Your sciatic nerve begins at your spinal cord, runs through your hips and buttocks, and then branches down each leg.
The sciatic nerve is your body’s longest nerve and one of the most important ones. It has a direct effect on your ability to control and feel your legs. When this nerve is irritated, you’ll experience sciatica.
Sciatica involves a sensation that can manifest itself as a moderate to severe pain in your back, buttocks, and legs. You may also feel weakness, burning or sharp pain, or numbness in these areas.
Sciatica is a symptom caused by an underlying injury to your sciatic nerve or an area that affects the nerve, such as your vertebrae, which are the bones in your neck and back.
When you receive a diagnosis of sciatica, your doctor will likely give you tips for treating your pain. You should continue your daily activities as much as possible. Lying in bed or avoiding activity
You can use ice packs or even use a package of frozen vegetables.
Wrap the ice pack or frozen vegetables in a towel and apply it to the affected area for short intervals several times per day, during the first few days of symptoms. This can help to reduce swelling and ease pain.
You can also use hot packs or a heating pad.
It’s recommended that you use ice during the first couple of days to reduce swelling. After 2 or 3 days, switch to heat. Heat can help relax muscles in the back, which can spasm when an injury occurs. If you continue to have pain, try alternating between ice and heat therapy.
Gently stretching your lower back can also be helpful. To learn how to stretch properly, get one-on-one physical therapy or even yoga instruction from a physical therapist or instructor trained to deal with your injury, if it’s available.
You may also look for free videos online to help you find the proper stretches. Make sure to consult with a medical professional first before starting a stretching routine.
Over-the-counter medications, such as aspirin and ibuprofen, can also help with pain, inflammation, and swelling. Be careful about using aspirin excessively, since it could cause complications, such as stomach bleeding and ulcers.
The more you stay active, the more endorphins your body releases. Endorphins are pain relievers made by your body. Stick to low impact activities at first, such as swimming and stationary bicycling.
As your pain decreases and your endurance improves, create an exercise regimen that includes aerobics, core stability, and strength training. A regimen with these components can decrease your risk of future back problems. Always talk with a medical professional before starting a new exercise routine to make sure it is safe for you.
Exercises in physical therapy can help to improve your posture and strengthen your back muscles.
Epidural steroid medication
Corticosteroid medications are injected into an area called the epidural space, which is the canal that surrounds your spinal cord. Because of side effects, these injections are given on a limited basis.
Surgery may be needed for severe pain or situations in which you have lost control of your bowel and bladder or have developed weakness in certain muscle groups of the lower extremity.
The two most common types of surgery are discectomy, in which part of the disc that’s pressing on nerves that make up the sciatic nerve is removed, and microdiscectomy, in which the disc removal is done through a small cut while your doctor uses a microscope.
If you’re experiencing pain that shoots from your lower back through your buttock area and into your lower limbs, it’s typically sciatica.
Sciatica is the result of damage or injury to your sciatic nerve, so other symptoms of nerve damage are usually present with the pain. Other symptoms may include the following:
- pain that gets worse with movement
- numbness, burning, or weakness in your legs or feet along your sciatic nerve pathway, which may become a loss of feeling or movement in severe cases
- sensation of pins and needles, which involves a painful tingling in your toes or feet
- incontinence, the inability to control your bladder or bowels, which is a rare symptom of cauda equina syndrome and calls for immediate emergency attention
Side-lying hip stretch
- Lie on the floor on your right side with your knees slightly bent. Place a pillow underneath your head.
- Slowly slide your left leg (top leg) toward your chest and lower that knee to the floor.
- Gently straighten your left leg so the hip and knee align with your bottom leg and lower your leg to the floor.
- Repeat 3 times.
- Switch sides and repeat with right leg on top.
Back-lying hip flexor stretch
- Lie on the floor on your back with your knees bent and feet flat on the floor.
- Raise both knees toward your chest.
- Bring your right knee close to your chest, clasping your arms around it.
- Slide your left leg down onto the floor, straightening it as much as possible and trying to touch the floor with the back of your knee.
- Hold the position for 5 seconds.
- Slowly return to the starting position and relax for 4 seconds.
- Repeat with the opposite leg.
- Repeat 3 times, alternating legs.
- Lie on the floor on your stomach with a small pillow under your abdomen.
- Squeeze your buttocks together tightly and hold for 5 seconds.
- Repeat 3 times, working up to 6 repetitions.
Back-lying hip rotation
- Lie on the floor on your back with your legs together, knees bent, and feet flat on the floor.
- Gently lower your knees toward the floor on the right side, keeping them together and keeping your shoulders “glued” to the floor.
- Do not strain or use muscular effort to force your knees to the floor.
- Hold for 15 seconds.
- Return to starting position and relax.
- Repeat on left side.
- Start with 3 reps, alternating sides, working up to 6 reps.
- Lie on the floor on your back.
- Extend your legs and flex your feet upward.
- Bend your right leg over your left leg, placing your right ankle on your left knee.
- Put your hand on your right knee and pull your right leg toward your left shoulder.
- Hold for 30–45 seconds.
- Repeat 3–4 times.
- Switch legs.
Sciatica is a symptom that varies from one person to another and depends on the condition that’s causing it. To diagnose sciatica, your doctor will first want to get your full medical history.
This includes whether you have had any recent injuries, where you feel the pain, and how the pain feels. They’ll want to know what makes it better, what makes it worse, and how and when it started.
The next step is a physical exam to test your muscle strength and reflexes. Your doctor might also ask you to do some stretching and moving exercises to determine which activities cause more pain.
The next round of tests for diagnosis is for people who have dealt with sciatica for longer than a month or have chronic condition, such as cancer.
Nerve tests will allow your doctor to examine how your sciatic nerve is conducting nerve impulses and learn if there are any abnormalities. These tests may help locate the area involved and the degree to which the impulse is being slowed.
Your doctor can get a look at your spine through imaging tests, which will help them determine the cause of your sciatica.
An MRI uses magnets and radio waves to create detailed images of your back. A CT scan uses radiation to create detailed images of your body.
Your doctor may order a CT myelogram. For this test, they’ll inject a special dye into your spine to help produce clearer pictures of your spinal cord and nerves.
If you need help finding a primary care doctor, you can browse doctors in your area through the Healthline FindCare tool.
The following steps can help you prevent sciatica or keep it from occurring again:
- Exercise often. Strengthening your back muscles and your core muscles is the key to maintaining a healthy back.
- Check your posture. Make sure your chairs offer proper support for your back, place your feet on the floor while sitting, and use your armrests.
- Mind how you move. Lift heavy objects in the proper way, by bending at your knees and keeping your back straight.
Complementary medicine is growing in popularity. There are a number of remedies that could potentially help with sciatica pain. These include the following:
- In acupuncture, a practitioner inserts sterilized needles into specific points in your body, which
may help improveyour back pain symptoms.
- A massage therapist can apply motion, pressure, tension, or vibration to your body
to helprelieve pressure and sciatic pain symptoms.
- Ask your doctor for a referral to a specialist who performs biofeedback therapy, a mind-body technique
shown toimprove back pain and chronic pain. This technique uses electrical sensors to help you understand how your body responds to stress and pain.
- Committing to a mindfulness meditation practice may help
reduce your painand increase your quality of life.
Sciatica can be caused by several conditions that involve your spine and can affect the nerves running along your back. It can also be caused by an injury, such as falling, or spinal or sciatic nerve tumors.
Common conditions that can cause sciatica are described below.
Your vertebrae, or spinal bones, are separated by discs made of cartilage. Cartilage is filled with a thick, clear material to ensure flexibility and cushioning while you move around. Herniated discs occur when the first layer of the cartilage rips.
The substance inside can bulge outward or completely spill out of the disc and compress on your sciatic nerve, resulting in lower limb pain and numbness. It’s estimated that
Spinal stenosis is also called lumbar spinal stenosis. It’s characterized by the abnormal narrowing of your lower spinal canal. This narrowing puts pressure on your spinal cord and your sciatic nerve roots.
Spondylolisthesis is one of the associated conditions of degenerative disc disorder. When one spinal bone, or vertebra, extends forward over another, the extended spinal bone can pinch nerves that make up your sciatic nerve.
Piriformis syndrome is a rare neuromuscular disorder in which your piriformis muscle involuntarily contracts or tightens, causing sciatica. This is the muscle that connects the lower portion of your spine to your thighbones.
When it tightens, it can put pressure on your sciatic nerve, leading to sciatica. Piriformis syndrome can worsen if you sit for long periods, fall, or experience a car crash.
Certain behaviors or factors can raise your risk of developing sciatica. The most common factors for developing sciatica
- As your body ages, it becomes more likely that parts will wear out or break down.
- Certain careers place a lot of strain on your back, especially those that involve lifting heavy objects, sitting for extended periods, or twisting movements.
- Having diabetes can increase your risk of nerve damage.
- Smoking can cause the outer layer of your spinal discs to break down.
- Having obesity may also be associated with sciatica.
Seek immediate medical attention if you experience the following symptoms:
- You experience pain after a severe injury or accident.
- You have sudden, excruciating pain in your lower back or leg that’s coupled with numbness or muscle weakness in that same leg.
- You’re unable to control your bladder or bowels.
Cauda equina syndrome
In rare cases, a herniated disc can press on nerves that cause you to lose control of your bowel or bladder. This condition is known as cauda equina syndrome.
It can also cause numbness or tingling in your groin area, decreased sexual sensation, and paralysis if left untreated.
This disorder often develops slowly. It’s important to go to your doctor or an emergency room immediately if the symptoms appear.
The symptoms of this disorder can include:
- an inability to control your bladder or bowels, which can result in incontinence or retention of waste
- pain in one or both of your legs
- numbness in one or both of your legs
- weakness in one or both of your legs, making it hard to get up after sitting
- stumbling when you try to get up
- a noticeable progression or sudden severe loss of feeling in your lower body, which includes the area between your legs, buttocks, inner thighs, heels, and entire foot
Sciatica is a painful sensation that happens when the sciatic nerve is irritated. If you have sciatica, you may feel moderate to severe pain in addition to weakness or numbness in your back, buttocks, and legs. Using hot and cold compresses, stretching, taking over-the-counter pain medications, and regularly exercising may help you manage your pain.
You can also talk with a doctor about physical therapy, prescription medication, steroid medications, and surgery for severe situations. Using complementary treatments alongside medical treatments may provide further relief.