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Sciatica: Causes, Treatment, and Symptoms

What are the symptoms of sciatica?

Sciatica is a symptom itself rather than a specific diagnosis. It is the term used to describe any type of shooting pain that begins at the spine and radiates through the buttocks and down the back of the leg and as far as the foot.

Sciatica symptoms can range from a mild nuisance to sharp, shooting pain and discomfort. Symptoms are most often temporary and vary greatly depending on the condition causing sciatica.

Symptoms of sciatica include:

  • Shooting pain that makes it difficult to stand up or move suddenly, which may worsen with cough or sneeze
  • Constant lower back pain or tingling sensation
  • Pain in the rear or one leg that worsens while sitting
  • Hip pain
  • Weakness, numbness, or difficulty moving the leg or foot
  • A minor movement such as bending over to pick something up (trigger for sciatic pain)

In severe cases, patients may lose sensation in the leg and may also have difficulty controlling the bowels and bladder.

What are the common causes of sciatica?

Sciatica is usually the symptom of a pinched nerve affecting one or more of the lower spinal nerves. The nerve might be pinched inside or outside of the spinal canal as it passes through the leg.

Some causes of sciatica include:

  • Herniated or slipped disk: It is the most common cause of sciatica that causes pressure on a nerve root.
  • Piriformis syndrome: Small piriformis muscle, which lies deep in the buttocks, becomes tight and spasms, thus creating pressure and causing irritation to the sciatic nerve.
  • Spinal stenosis: It is narrowing of the spinal canal that puts pressure on the nerves.
  • Spondylolisthesis: It occurs when one vertebra slips so that it is out of line with the one above it, narrowing the opening through which the sciatic nerve exits.
  • Degenerative disk disease: It is caused by the wear and tear and effects of aging on the spine.
  • Osteoarthritis: It is characterized by the formation of bone spurs (bits of protruding bone) that may press the nerve roots. It is mostly seen in older people.
  • Pregnancy: Sciatica is often associated with pregnancy in women.
  • A spinal tumor is rare but may also cause sciatica pain

Severe injury to the spine or back may sometimes compress sciatic nerve leading to lower back pain.

What are the common exercises that may relieve sciatic pain?

Sciatic pain may be sometimes relieved by exercises. Exercises can ease symptoms and muscle tension. Do not perform any exercises without consulting your doctor.

  • Stretching exercises: Stretches for the lower back and buttock muscles are particularly useful. Hold stretches for 20-30 seconds, rest, and repeat the same stretch once or even twice more. 
  • Mobility and strengthening: If sciatica is caused by a lumbar disk prolapse (slipped disk), then extension exercises are recommended to help reduce the compression of the disk on the nerve root. 
  • Core exercises: Core strengthening exercises to strengthen the core muscles of the trunk is a popular option for managing back conditions.

What are the common treatment options for sciatica?

Sciatica can be relieved by treating symptoms and underlying causes, such as a slipped disk. Depending on the underlying cause of sciatica, various treatments and therapies may be recommended, including:

  • Bed rest and frequent changing of the body posture may help in relieving the symptoms.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Advil and Motrin (ibuprofen) and Aleve and Naprosyn (naproxen) help to control inflammation and pain. NSAIDs should only be used as recommended by your physician.
  • Muscle relaxants are prescribed to ease muscle tension and pain.
  • Corticosteroid medications that are generally given through direct injection into the spine may reduce inflammation and pain.
  • Antidepressants are usually prescribed to reduce nerve pain.
  • Non Opioid pain drugs that work at the opioid receptor (Tramadol) are given for the treatment of severe sciatic pain.
  • Short-term opioids may also help in treating sciatica pain.
  • Chiropractic therapies, such as spinal manipulation, electrical stimulation, and trigger-point therapy, are generally recommended for limiting the symptoms.
  • Complementary therapies, such as yogaacupuncture, massage, and biofeedback, are considered to relax the body and nerves.
  • Physical therapy and exercises are prescribed to improve muscle strength in the back and abdomen, increase flexibility and movement, and reduce pain.
  • Surgery may relieve severe pain or solve bowel incontinence, bladder incontinence, or leg weakness. Surgical options include laminectomy or discectomy, both of which relieve pressure on the sciatic nerve.

Sciatica may always recur. To minimize the chances of recurrence, people should exercise regularly, maintain proper posture, and protect the back by bending at the knees to lift heavier objects.

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