The sciatic nerve is one of the largest nerves in the body, running from the low back over the hip joint and down the back of the leg to the feet. There are two sciatic nerves, one on the right and the other on the left. Whenever this nerve is subjected to compressive forces (“pinched”) or becomes inflamed (or both), the resulting painful condition is called sciatica.
Compression or inflammation of one or both sciatic nerves causes the pain of sciatica. Sciatica is associated with many things, including:
- Diabetes that can cause nerve damage (diabetic neuropathy)
- Spinal trauma (which might occur during a fall)
- Poor biomechanics (for example, lifting or carrying things incorrectly)
- Prolonged sitting
- Unhealthy lifestyle, such as being too sedentary, tobacco use, unhealthful diet, alcohol abuse, and so on
- Tumoral or infectious pathology
The sciatic nerves can become compressed (pinched) or inflamed or both. If a loss of control of bowel and/or bladder occur, possibly accompanied by difficulty walking, this is a sign of medical emergency. These symptoms are associated with cauda equina syndrome, a serious medical condition that requires emergency care. If you or a family member experiences such symptoms, seek emergency help at once.
The classic sciatica symptom is low back pain that travels through the buttock and down the leg (back of thigh and calf) and sometimes into the foot. Sciatica may occur on one or both sides.
Common symptoms of sciatica include:
- Pain, ranging from a mild ache to a severe sharp pain (the pain may also be of burning or stretching type)
- Electric shock-like pain
- Leg pain aggravated by a cough or sneeze
Sciatica usually heals without treatment and seldom is surgery needed. Depending on the cause of sciatica, treatment may include any or a combination of several of the following:
- Short-term rest
- Physical therapy
- Anti-inflammatory medication
- Muscle relaxant medication
- Epidural injections
Depending on the cause of sciatica, the presence of neurological deficits, the possibility of cauda equina syndrome, i.e., loss of bowel and/or bladder control, or other factors, surgery may be recommended. However, sciatica rarely requires surgical intervention.
Although sciatica can be a painful condition that reduces quality of life, impairs mobility, and decreases flexibility, most sciatica can be effectively treated. In fact, conservative therapies can usually reduce pain and inflammation, and lifestyle modifications may be sufficient to prevent future attacks.
Degenerative conditions associated with aging may be a risk factor for sciatica. Sciatica can also be brought on by a sedentary lifestyle, tobacco use, alcohol abuse, and prolonged sitting. Stress or trauma to the spine may cause sciatica. Individuals with diabetic neuropathy are at special risk for sciatica.
Sciatica is a painful condition that can usually be effectively treated if it is properly diagnosed. Part of treatment will be learning healthy spine habits and making lifestyle changes which may reduce current symptoms and prevent further attacks. Consult with the experts in back pain if you think you may be dealing with sciatica.