Sciatica is caused by compression or irritation of the sciatic nerve, which extends from the lower back down to the back of the legs. This area consists of one to five nerves, and provides feeling in the buttocks, lower legs, back of the thighs and the feet. If the sciatic nerve is irritated or inflamed, you can experience pain, weakness and numbness, typically on only one side of the lower body.
Wellness & Prevention
Sciatica can be caused by many conditions, including lumbar spinal stenosis, lumbar disc herniation, pregnancy, degenerative disc disease, obesity, neuromuscular disorders and more. It is not always possible to prevent sciatica. You can decrease your chances of developing the condition by:
- Exercising regularly, paying special attention to your core muscles.
- Practicing good posture, especially when sitting.
- Lifting objects safely (with the legs).
- Avoiding sitting for long periods of time.
- Sleeping on your side or back with a pillow under your knees.
The first step in diagnosing sciatic nerve pain is a physical exam. The physical exam determines strength and reflexes, and is an especially helpful diagnostic method for testing the nerves.
In order to pinpoint the exact diagnosis, physicians may use a range of diagnostic tests following the physical exam:
- X-rays show the bones and tissues located in the back and can help pinpoint any fractures or bone abnormalities.
- Computed Tomography (a CT scan) uses an X-ray machine and computer to take pictures of the legs, thighs and hips.
- A myelogram is the only test that can show nerves in a standing posture. This is important if instability is a suspected symptom. This procedure involves an X-ray and the injection of a dye.
- Nerve conduction tests monitor how nerves near the surface of the skin and in related muscles respond to electrical stimulation. Small electrodes are placed on areas near the buttocks and legs for the most accurate readings.
- An electromyography (EMG) test measures muscle and nerve function. It uses electrodes to measure the electrical activity of the muscles in various situations.
- Magnetic resonance imaging (an MRI scan) uses radio waves and magnetic fields to take photos of the hips, legs and thighs. This tool can show damage in muscles, bones, nerves and blood vessels.
Common sciatica symptoms include:
- Pain in the buttocks area or leg that worsens with standing
- Weakness in the leg, knee or foot
- Numbness or difficulty moving the leg, knee or foot
- Burning or tingling sensation down the leg
- Continuous pain on one side of buttocks
- Pain that makes it difficult to stand up
Depending on which nerve is affected, the type of pain can vary. Sciatica from the L3 nerve root may result in pain and numbness. These symptoms are specifically in the front of the thigh. Someone experiencing this type of sciatica may have trouble getting out of a chair.
Symptoms of sciatica from the L4 nerve root are similar to those in the L3 nerve root. In addition to pain in the front of the thigh, people may experience pain or weakness in the inner thigh, the lower leg and foot area. Much like sciatica from the L3 nerve root, a person with this condition may have trouble getting out of a chair. If diagnosed with sciatica from the L4 nerve root, a person may experience ankle weakness, such as difficulty lifting the foot upward.
Sciatica from the L5 nerve root may reach to the top of the foot and result in pain and weakness of the big toe.
Sciatica from the S1 nerve root can cause pain and weakness in the calf or foot area. A person experiencing sciatica from the S1 nerve root may be unable to walk on tiptoes and suffer from reduced angle reflexes.
Although severe pain can result from sciatica, most cases can be resolved with conservative treatments in just a few weeks. People are usually advised to alleviate pain with medications and practice physical therapy exercises. Certain types of stretching, strengthening and aerobic conditioning can help heal sciatica.
People who continue to suffer from severe sciatica after non-surgical treatments may benefit from surgery to relieve pressure on the affected sciatic nerve. However, it is rare that surgery is necessary to treat sciatica.
In most cases, the sciatic nerve pain will go away after about six weeks of care. To prevent sciatica from recurring, practice good posture and participate in gentle back strengthening exercises like walking or swimming. Always lift objects from a squatting position to avoid straining your back, and avoid sitting for extended periods of time.
Sciatica is a fairly common condition and can recur after healing. The best way to manage sciatic nerve pain is to practice protecting your spine and see your doctor if you begin experiencing symptoms.