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Sciatica

Sciatica

What is Sciatica?

Sciatica refers to pain that radiates along the path of the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg. Typically, sciatica affects only one side of your body. Sciatica most commonly occurs when a herniated disk, bone spur on the spine or narrowing of the spine (spinal stenosis) compresses part of the nerve. This causes inflammation, pain and often some numbness in the affected leg. Although the pain associated with sciatica can be severe, most cases resolve with non-operative treatments in a few weeks. People who have severe sciatica that's associated with significant leg weakness or bowel or bladder changes might be candidates for surgery.

What are the Symptoms of Sciatica?

Pain that radiates from your lower (lumbar) spine to your buttock and down the back of your leg is the hallmark of sciatica. You might feel the discomfort almost anywhere along the nerve pathway, but it's especially likely to follow a path from your low back to your buttock and the back of your thigh and calf. The pain can vary widely, from a mild ache to a sharp, burning sensation or excruciating pain. Sometimes it can feel like a jolt or electric shock. It can be worse when you cough or sneeze, and prolonged sitting can aggravate symptoms. Usually only one side of your body is affected. Some people also have numbness, tingling or muscle weakness in the affected leg or foot. You might have pain in one part of your leg and numbness in another part.

What Causes Sciatica?

Sciatica occurs when the sciatic nerve becomes pinched, usually by a herniated disk in your spine or by an overgrowth of bone (bone spur) on your vertebrae. More rarely, the nerve can be compressed by a tumor or damaged by a disease such as diabetes.

Risk factors associated with Sciatica

Risk factors for sciatica include:

  • Age: Age-related changes in the spine, such as herniated disks and bone spurs, are the most common causes of sciatica.
  • Obesity: By increasing the stress on your spine, excess body weight can contribute to the spinal changes that trigger sciatica.
  • Occupation: A job that requires you to twist your back, carry heavy loads or drive a motor vehicle for long periods might play a role in sciatica, but there's no conclusive evidence of this link.
  • Prolonged sitting: People who sit for prolonged periods or have a sedentary lifestyle are more likely to develop sciatica than active people are.
  • Diabetes: This condition, which affects the way your body uses blood sugar, increases your risk of nerve damage.

Tests and diagnosis

During the physical exam, your doctor may check your muscle strength and reflexes. For example, you may be asked to walk on your toes or heels, rise from a squatting position and, while lying on your back, lift your legs one at a time. Pain that results from sciatica will usually worsen during these activities.

Not everyone who has sciatica needs medical care. If your symptoms are severe or persist for more than a month, though, make an appointment with your primary care doctor.