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Sciatica

Overview

Sciatica refers to pain that travels along the regions surrounding the sciatic nerve when this nerve is compressed, pinched, inflamed, or irritated; the pain radiates from the lower back to the buttock, thigh, calf, and sometimes, the foot. Usually sharp or shooting, this pain worsens with activity and improves with rest. Nevertheless, sciatica is not a serious condition and usually goes away on its own with time and rest.

Sciatica can be classified based on its cause and duration:

  • Acute sciatica lasts for a few weeks and is often due to a sudden injury, strain, or disc problem.
  • Chronic sciatica lasts longer than 3 months and may be linked to long-term issues like spinal degeneration.
  • Sciatica can also be classified based on the side it affects: unilateral (one leg) or bilateral (both legs, which is less common).

The symptoms of sciatica can vary in severity:

  • Pain radiating from the lower back down one or both legs, often accompanied by tingling or numbness.
  • Weakness in the leg muscles, and subsequently, difficulty in walking or climbing stairs.
  • In rare cases, severe nerve compression may cause loss of bladder or bowel and numbness around the groin or perineal region.

Several factors increase the risk of developing sciatica:

  • Being in the adult age group, especially middle-aged or older adults.
  • Heavy weightlifting or strenuous labour.
  • Obesity, which places extra stress on the spine.
  • Poor posture or prolonged sitting.
  • Trauma or injury to the spine.

Doctors use a combination of physical assessment and imaging tests to diagnose sciatica:

  • A thorough clinical examination helps rule out pain from any nearby joints.
  • A neurological examination checks for pinched nerves.
  • X-ray of the lower back help identify fractures, malalignment, or abnormal soft tissue changes.
  • Spinal magnetic resonance imaging (MRI) to locate the site of disc prolapse or nerve compression.

Depending on the severity of symptoms, doctors recommend one or more of the following treatments:

  • Non-surgical treatments:
    • Pain relievers, anti-inflammatory medicines, and rest.
    • Epidural injections may be given by the physician or pain management specialist for spine pain management.
  • Surgical treatments: These are considered if:
    • Patients do not improve with conservative measures or if they present with severe symptoms.
    • There is severe compression on the spinal nerves and to reduce patient symptoms.

Medical attention should be sought if:

  • The pain is severe or persistent or worsens.
  • There is notable weakness in the legs.
  • There is numbness in the groin area or difficulty controlling urine or stool.
  • Conservative treatment is not helping after several weeks.

While sciatica cannot always be prevented, certain habits can lower the risk:

  • Maintaining a good posture while sitting, standing, and lifting.
  • Exercise regularly to strengthen the core and back muscles.
  • Refraining from heavy lifting or using improper lifting techniques.
  • Maintaining a healthy body weight to decrease the strain on the spine.

Patients with sciatica are advised to consult with:

  • A general physician for initial assessment and pain relief.
  • An orthopaedic surgeon or spine specialist for further evaluation and treatment.
  • A physiotherapist for rehabilitation, posture correction, and guided exercises.
  • A pain management specialist if injections or advanced therapies are needed.

Disclaimer:

The information in this Health Library is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional with any questions about a medical condition or before starting any treatment. Use of this site and its content does not establish a doctor–patient relationship. In case of a medical emergency, call your local emergency number or visit the nearest emergency facility immediately.