Sciatica and MS: Are They Connected?

MS is an autoimmune disorder in which your immune system attacks myelin, the protective layer around nerve fibers. This affects the pathways of your CNS that regulate feeling and sensation in the body.

MS can cause painful sensations, including:

• muscle weakness, muscle stiffness, and muscle spasms
• tingling and numbness, typically on the arms, legs, trunk, or face
• painful limb spasms
• sharp pain shooting down the legs or around the abdomen
• sudden burning or shocking pain affecting the face, especially in people with trigeminal neuralgia
• lower back pain and changes in sensation in the lower limbs, especially in people with spinal cord inflammation (transverse myelitis)

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, habits, or injuries that cause inflammation or that pinch or twist the nerve. Some medical conditions can put pressure on or irritate the sciatic nerve, including:

• herniated disks
• bone spurs
• obesity

People in sedentary occupations who sit for prolonged periods of time are also more likely to show signs of sciatica.

Sciatica can cause symptoms that may include:

• lower back pain that radiates to the lower limbs
• tingling and numbness in the lower back and lower limbs
• pain that worsens when twisting, bending, or coughing

The key difference is that MS causes dysfunction of the CNS’s signaling and pathways. In sciatica, the most common cause is pressure that pinches or irritates the sciatic nerve.

Between 10-40% of people will report sciatic pain at some point in their lives. So it’s not unusual for people with MS to experience sciatica, too.

MS can lead to changes in your body and activity level. Decreased mobility may lead to long periods of sitting, which is associated with sciatica.

People with MS can have peripheral nerve lesions, or damage to the peripheral nerves. Researchers aren’t sure whether the lesions are caused by the inflammation of MS or due to other factors, such as nerve degeneration due to long-term weakness or chronic changes in mobility and position.

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 considered to be one of the only to visualize 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 the severity of the pain and the cause of nerve compression. They include:

• prescription medications, like anti-inflammatories, muscle relaxants, narcotics, tricyclic antidepressants, and antiseizure drugs prescribed off-label for nerve pain, like gabapentin (Neurontin)
• physical therapy to correct posture that may be straining the nerve and to strengthen the support muscles around the nerve
• lifestyle changes, like changes to exercise and stretching, improving your sitting posture, or weight management, if recommended
• cold and hot packs for pain management
• over-the-counter pain relievers
• steroid injections, like corticosteroids
• complementary therapies, such as acupuncture, massage, and yoga
• surgery

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 an interaction with an MS treatment. A 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.

Is sciatica associated with MS?

While recent research has suggested that MS may potentially affect the peripheral nervous system, more studies need to be done to determine a definitive relationship between the two. But if your MS has caused decreased mobility, you may be more likely to develop sciatica due to long periods of sitting or other postural changes.

Does MS cause buttock pain?

MS can cause muscle tightness (spasticity) that can result in cramping and pain. Sciatica can also cause pain that radiates down the back and leg.

Can a pinched nerve be mistaken for MS?

While a pinched nerve and MS can both cause muscle and nerve pain, they have different causes that doctors can test for. A pinched nerve occurs due to compression of a nerve, while MS occurs due to damage to the pathways that regulate your bodily sensations.

What does MS nerve pain feel like?

MS nerve pain can feel like burning, stabbing, sharpness, or squeezing. You can also experience tingling, numbness, and painful muscle spasms.

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 is typically caused by strain or irritation on the sciatic nerve.

A healthcare professional can help you relieve sciatica pain while also taking your MS and its treatments into consideration.