Pain from sciatica can significantly impact your quality of life and overall health if not addressed in a timely manner. At the core of the sciatica problem is the sciatic nerve, which extends from the lower back through the hips and buttocks down each leg. Pain associated with the sciatic nerve can manifest anywhere along this nerve pathway, usually radiating from the lower back through the buttock and along the thigh and calf. This pain can range from mild discomfort to sharp, burning sensations.
Sciatic pain causes discomfort that begins in the lower back and spreads through the buttock, down the leg, calf, and sometimes to the foot. Although it can be a disruptive and painful condition, early intervention and lifestyle adjustments can greatly relieve symptoms and improve quality of life.
Sciatica Sciatica is a common condition that refers to leg pain caused by irritation or sensitivity of the nerves traveling from the lower back down the leg. Occasionally, people with sciatica may also experience back pain. While sciatica can be daunting, painful, and affect many aspects of a person’s life, it is rarely serious. Most cases of sciatica tend to resolve without treatment within 6-12 weeks.
Sciatica Symptoms
Sciatica can cause discomfort and pain in the lower back, buttocks, and legs, with pressure on the spinal cord or nerves being the most common cause of this condition.
Sciatic Pain
Sciatic pain occurs when the sciatic nerve, which runs from the lower back down to the foot, becomes irritated or compressed. Symptoms typically improve within 4 to 6 weeks, although in some cases, they may last longer.
How to Recognize Sciatic Pain
If you suffer from sciatic pain, you may feel discomfort in areas such as:
- the buttocks
- the back of the leg
- the foot and toes
The pain may present as:
- sharp, stabbing pain or a sensation similar to an electric shock
- tingling, like “pins and needles”
- numbness
- muscle weakness
Your symptoms may worsen with movement, sneezing, or coughing. You may experience back pain, but the pain in the buttocks, leg, or foot is typically more intense.
It’s important to note: If you only have back pain without additional symptoms, it’s unlikely that you have sciatica.
Symptoms and Causes of Sciatica
Symptoms can include:
- Pain: Sciatic pain occurs due to pressure on the sciatic nerve, often described as burning or like an electric shock, and it usually spreads down the affected leg. It can intensify with coughing, sneezing, bending, or raising the leg while lying down.
- Tingling: This sensation, similar to “pins and needles,” appears due to poor circulation or nerve compression.
- Numbness: This occurs when the transmission of signals from the nerves to the brain is hindered, which can reduce sensation in affected areas of the back or leg.
- Muscle Weakness: A more severe symptom indicating difficulty in signal transmission for muscle control in the back or legs.
- Urinary or fecal incontinence: A serious symptom suggesting issues with the signal transmission controlling the bladder and bowels.
Common Symptoms
Sciatica symptoms may include:
- Pain felt in the back, buttocks, hip, and down the back of the leg, sometimes reaching the foot
- Burning or electric shock-like pain
- Tingling, numbness, feeling of coldness, or heaviness in the leg and/or foot
- Back pain, although leg pain is typically more severe
- Difficulty with sitting, standing, bending, kneeling, walking, and/or lying down
- Sleep disturbances due to pain
Sciatica symptoms may be constant or intermittent, worsened by certain activities or without obvious causes, and may ease with other activities.
What is the Sciatic Nerve?
The sciatic nerve is responsible for pain that occurs due to injury or irritation of this nerve. In addition to pain, symptoms may include tingling and numbness in the lower back or buttocks, which can spread down the leg. In more severe cases, additional symptoms may also appear.
The sciatic nerve is the longest and thickest nerve in the body, with a diameter of up to 2 centimeters (about the size of a U.S. dollar coin or a British penny). Despite its name, the sciatic nerve is not a single nerve but rather a bundle of nerves that stem from five nerve roots branching from the spinal cord.
There are two sciatic nerves in the body, one on each side. Each one runs through the hip and buttock and down the leg until just below the knee, where it divides into smaller nerves that extend to further parts of the body, including the lower leg, foot, and toes.
With sciatica, you may experience mild to severe pain in any area connected to the sciatic nerve. Symptoms can affect the lower back, hips, buttocks, or legs, and in some cases, may extend all the way to the foot and toes, depending on the specific nerve affected.
Facts About Sciatica
- Sciatica is rarely associated with serious tissue damage or life-threatening conditions.
- Sciatica is most commonly caused by irritation and/or inflammation of the nerve.
- If the sciatic nerve is compressed, you may experience numbness and weakness in your legs.
- Discs do NOT “slip” out of place, as they are securely attached to the bones in your back.
- Discs are strong, round structures located between the bones of your spine.
- If a disc herniates, it often shrinks and returns to normal over time (about six months). In fact, the larger the disc herniation, the more likely it is that the person will heal faster and better.
- X-rays and scans are NOT always necessary to identify the cause of your pain or aid in recovery.
- Regular movement, exercise, quality sleep, relaxation, stress management, and overall good health can HELP reduce inflammation and pain associated with the sciatic nerve.
- Gradual loading of your back, including bending and lifting movements, is SAFE. Running has even been shown to help strengthen discs.
- There is no perfect position; bending WILL NOT damage your back or discs.
- Medications and injections MAY help in some cases, but surgery is rarely needed.
- Your sciatica can often improve with proper management. Even if it lasts for a long time, regardless of your age, DON’T GIVE UP and try working with a healthcare professional who can help you create a self-care plan to follow.
Why Pain Occurs
Sciatica occurs when irritation, inflammation, pressure, or compression affect one or more nerves that extend from the lower back down to the legs. Typically, this is not a serious or dangerous condition, and most people with sciatica recover on their own over time with self-care. However, severe cases may require surgery.
Discomfort often arises when a herniated disc or bony growth presses on a nerve, leading to inflammation and numbness in the affected leg.
Causes of Sciatic Pain
Sciatic pain occurs when something compresses or irritates the sciatic nerve.
Causes include:
- Herniated disc (most common cause) – When the soft, cushion-like tissue between the bones in your spine ruptures.
- Spinal stenosis – Narrowing of part of the spine through which the nerves pass.
- Spondylolisthesis – When one of the bones in your spine slips out of position.
- Back injury.
How the pain feels
People may experience sudden bursts or sensations like an electric shock, especially during movements such as coughing, sneezing, or prolonged sitting. Generally, sciatica issues affect only one side of the body, and symptoms may include numbness, tingling, or muscle weakness in the leg or foot.
How long does sciatica last – duration of pain
The majority of people experiencing sciatica recover within a few weeks. With careful monitoring, treatment, and preventive measures, you can also reduce the chances of the pain returning.
Although the pain can be intense, it often subsides within three months with conservative treatment approaches. These methods, which include non-invasive therapies, can typically be practiced at home to ease discomfort.
As sciatica pain is often quite severe, you may worry that something serious is wrong. However, about 3 out of 4 people with sciatica improve within a few weeks. Increasing movement and reducing sitting usually helps, and over-the-counter pain relievers can provide relief.
Self-care and pain medications may not be the best option if the pain persists for more than four months. In such cases, your doctor may recommend physical therapy, where a therapist guides you through passive and active exercises to alleviate pain and prevent future back problems. Those with long-lasting pain caused by a herniated disc may find more significant relief through surgical intervention.
Outlook / Prognosis
Although sciatica symptoms can be quite uncomfortable and seem serious, most people recover without long-term issues or complications. While symptoms may occasionally persist for a few months, the majority of individuals experience full recovery over time. In rare cases, some people may experience permanent pain or weakness in the legs.
Types of Pain
There are two main types of sciatica. Regardless of which type you have, the effects are similar. The types are:
- True Sciatica: This is a condition or injury that directly affects your sciatic nerve.
- Conditions Similar to Sciatica: These are conditions that cause symptoms similar to sciatica but arise from other issues related to the sciatic nerve or the nerves that make up its structure.
Healthcare professionals usually refer to both types simply as “sciatica.” The differences between them are typically important only when your healthcare provider is determining the best course of treatment.
How common is sciatica?
Sciatica is a very common condition worldwide. Around 40% of people experience some form of sciatica at some point in their lives. It rarely occurs before the age of 20, unless it is related to an injury.
What causes sciatica?
Sciatica can occur due to any condition that affects the sciatic nerve. It can also arise from conditions that affect any of the five spinal nerves that come together to form the sciatic nerve.
Conditions that can cause sciatica include:
- Herniated discs
- Degenerative disc disease
- Spinal stenosis
- Foraminal stenosis
- Spondylolisthesis
- Osteoarthritis
- Injuries
- Pregnancy
- Tumors, cysts, or other growths
- Conus medullaris syndrome
- Cauda equina syndrome
Common causes
Sciatica can occur due to irritation or inflammation of the sciatic nerve in the lower back. Several factors are associated with sciatica, the most common of which include:
- Strain/sprain, such as improper lifting or lifting something too heavy for your physical capacity
- A sudden increase or decrease in usual activity or exercise levels
- Changes in the discs causing irritation, inflammation, and/or compression of the sciatic nerve
- Other conditions such as osteoarthritis, rheumatoid arthritis, or fibromyalgia
- Periods of increased stress, worry, or low mood
- Periods of poor sleep, fatigue, or exhaustion
- Lifestyle factors such as excess body weight and smoking
- Worsening of chronic sciatica or back pain
What are the risk factors for sciatica?
Since sciatica can result from many different reasons, there are many potential risk factors, including but not limited to:
- Having a current or previous injury. A spine or lower back injury increases the risk of developing sciatica.
- Normal wear and tear. As you age, normal wear and tear on your spine can lead to pinched nerves, herniated discs, and other conditions that can cause sciatica. Age-related conditions, such as osteoarthritis, may also play a role.
- Being overweight or obese. Your spine functions like a crane when you stand upright. The weight you carry forward in your body is what your spine (the crane) has to lift. The muscles in your back act like the winch and cables, pulling to keep you upright. The more weight you carry, the harder your back muscles must work. This can lead to strain, pain, and other problems.
- Having insufficient core strength. Your “core” refers to the muscles in your back and abdomen (the stomach area). In the crane analogy, having a stronger core is like upgrading the crane components to lift a heavier load. Your abdominal muscles are crucial because they help stabilize your back muscles.
- Your job. Jobs that require heavy lifting, frequent bending, or working in awkward or unusual positions can increase the risk of lower back problems. However, jobs with prolonged sitting—especially without adequate back support—can also increase the risk of back issues.
- Not using good posture and form when lifting. Even if you are physically fit and active, you can still be prone to sciatica if you do not follow proper body mechanics when lifting weights, strength training, or engaging in similar activities.
- Having diabetes. Type 2 diabetes increases the risk of peripheral neuropathies associated with diabetes. This damages your nerves, including those that may cause or contribute to sciatica.
- Physical inactivity. Sitting for long periods and lack of physical activity can contribute to an increased risk of sciatica.
- Smoking. Using nicotine can affect circulation and increase the risk of chronic pain, including sciatica.
- Unknown causes. Many cases of sciatica do not have an identifiable cause that healthcare providers can pinpoint.
