Sciatica refers to back pain caused by a problem with
the sciatic nerve. This is a large nerve that runs from the lower back down the
back of each leg. When something injures or puts pressure on the sciatic nerve,
it can cause pain in the lower back that spreads to the hip, buttocks, and leg.
Up to 90% of people recover from sciatica without surgery.
Course of Sciatica Pain
Sciatica rarely occurs before age 20, and becomes more
commonplace in middle age. It is most likely to develop around age 40 or 50.
Perhaps because the term sciatica is often used
loosely to describe leg pain, estimates of its prevalence vary widely. Some
researchers have estimated it will affect up to 43% of the population at some
Often, a particular event or injury does not cause
sciatica—rather it tends to develop over time.
The vast majority of people who experience sciatica
get better within a few weeks or months and find pain relief with nonsurgical
sciatica treatment.1 For others, however, the leg pain from a pinched nerve can
be severe and debilitating.
Seeing a doctor for sciatica pain is advised, both for
learning how to reduce the pain and to check for the possibility of a serious
Pain that radiates from your lower (lumbar) spine to
your buttock and down the back of your leg is the hallmark of sciatica. You
might feel the discomfort almost anywhere along the nerve pathway, but it’s
especially likely to follow a path from your low back to your buttock and the
back of your thigh and calf.
The pain can vary widely, from a mild ache to a sharp,
burning sensation or excruciating pain. Sometimes it can feel like a jolt or
electric shock. It can be worse when you cough or sneeze, and prolonged sitting
can aggravate symptoms. Usually only one side of your body is affected.
Some people also have numbness, tingling or muscle
weakness in the affected leg or foot. You might have pain in one part of your
leg and numbness in another part.
Although most people recover fully from sciatica,
often without treatment, sciatica can potentially cause permanent nerve damage.
Seek immediate medical attention if you have:
Loss of feeling in the affected leg
Weakness in the affected leg
Loss of bowel or bladder function
Relief: Ice and Heat
There are steps you can take at home to ease
the pain of sciatica. A heating pad or ice pack may be especially helpful.
Apply the heat or ice for about 20 minutes every two hours. Experiment to see
which provides more relief, or try alternating between the two.
Over-the-counter pain relievers can provide
short-term relief from sciatica. Acetaminophen and nonsteroidal
anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and naproxen are
options. Your doctor may give you a steroid injection to further reduce the
While sciatica is healing, try to remain
active. Motion can actually help reduce inflammation and pain. A physical
therapist can show you how to gently stretch the hamstring and lower back.
Practicing tai chi or yoga can help stabilize the affected area and strengthen
your core. Depending on your medical condition, certain exercises may not be
recommended. Your doctor may also recommend taking short walks.
In severe cases, a doctor may recommend
injecting steroids into the spine area to reduce inflammation. It delivers the
medication directly to the area around the sciatic nerve.
If your sciatica is due to a herniated disk,
and it’s still causing severe pain after four to six weeks, surgery may be an
option. The surgeon will remove a portion of the herniated disk to relieve the
pressure on the sciatic nerve. About 90% of patients get relief from this type
of surgery. Other surgical procedures can relieve sciatica caused by spinal
After back surgery, you will generally need
to avoid driving, lifting, or bending forward for about a month. Your doctor
may recommend physical therapy to help you strengthen the muscles in the back.
Once recovery is complete, there’s an excellent chance you’ll be able to get
back to all your usual activities.
There is evidence that acupuncture, massage,
yoga, and chiropractic adjustments can relieve typical lower back pain. But
more research is needed to determine whether these therapies are helpful for
It’s not always possible to prevent sciatica, and the
condition may recur. The following can play a key role in protecting your back:
Exercise regularly. To keep your back strong, pay
special attention to your core muscles — the muscles in your abdomen and lower
back that are essential for proper posture and alignment. Ask your doctor to
recommend specific activities.
Maintain proper posture when you sit. Choose a seat
with good lower back support, armrests and a swivel base. Consider placing a
pillow or rolled towel in the small of your back to maintain its normal curve.
Keep your knees and hips level.
Use good body mechanics. If you stand for long
periods, rest one foot on a stool or small box from time to time. When you lift
something heavy, let your lower extremities do the work. Move straight up and
down. Keep your back straight and bend only at the knees. Hold the load close
to your body. Avoid lifting and twisting simultaneously. Find a lifting partner
if the object is heavy or awkward
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