So many of us have felt it: a twinge in the lower back and then pain that travels down the back of your leg to your calf. It’s numb. It’s weak. There’s tingling. It can hurt to sit down. If you’ve felt this, it may be sciatica brought on by irritation of the nerve roots in the lumbar spine that make up the sciatic nerve.
Pressure on the Sciatic Nerve
The sciatic nerve is the largest nerve in the body. There are two sciatic nerves that begin in the lower back, where they’re formed with spinal nerves, and run down each side of the body – from the back, through the buttocks and down the thigh. From there, they divide into other nerves that allow feeling and muscle function in the lower legs and feet.
Sciatica is a broad term used to describe the pain patients feel when something is wrong with their sciatic nerve – it’s not a medical condition but a symptom or group of symptoms. The most common cause of sciatica is compression of the nerve at the spine, usually caused by a problem with the discs, bone spurs, cysts or injury to the nerve in the lower pelvic cavity or back of the thigh.
A Lightning Bolt of Pain
Typically, sciatica only affects one side of the lower body depending on where the nerve is being compressed. People with sciatica typically experience:
- Pain in the lower back
- Pain in the buttock
- Pain in the backs of the thigh
- Pain down the leg
- Aching or sharp pain
- Burning or searing pain
- Shooting pain – like a lightning bolt
Pain can come and go and is typically worse when the patient is standing or sitting and begins to feel better if the patient is lying down or walking. Sometimes patients feel sharp pain when they experience a sudden movement of the spine, like with a sneeze or a cough.
Studies show that nearly 40 percent of people will experience sciatica in their lifetime, but risk factors such as obesity, jobs that require lots of heavy lifting or twisting, smoking (which decreases circulation) or jobs that require sitting for long periods of time on hard surfaces can increase someone’s risk of sciatica.
A Combination of Treatments Usually Bring Relief
If you’re experiencing pain, see your doctor for an evaluation to determine what is causing your discomfort. If you have sciatica, your doctor will determine a treatment plan that works best for you. There are nonsurgical and surgical treatments for sciatica. Nonsurgical options include specific exercises to strengthen the muscles, ligaments and tendons supporting the spinal cord, stretching exercises, massage, heat and ice applications and over-the-counter pain medication. If pain is severe, your doctor might recommend an epidural steroid injection to reduce inflammation. Surgery is typically limited to extreme cases and usually involves removing all or part of a herniated disc that’s pushing on your sciatic nerve.
Dr. Jamise Crooms is an Internal Medicine physician who cares for patients at Kelsey-Seybold’s Tanglewood Clinic. Central to her medical philosophy is the need for doctors to educate patients so they can make informed health decisions together.