Lybrate Logo
Get the App
For Doctors
Login/Sign-up
Last Updated: Aug 29, 2019
BookMark
Report

Sciatica Pain - Causes, Symptoms and Treatment

Profile Image
Dr. Ritesh KharnalPhysiotherapist • 20 Years Exp.Master in physiotherapy, BPT
Sciatica Pain - Causes, Symptoms and Treatment

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.
Sciatica is not a medical diagnosis in and of itself—it is a symptom of an underlying medical condition, such as a lumbar herniated disc, degenerative disc disease, or spinal stenosis.
Lumbar herniated disc
A herniated disc occurs when the soft inner core of the disc (nucleus pulposus) leaks out, or herniates, through the fibrous outer core (annulus) and irritates the contiguous nerve root.
A herniated disc is sometimes referred to as a slipped disc, ruptured disc, bulging disc, protruding disc, or a pinched nerve. Sciatica is the most common symptom of a lumbar herniated disc.
Degenerative disc disease
While disc degeneration is a natural process that occurs with aging, for some people one or more degenerated discs in the lower back can also irritate a nerve root and cause sciatica.
Degenerative disc disease is diagnosed when a weakened disc results in excessive micro-motion at that spinal level, and inflammatory proteins from inside the disc become exposed & irritate the nerve root(s) in the area.
Lumbar spinal stenosis
This condition commonly causes sciatica due to a narrowing of the spinal canal. Lumbar spinal stenosis is related to natural aging in the spine and is relatively common in adults over age 60.
The condition typically results from a combination of one or more of the following: enlarged facet joints, overgrowth of soft tissue, and a bulging disc placing pressure on the nerve roots, causing sciatica pain.
What are the symptoms of Sciatica?
Usually, sciatica only affects one side of the lower body and the pain often radiates from the lower back all the way through the back of the thigh & down through the leg.
Some combinations of the following symptoms are most common:
Lower back pain, if experienced at all, is not as severe as leg pain
Constant pain in only one side of the buttock or leg, but rarely both the right and left sides
Pain that originates in the low back or buttock and continues along the path of the sciatic nerve - down the back of the thigh and into the lower leg & foot
Pain that feels better when patients lie down or are walking, but worsens when standing or sitting
Pain that is typically described as sharp or searing, rather than dull
Some experience a "pins-and-needles" sensation, numbness or weakness, or a prickling sensation down the leg
Weakness or numbness when moving the leg or foot
Severe or shooting pain in one leg that may make it difficult to stand up or walk
Depending on where the sciatic nerve is affected, the pain and other symptoms may also include foot pain or pain in the toes.
What is the treatment for Sciatica Pain?
The goals of non-surgical sciatica treatments are to relieve pain and any neurological symptoms caused by a compressed nerve root. There is a broad range of options available for sciatica treatment. One or some combination of the treatments below are usually recommended in conjunction with specific exercises.
Heat/Ice
For acute sciatic pain, heat and/or ice packs are readily available and can help alleviate the leg pain, especially in the initial phase. Usually ice or heat is applied for approximately 20 minutes, and repeated every two hours. Most people use ice first, but some people find more relief with heat. The two may be alternated. It is best to apply ice with a cloth or towel placed between the ice and skin to avoid an ice burn.
Pain Medications
Over-the-counter or prescription medications are often effective in reducing or relieving sciatica pain. Non-steroidal anti-inflammatory drugs or oral steroids can reduce the inflammation that is usually part of the cause of the pain.
Alternative sciatica treatment
In addition to standard medical treatments, several alternative treatments have also been shown to provide effective sciatica pain relief for many patients. Three of the more common forms of alternative care for sciatica include chiropractic manipulation, acupuncture, and massage therapy.
Chiropractic/manual manipulation
Spinal adjustments and manual manipulation performed by appropriately trained health professionals, such as chiropractors and osteopathic physicians, are focused on providing better spinal column alignment, which in turn should help to address a number of underlying conditions that can cause sciatic nerve pain.
Acupuncture
The practice is centered on the philosophy of achieving or maintaining well being through the open flow of energy via specific pathways in the body. Hair-thin needles (that are usually not felt) are inserted into the skin near the area of pain.
Massage therapy
Certain forms of massage therapy have been shown to have a number of benefits for back pain, including increased blood circulation, muscle relaxation, and release of endorphins (the body’s natural pain relievers).
Sciatica Surgery
Typically, it is reasonable to consider surgery for sciatica in the following situations:
Severe leg pain that has persisted for 4 to 6 weeks or more
Pain relief that is not achieved after a concerted effort at non-surgical sciatica treatments, such as one or a combination of oral steroids, non-steroidal anti-inflammatory medication, manual manipulation, injections, and/or physical therapy
The condition is limiting the patient’s ability to participate in everyday activities
Urgent surgery is typically only necessary if the patient experiences progressive weakness in the legs, or sudden loss of bowel or bladder control, which may be caused by cauda equina syndrome.
Depending on the cause and the duration of the sciatica pain, one of two surgical procedures will typically be considered:
A microdiscectomy (or small open surgery)
A lumbar laminectomy (an open decompression)
chat_icon

Ask a free question

Get FREE multiple opinions from Doctors

posted anonymously
doctor

Book appointment with top doctors for Leg Pain treatment

View fees, clinc timings and reviews
doctor

Treatment Enquiry

Get treatment cost, find best hospital/clinics and know other details