What is Sciatica?

The sciatic nerve is a long, wide nerve that starts in the lower (lumbar) spine and goes all the way down the buttock and thigh, and through to the foot and toes.

Sciatica is the name given to the pain that radiates along this nerve and is also a type of “pinched nerve.”

What causes a nerve to become pinched?

The human spine contains 31 nerve pairs, each of which controls the sensations and movements in different areas of the body. Nerves leave the spinal column at specific locations between the bones of the spine, or vertebrae. Sometimes, the vertebrae or the spongy discs located between them “slip” or move out of place, or the soft tissues surrounding the nerves become inflamed and swollen.

Other times, natural changes such as arthritis can cause the openings in the vertebrae to become narrow, decreasing the space occupied by the nerves.

When these conditions occur, the nerves can become compressed or “pinched.”

Several factors can contribute to a pinched nerve, including:

  • Trauma and injury, especially car accidents, falls, and sports injuries that cause impact-related compression or inflammation.
  • Bad posture when standing or sitting, which places stress on the spine.
  • Poor body mechanics such as improper lifting or reaching.
  • Obesity can cause the spine to become compressed or place uneven stresses on the spine.
  • Degenerative disc disease causes nerves to become “pinched” or trapped between vertebrae.
  • Herniated discs cause pressure on the nerves near the spinal column.
  • Arthritis or spinal stenosis can cause the spinal column to become narrow, crowding nerves as they pass through the spinal column.
There are additional risk factors that make people more prone to developing pinched nerves, including:
  • Gender (women are more prone to developing a pinched nerve)
  • Thyroid disease
  • Rheumatoid arthritis
  • Diabetes

What Causes Sciatica?

The most common cause of sciatica is a herniated disc, a condition that causes the gel-like interior of the disc to ooze out and leads to nerve compression. This gel also contains compounds that can irritate and inflame nerve roots if they come in contact with it (see section on herniated discs).

What Are the Symptoms of Sciatica?

Sciatic pain is usually only felt in one leg at a time, and can cause symptoms like:
  • Sharp pain
  • Severe cramps
  • Sharp, electrical pain or stinging
  • Dull, throbbing ache
  • Weakness or numbness
  • Discomfort that is exacerbated by coughing or sneezing
Discomfort is usually exacerbated in the affected leg when you are lying down, sitting in certain positions (like driving), or standing.

How is Sciatica Treated?

In many cases, sciatica will resolve on its own with rest. For chronic sciatic pain, it’s necessary to seek medical advice. Some of the conservative treatment options to help reduce pain are:

  • Anti-inflammatory medications.
  • Application of hot or cold compresses to the lower back.
  • Injections of corticosteroids to relieve pain and inflammation.
  • Physical therapy and exercises like walking and stretching.
If conservative management fails, surgical treatment may be necessary to relieve nerve pain. The most common surgery used to treat persistent pain is the removal of the herniated portion of the relevant disc to relieve pressure on the nerves if that is the cause of the symptoms.

Three Tips to Prevent Sciatica from Recurring

Some people experience sciatica just once in their lifetimes, while others may have symptoms that recur. The best way to prevent sciatica from recurring is to follow these three simple tips:
  • Maintain a healthy weight. The more weight you carry, the more load that your spine will have to bear which will worsen sciatic symptoms. This is probably the hardest goal for a patient to achieve but it’s the one that reaps the most rewards.
  • Give your back a break. When lifting objects, use your leg muscles rather than your back to prevent strain.
  • Keep your core tight. Keeping the core muscles in your abdomen and lower back strong and flexible is the best thing you can do to avoid sciatica. Low-impact exercises like Pilates and swimming are highly recommended.