Sciatica is a symptom. It consists of leg pain, which might feel like a bad leg cramp, or it can be excruciating, shooting pain that starts in one place in the leg and then moves to another quickly. This leg pain makes standing or sitting nearly impossible.
The pain might be worse when you sit, sneeze, or cough. Sciatica can occur suddenly or it can develop gradually. You might also feel weakness, numbness, or a burning or tingling (“pins and needles”) sensation down your leg, possibly even in your toes. Less common symptoms might include the inability to bend your knee or move your foot and toes.
Sciatica might be a symptom of a “pinched nerve” affecting one or more of the lower spinal nerves. The nerve might be
pinched inside or outside of the spinal canal as it passes into the leg.
Conditions that cause sciatica:
A complete medical history, including a review of your symptoms, and a physical exam can help the healthcare provider diagnose sciatica and determine its cause. For example, he or she might perform a straight-leg-raise test, in which you lie on your back with your legs straight. The healthcare provider will slowly raise each leg and note the elevation at which your pain begins. This test can help pinpoint the affected nerves and determine if there is a problem with one of your discs.
Other diagnostic tests might be performed to look for other causes of sciatic pain. Depending on what your health care provider finds, he or she might recommend further testing. Such testing might include:
However, most patients with sciatica can be treated without the need for further diagnostic testing.
The goal of treatment is to decrease pain and increase mobility. Treatment most often includes limited rest (on a firm mattress or on the floor), physical therapy, and the use of medicine to treat pain and inflammation. A customized physical therapy exercise program might be developed.
Medicine — Pain medicines and anti-inflammatory drugs help to relieve pain and stiffness, allowing for increased mobility and exercise. There are many common over-the-counter medicines called non-steroidal anti-inflammatory drugs (NSAIDs). They include aspirin, ibuprofen (Motrin, Advil), and naproxen (Naprosyn, Aleve).
Muscle relaxants, such as cyclobenzaprine (Flexeril), might be prescribed to relieve the discomfort associated with muscle spasms. However, these medicines might cause confusion in older people. Depending on the level of pain, prescription pain medicines might be used in the initial period of treatment.
Physical therapy —The goal of physical therapy is to find exercise movements that decrease sciatic pain by reducing pressure on the nerve. A program of exercise often includes stretching exercises to improve the flexibility of tight muscles and aerobic exercise, such as walking.
The therapist might also recommend exercises to strengthen the muscles of your back, abdomen, and legs.
Spinal injections — An injection of a cortisone-like anti-inflammatory medicine into the lower back might help reduce swelling and inflammation of the nerve roots, allowing for increased mobility.
Surgery — Surgery might be needed for people who do not respond to conservative treatment, who have progressing symptoms, and are experiencing severe pain.
Surgical options include:
Many people believe that yoga or acupuncture can improve sciatica. Massage might help muscle spasms that often occur along with sciatica. Biofeedback is an option to help manage pain and relieve stress, which can affect your ability to cope with pain. These are referred to as alternative therapies.
Chronic (ongoing and lasting) pain is a complication of untreated sciatica. If the “pinched nerve” is seriously injured, chronic muscle weakness, such as a “drop foot,” might occur.
Sciatic pain usually goes away with time and rest. Most people with sciatica (80 percent to 90 percent) will get better without surgery. About half of affected individuals recover from an episode within six weeks.
Some sources of sciatica are not preventable, such as degenerative disc disease, back strain due to pregnancy, and accidental falls.
Although it might not be possible to prevent all cases of sciatica, you can take steps to protect your back and reduce your risk.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition.
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