Many patients find a physical therapy program effective for sciatica pain relief. A physical therapist will guide you through specific movements meant to centralize the pain and strengthen the related muscles. Show
If severe pain or disability makes it challenging to exercise on a hard surface, you might also benefit from water therapy. Water’s buoyancy will support your joints, helping improve your range of motion. As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. Sciatica pain is caused by an irritation, inflammation, pinching or compression of a nerve in the lower back. The most common cause is a herniated or slipped disk that causes pressure on the nerve root. Most people with sciatica get better on their own with time and self-care treatments.
OverviewTrue sciatica is an injury or irritation to the sciatic nerve, which starts in your buttock/gluteal area.What is sciatica?Sciatica is nerve pain from an injury or irritation to the sciatic nerve, which originates in your buttock/gluteal area. The sciatic nerve is the longest and thickest (almost finger-width) nerve in the body. It’s actually made up of five nerve roots: two from the lower back region called the lumbar spine and three from the final section of the spine called the sacrum. The five nerve roots come together to form a right and left sciatic nerve. On each side of your body, one sciatic nerve runs through your hips, buttocks and down a leg, ending just below the knee. The sciatic nerve then branches into other nerves, which continue down your leg and into your foot and toes. True injury to the sciatic nerve “sciatica” is actually rare, but the term “sciatica” is commonly used to describe any pain that originates in the lower back and radiates down the leg. What this pain shares in common is an injury to a nerve -- an irritation, inflammation, pinching or compression of a nerve in your lower back. If you have “sciatica," you experience mild to severe pain anywhere along the path of the sciatic nerve – that is, anywhere from the lower back, through the hips, buttocks and/or down your legs. It can also cause muscle weakness in your leg and foot, numbness in your leg, and an unpleasant tingling pins-and-needles sensation in your leg, foot and toes. What does sciatica pain feel like?People describe sciatica pain in different ways, depending on its cause. Some people describe the pain as sharp, shooting, or jolts of pain. Others describe this pain as “burning,” "electric” or “stabbing.” The pain may be constant or may come and go. Also, the pain is usually more severe in your leg compared to your lower back. The pain may feel worse if you sit or stand for long periods of time, when you stand up and when your twist your upper body. A forced and sudden body movement, like a cough or sneeze, can also make the pain worse. Can sciatica occur down both legs?Sciatica usually affects only one leg at a time. However, it’s possible for sciatica to occur in both legs. It’s simply a matter of where the nerve is being pinched along the spinal column. Does sciatica occur suddenly or does it take time to develop?Sciatica can come on suddenly or gradually. It depends on the cause. A disk herniation can cause sudden pain. Arthritis in the spine develops slowly over time. How common is sciatica?Sciatica is a very common complaint. About 40% of people in the U.S. experience sciatica sometime during their life. Back pain is the third most common reason people visit their healthcare provider. What are the risk factors for sciatica?You are at greater risk of sciatica if you:
Is the weight of pregnancy the reason why so many pregnant women get sciatica?It’s true that sciatica is common in pregnancy but increased weight is not the main reason why pregnant women get sciatica. A better explanation is that certain hormones of pregnancy cause a loosening of their ligaments. Ligaments hold the vertebrae together, protect the disks and keep the spine stable. Loosened ligaments can cause the spine to become unstable and might cause disks to slip, which leads to nerves being pinched and the development of sciatica. The baby’s weight and position can also add pressure to the nerve. The good news is there are ways to ease sciatic pain during pregnancy, and the pain goes away after birth. Physical therapy and massage therapy, warm showers, heat, medications and other measures can help. If you are pregnant, be sure to follow good posture techniques during pregnancy to also ease your pain. Symptoms and CausesWhat causes sciatica?Sciatica can be caused by several different medical conditions including:
What are the symptoms of sciatica?The symptoms of sciatica include:
Diagnosis and TestsStraight leg raise test helps spot your point of pain. This test helps identify a disk problem.How is sciatica diagnosed?First, your healthcare provider will review your medical history. Next, they’ll ask about your symptoms. During your physical exam, you will be asked to walk so your healthcare provider can see how your spine carries your weight. You may be asked to walk on your toes and heels to check the strength of your calf muscles. Your provider may also do a straight leg raise test. For this test, you’ll lie on your back with your legs straight. Your provider will slowly raise each leg and note the point at which your pain begins. This test helps pinpoint the affected nerves and determines if there is a problem with one of your disks. You will also be asked to do other stretches and motions to pinpoint pain and check muscle flexibility and strength. Depending on what your healthcare provider discovers during your physical exam, imaging and other tests might be done. These may include:
Management and TreatmentHow is sciatica treated?The goal of treatment is to decrease your pain and increase your mobility. Depending on the cause, many cases of sciatica go away over time with some simple self-care treatments. Self-care treatments include:
How long should I try self-care treatments for my sciatica before seeing my healthcare professional?Every person with sciatic pain is different. The type of pain can be different, the intensity of pain is different and the cause of the pain can be different. In some patients, a more aggressive treatment may be tried first. However, generally speaking, if a six-week trial of conservative, self-care treatments – like ice, heat, stretching, over-the-counter medicines – has not provided relief, it’s time to return to a healthcare professional and try other treatment options. Other treatment options include:
When is surgery considered?Spinal surgery is usually not recommended unless you have not improved with other treatment methods such as stretching and medication, your pain is worsening, you have severe weakness in the muscles in your lower extremities or you have lost bladder or bowel control. How soon surgery would be considered depends on the cause of your sciatica. Surgery is typically considered within a year of ongoing symptoms. Pain that is severe and unrelenting and is preventing you from standing or working and you’ve been admitted to a hospital would require more aggressive treatment and a shorter timeline to surgery. Loss of bladder or bowel control could require emergency surgery if determined to be cauda equine syndrome. The goal of spinal surgery for sciatic pain is to remove the pressure on the nerves that are being pinched and to make sure the spine is stable. Surgical options to relieve sciatica include: Microdiscectomy: This is a minimally invasive procedure used to remove fragments of a herniated disk that are pressing on a nerve.
How long does it take to perform spine surgery and what’s the typical recovery time?Discectomy and laminectomy generally take one to two hours to perform. Recovery time depends on your situation; your surgeon will tell you when you can get back to full activities. Generally the time needed to recover is six weeks to three months. What are the risks of spinal surgery?Though these procedures are considered very safe and effective, all surgeries have risks. Spinal surgery risks include:
What complications are associated with sciatica?Most people recover fully from sciatica. However, chronic (ongoing and lasting) pain can be a complication of sciatica. If the pinched nerve is seriously injured, chronic muscle weakness, such as a “drop foot,” might occur, when numbness in the foot makes normal walking impossible. Sciatica can potentially cause permanent nerve damage, resulting in a loss of feeling in the affected legs. Call your provider right away if you lose feeling in your legs or feet, or have any concerns during your recovery time. PreventionCan sciatica be prevented?Some sources of sciatica may not be preventable, such as degenerative disk disease, sciatica due to pregnancy or accidental falls. Although it might not be possible to prevent all cases of sciatica, taking the following steps can help protect your back and reduce your risk:
Outlook / PrognosisWhat can I expect if I have been diagnosed with sciatica?The good news about sciatic pain is that it usually goes away on its own with time and some self-care treatments. Most people (80% to 90%) with sciatica get better without surgery, and about half of these recover from an episode fully within six weeks. Be sure to contact your healthcare provider if your sciatica pain is not improving and you have concerns that you aren’t recovering as quickly as hoped. Living WithWhen should I contact my healthcare provider?Get immediate medical attention if you experience:
Even if your visit doesn’t turn out to be an emergency situation, it’s best to get it checked out. Is the sciatic nerve the only source of “sciatica” pain?No, the sciatic nerve is not the only source of what is generally called “sciatica” or sciatica pain. Sometimes the source of pain is higher up in the lumbar spine and causes pain in front of the thigh or in the hip area. This pain is still called sciatica. How can I tell if pain in my hip is a hip issue or sciatica?Hip problems, such as arthritis in the hip, usually cause groin pain, pain when you put weight on your leg, or when the leg is moved around. If your pain starts in the back and moves or radiates towards the hip or down the leg and you have numbness, tingling or weakness in the leg, sciatica is the most likely cause. Is radiculopathy the same as sciatica?Radiculopathy is a broader term that describes the symptoms caused by a pinched nerve in the spinal column. Sciatica is a specific type, and the most common type, of radiculopathy. Should I rest if I have sciatica?Some rest and change in your activities and activity level may be needed. However, too much rest, bed rest, and physical inactivity can make your pain worse and slow the healing process. It’s important to maintain as much activity as possible to keep muscles flexible and strong. Before beginning your own exercise program, see your healthcare provider or spine specialist first to get a proper diagnosis. This healthcare professional will refer you to the proper physical therapist or other trained exercise or body mechanics specialist to devise an exercise and muscle strengthening program that’s best for you. Can sciatica cause my leg and/or ankle to swell?Sciatica that is caused by a herniated disk, spinal stenosis, or bone spur that compresses the sciatic nerve can cause inflammation – or swelling – in the affected leg. Complications of piriformis syndrome can also cause swelling in the leg. Are restless leg syndrome, multiple sclerosis, carpal tunnel syndrome, plantar fasciitis, shingles or bursitis related to sciatica?While all these conditions affect either the spinal cord, nerves, muscles, ligaments or joints and all can cause pain, none are directly related to sciatica. The main causes of these conditions are different. Sciatica only involves the sciatic nerve. That being said, the most similar condition would be carpal tunnel syndrome, which also involves a compression of a nerve. A final word about sciatica. . . . Most cases of sciatica do not require surgery. Time and self-care treatment are usually all that’s needed. However, if simple self-care treatments do not relieve your pain, see your healthcare provider. Your healthcare provider can confirm the cause of your pain, suggest other treatment options and/or refer you to other spine health specialists if needed. Share Facebook Twitter LinkedIn Email Print Last reviewed by a Cleveland Clinic medical professional on 03/25/2020. References
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