Sciatica


Definition

Sciatica refers to pain, weakness, numbness, or tingling in the leg. It is caused by injury to or pressure on the sciatic nerve. Sciatica is a symptom of a medical problem. It is not a medical condition on its own.

Alternative Names

Neuropathy - sciatic nerve; Sciatic nerve dysfunction; Low back pain - sciatica; LBP - sciatica; Lumbar radiculopathy - sciatica

Causes

This EM Should be displayed at the top of the article section "Causes"

Sciatica occurs when there is pressure or damage to the sciatic nerve. This nerve starts in the lower back and runs down the back of each leg. This nerve controls the muscles of the back of the knee and lower leg. It also provides sensation to the back of the thigh, part of the lower leg, and the sole of the foot.

Common causes of sciatica include:

Men between 30 and 50 years of age are more likely to have sciatica.

Symptoms

Sciatica pain can vary widely. It may feel like a mild tingling, dull ache, or burning sensation. In some cases, the pain is severe enough to make a person unable to move.

The pain most often occurs on one side. Some people have sharp pain in one part of the leg or hip and numbness in other parts. The pain or numbness may also be felt on the back of the calf or on the sole of the foot. The affected leg may feel weak. Sometimes, your foot gets caught on the ground when walking.

The pain may start slowly. It may get worse:

Exams and Tests

The health care provider will perform a physical exam. This may show:

Tests are often not needed unless pain is severe or long-lasting. If tests are ordered, they may include:

Treatment

As sciatica is a symptom of another medical condition, the underlying cause should be identified and treated.

In some cases, no treatment is required and recovery occurs on its own.

Conservative (non-surgical) treatment is best in many cases. Your provider may recommend the following steps to calm your symptoms and reduce inflammation:

Measures to take care of your back at home may include:

Your provider may also suggest physical therapy. Additional treatments depend on the condition that is causing the sciatica.

If these measures do not help, your provider may recommend injections of certain medicines to reduce swelling around the nerve. Other medicines may be prescribed to help reduce the stabbing pains due to nerve irritation.

Nerve pain is very difficult to treat. If you have ongoing problems with pain, you may want to see a neurologist or a pain specialist to ensure that you have access to the widest range of treatment options.

Outlook (Prognosis)

Often, sciatica gets better on its own. But it is common for it to return.

Possible Complications

More serious complications depend on the cause of sciatica, such as slipped disk or spinal stenosis. Sciatica can lead to permanent numbness or weakness of your leg.

When to Contact a Medical Professional

Call your provider right away if you have:

Also call if:

Prevention

Prevention varies, depending on the cause of the nerve damage. Avoid prolonged sitting or lying with pressure on the buttocks.

References

Kim DH, Hudson AR, Kline DG. Sciatic nerve. In: Kim DH, Hudson AR, Kline DG, eds. Atlas of Peripheral Nerve Surgery. 2nd ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 16.

Marques DR, Carroll WE. Neurology. In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 41.

Ropper AH, Zafonte RD. Sciatica. N Engl J Med. 2015;372(13):1240-1248. PMID: 25806916 www.ncbi.nlm.nih.gov/pubmed/25806916.

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