Sciatica is an irritation of the sciatic nerve. The sciatic nerve leaves the spine in the low back. There is one on the left and one on the right. The nerve travels deep into the pelvis to the lower buttocks. From there, it passes down the back of each thigh. Then, the nerve divides at the knee into branches that go to the feet.
|Sciatic Nerve Pain|
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Sciatica is caused by pressure on the nerve. This can be the result of:
- Herniated disc —the cushions between the bones of the spine bulge and press on the nerve as it exits the spinal column
- Arthritis of the back—swelling in joints of the lower back
- Spinal stenosis —narrowing of the spinal canal in the lower back
- Spondylolisthesis —slippage of a bone in the lower back
- Cauda equina syndrome —nerve roots at the base of the spinal cord are compressed
- Piriformis syndrome—spasm of the piriformis muscle deep in the pelvis/hip
Things that may raise the risk of this problem are:
Personal health factors, such as:
- A history of low back problems
- Anxiety and depression
Job-related factors, such as:
- Heavy manual labor
- Exposure to vibrations
- A job that requires standing for long periods of time and forward bending
Having other health problems, such as:
- Fractures in the back
- Metabolic problems, such as diabetes
The goal of treatment is to reduce sciatic nerve irritation. Choices are:
- Supportive care, such as resting the area for no more than 1 to 2 days and avoiding things that may the pain worse
- Medicines, such as:
- Over the counter and prescription pain relievers
- Muscle relaxants to ease spasms
- Corticosteroids to ease swelling
- Physical therapy to improve strength, flexibility, and range of motion
People who are not helped by these methods may need surgery. It can help ease pressure on the nerve. Choices are:
- Microdiscectomy—part of disc between spinal bones is removed
- Lumbar laminectomy —part of spinal bone is removed
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
Edits to original content made by Denver Health.
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North American Spine Society http://www.spine.org
Ortho Info—American Academy of Orthopaedic Surgeons http://www.orthoinfo.org
Canadian Orthopaedic Association http://www.coa-aco.org
Canadian Orthopaedic Foundation http://www.canorth.org
Deyo RA, Mirza SK. CLINICAL PRACTICE. Herniated Lumbar Intervertebral Disk. N Engl J Med. 2016 May 5;374(18):1763-1772.
Sciatica. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00351. Updated December 2013. Accessed November 15, 2017.
Sciatica. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/sciatica. Accessed January 28, 2021.