pain, tingling, or numbness produced by an irritation of the nerve roots that
lead to the
sciatic nerve. The sciatic nerve is formed by the
nerve roots coming out of the spinal cord into the lower back. It goes down through the buttock, then its branches extend down the back of the leg to the
ankle and foot.
What causes sciatica?
The most common cause of
sciatica is a bulging or ruptured disc (herniated disc)
in the spine pressing against the nerve roots that lead to the sciatic nerve.
But sciatica also can be a symptom of other conditions that affect the spine,
such as narrowing of the spinal canal (spinal stenosis), bone spurs (small, bony growths that form along joints)
arthritis, or nerve root compression (pinched nerve)
caused by injury. In rare cases, sciatica can also be caused by conditions that
do not involve the spine, such as tumors or pregnancy.
What are the symptoms?
Symptoms of sciatica
include pain that begins in your back or buttock and moves down your leg and
may move into your foot. Weakness, tingling, or numbness in the leg may also
Sitting, standing for a long time, and
movements that cause the spine to flex (such as knee-to-chest exercises) may
make symptoms worse.
Walking, lying down, and movements that extend
the spine (such as press-ups) may relieve symptoms.
In many cases, sciatica will
improve and go away with time. Initial treatment usually focuses on medicines
and exercises to relieve pain. You can help relieve pain by:
Avoiding sitting (unless it is more
comfortable than standing).
Alternating lying down with short
walks. Increase your walking distance as you are able to without
Using a heating pad on a low or medium setting for 15 to 20 minutes every 2 or 3 hours. Try a warm shower in place of one session with the heating pad. You can also buy single-use heat wraps that last up to 8 hours. You can also try an ice pack
for 10 to 15 minutes every 2 to 3 hours. There is not strong evidence that
either heat or ice will help, but you can try them to see if they help
Additional treatment for sciatica depends on what is
causing the nerve irritation. If your symptoms do not improve, your doctor may
suggest physical therapy, injections of medicines such as steroids, stronger medicines such as muscles relaxants or opiates, or even
surgery for severe cases.
American Academy of Orthopaedic Surgeons and American Academy of Pediatrics (2010). Lumbar herniated disc. In JF Sarwark, ed., Essentials of Musculoskeletal Care, 4th ed., pp. 952–956. Rosemont, IL: American Academy of Orthopaedic Surgeons.
Atlas SJ, et al. (2005). Long-term outcomes of surgical and nonsurgical management of sciatica secondary to a lumbar disc herniation: 10-year results from the Maine Lumbar Spine Study. Spine, 30(8): 927–935.
Ellenberg M, Ellenberg MJ (2015). Lumbar radiculopathy. In WR Frontera et al., eds., Essentials of Physical Medicine and Rehabilitation, 3rd ed., pp. 237–243. Philadelphia: Saunders.
ByHealthwise Staff Primary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP - Emergency Medicine E. Gregory Thompson, MD - Internal Medicine Adam Husney, MD - Family Medicine Specialist Medical ReviewerRobert B. Keller, MD - Orthopedics