Sciatica is a specific kind of pain caused by pinching or damage to the sciatic nerve. This nerve extends from the lower back, through the hips and buttocks, and splits down both legs. The pain sensation radiates across the nerve, but the frequency and severity varies.
Pain, especially neuropathic pain, is a common symptom in people living with multiple sclerosis (MS). It results from damage to the nerves of the central nervous system and can lead to burning or a sharp, stabbing sensation.
Understandably, people with MS who also experience sciatica may think it’s rooted in their MS.
But most of the neuropathic pain of MS is limited to the central nervous system, which doesn’t involve the sciatic nerve. Pain associated with MS also has different causes and mechanisms than sciatica.
Still, MS and sciatica can exist together. Some of the daily difficulties associated with living with MS coincide with suspected causes of sciatica. The current understanding, though, is that the two are mostly unrelated conditions.
MS is an autoimmune disorder in which your immune system attacks myelin, the protective layer around nerve fibers. This affects the pathways of your central nervous system that regulate feeling and sensation in the body.
MS can cause a variety of painful sensations, including:
- muscle spasms
- feelings of burning, tingling, or aching in lower legs
- shock-like sensations traveling from your back toward your lower limbs
Most of these painful sensations result from short circuiting of the brain’s neural pathways.
Sciatica is a bit different. Its pathway isn’t an autoimmune response, but bodily stressors on the sciatic nerve itself. This pain is usually caused by lower body changes or habits that pinch or twist the nerve.
Herniated disks, bone spurs, and obesity can put pressure on the sciatic nerve. People in sedentary occupations who sit for prolonged periods of time are also more likely to show signs of sciatica.
The key difference is that MS causes dysfunction of the central nervous system’s signaling and pathways. In sciatica, the most common cause is pressure that pinches or strains the sciatic nerve.
Approximately 40 percent of Americans will report sciatic pain at some point in their lives. So, it’s not unusual that people with MS may experience sciatica, too.
Also, MS can lead to changes to your body and activity level. Decreased mobility may lead to long periods of sitting, which is associated with sciatica.
There is some evidence that the lesions that are a sign of MS damage can extend to the sciatic nerve.
One 2017 study compared 36 people with MS to 35 people without MS. All of the participants underwent magnetic resonance neurography, an advanced technology for obtaining high-resolution images of nerves. The researchers found that the people with MS had slightly more lesions on the sciatic nerve than those without MS.
This study is one of the only to demonstrate peripheral nervous system involvement in people with MS. Some experts believe this research can change the way doctors diagnose and treat MS. But more research is necessary to truly understand the involvement of the peripheral nervous system, including the sciatic nerve, in people with MS.
It may be difficult to differentiate the types of pain you’re experiencing. Sciatica is unique in that the sensation seems to move from your lower spine to your buttocks and down the back of your leg, as if traveling the length of the nerve.
Also, people with sciatica often feel it in only one leg. The pinch causing the pain is usually only on one side of the body.
Treatments for sciatica vary according to severity. They include:
- medications, like anti-inflammatories, muscle relaxants, narcotics, tricyclic antidepressants, and antiseizure medications
- physical therapy to correct posture that may be straining the nerve and strengthen the support muscles around the nerve
- lifestyle changes, like more exercise, weight loss, or better sitting posture
- cold and hot packs for pain management
- over-the-counter pain relievers
- steroid injections, like corticosteroids
- acupuncture and chiropractic adjustment
Surgery is usually reserved for cases with loss of bowel or bladder control or lack of success with other therapies. In situations where a bone spur or herniated disk is pinching the sciatic nerve, surgery may also be necessary.
Certain medications may cause a negative interaction with an MS treatment. Your doctor can help you determine which treatments are right for you. They can also help you come up with an exercise plan that matches your abilities.
It’s easy to mistake sciatica as a symptom or related condition of MS, which often causes neuropathic pain. But while the two do coexist, sciatica isn’t caused by MS. It’s caused by strain on the sciatic nerve.
Thankfully, there are many remedies for sciatica. Your healthcare provider can point you to treatments to alleviate sciatica pain while also taking your MS and its treatments into consideration.