Back Pain: Sciatica

Location of the spine.

Sciatica (say "sye-AT-ih-kuh") is pain along the sciatic nerve. The sciatic nerve is the largest nerve in the body. It's formed by nerve roots coming out of the spinal cord in the lower back. The nerve goes down through the buttock, then its branches extend down the back of the leg to the ankle and foot. The pain is caused by irritation or pressure against this nerve.

People with sciatica usually have a shooting pain down the back of the leg. Your leg may also feel weak, tingly, or numb.

Who gets sciatica?

People are more likely to get sciatica as their spines begin to age.

Having a job that requires you to twist your back, carry heavy loads, or drive for long periods makes you more prone to get sciatica.

People who have diabetes are more likely to get it.

What causes sciatica?

A common cause of sciatica is a bulging or ruptured disc in your spine. This is also called a herniated disc. If this disc presses on the nerve roots that lead to your sciatic nerve, it can cause pain. This can happen as you grow older or after an injury. Sitting or lying for a long time with pressure on your buttock may also injure your sciatic nerve.

Sciatica also can be caused by other problems, like arthritis. A narrowing of the spinal canal, called spinal stenosis, can cause it. Bone spurs, which are small, bony growths along your joints, can cause it. An injury that causes a nerve root compression, called a pinched nerve, could lead to sciatica. It can also be caused by a tumor, but this is rare.

What are the symptoms of sciatica?

The main symptom of sciatica is pain that begins in your back or buttock and shoots down your leg. The pain may go all the way to your foot. Your leg may also feel weak, tingly, or numb.

Sitting, standing for a long time, and bending over may make your symptoms worse.

Walking, lying down, and stretching your back may make your symptoms better.

How is sciatica treated?

Sciatica often will go away with time. Early treatment usually includes pain medicine and exercises. There are things you can do at home to ease your pain:

  • Use heat or ice on the middle of your lower back.
  • Avoid sitting, unless it feels better than standing.
  • Alternate lying down and short walks. Increase your walking distance as you are able to do so without pain.
  • Take over-the-counter pain medicine, if needed. Ibuprofen and naproxen are examples. Follow the directions on the label.

Additional treatment depends on what is causing the problem. If your symptoms do not improve, your doctor may suggest physical therapy, medicines that can be injected, or even surgery in severe cases.

When to call a doctor

Call 911 anytime you think you may need emergency care. For example, call if:

  • You are unable to move an arm or a leg at all.

Call your doctor now or seek immediate medical care if:

  • You have new or worse symptoms in your legs or buttocks. Symptoms may include:
    • Numbness or tingling.
    • Weakness.
    • Pain.
  • You lose bladder or bowel control.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You have a fever, lose weight, or don't feel well.
  • You are not getting better as expected.