Sciatica

Sciatica refers to pain that radiates along the path of the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg. Typically, sciatica affects only one side of your body.

Sciatica most commonly occurs when a herniated disk, bone spur on the spine or narrowing of the spine (spinal stenosis) compresses part of the nerve. This causes inflammation, pain and often some numbness in the affected leg.

Although the pain associated with sciatica can be severe, most cases resolve with non-operative treatments in a few weeks. People who have severe sciatica that’s associated with significant leg weakness or bowel or bladder changes might be candidates for surgery.

 

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 and down through the leg.

Some combination of the following symptoms is 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 and 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.

Pain may be made worse by prolonged sitting, standing up, coughing, sneezing, twisting, lifting, or straining. Treatment for sciatic pain ranges from hot and cold packs and medications to exercises and complementary and alternative remedies.

Medications can offer relief of pain from Sciatica

Over-the-counter pain relievers such as acetaminophen, aspirin, or NSAIDs (such as ibuprofen [Advil, Motrin], ketoprofen, or naproxen [Aleve])
Prescription muscle relaxants to ease muscle spasms
Antidepressants for chronic low back pain
Prescription pain medications for more severe pain

In some cases, a steroid medication is injected into the space around the spinal nerve. Research suggests these injections have a modest effect when irritation is caused by pressure from a herniated, or ruptured, disc.

Surgery for Sciatica

If pain from sciatica persists for at least six weeks despite treatment, you may be referred to a specialist. At that point, surgery may be an option. The goal for surgery is to remedy the cause of the sciatica. For example, if a herniated disc is putting pressure on the nerve, then surgery to correct the problem may relieve sciatica pain.

If sciatica symptoms are severe or become progressively worse, then immediate referral to a specialist is necessary.

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