominal muscles in shape (this can be as simple as walking),
Learn to lift properly. Bend your knees and hips and keep your back straight when you lift a heavy object.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIA File BRN3425F.HTM Release 9.0/2006