The Pain of Sciatica

Sciatica is sometimes described as a very bad leg cramp that doesn't go away. It is the name for pain that runs along the sciatic nerve, the longest and broadest nerve in your body. This nerve starts in the lower back and extends through the buttocks, down the back of both legs and into the feet.

The pain is usually felt in one leg, along the entire path of the nerve or only in some areas. People describe it as a sharp, stabbing or burning sensation, sometimes accompanied by jolts into the leg. Others have only mild discomfort or "pins and needles" in the feet or toes. Coughing, sneezing or long sitting in the same position often makes it worse. The pain can be gradual or may start suddenly.

You should seek emergency care if you have any of these symptoms of sciatica:

• Feel increasing weakness in your buttocks, legs or trunk
• Numbness begins creeping upward from your toes or feet
• Numbness or tingling in a saddle pattern (the area of your body that would be touching the saddle if you were riding a horse)
• You lose bowel or bladder control
• Fever or forceful vomiting is accompanying these other symptoms

Cause
Sciatic pain is caused by conditions that affect the root of the nerve in the lower back. It doesn't help to rub the painful leg, because the pain doesn't originate there.

The pain is caused by pressure on the sciatic nerve. Some causes include pressure from a herniated disk, a vertebra that has moved or a narrowing of the spinal canal. Less frequently, tumors or infection could be the cause. Pregnancy can also cause sciatica if the growing uterus puts pressure on the nerve.

Sometimes a muscle reaching from the lower spine to the thighbone contracts too much or goes into spasms, pinching the sciatic nerve. This is especially common in runners.

Treatment
In 90 percent of people, sciatica pain responds well to self-care measures and goes away after a few weeks. Treatment focuses on relieving pressure, inflammation and swelling. Over-the-counter pain relievers like acetaminophen or ibuprofen may help relieve mild or moderate pain if your doctor suggests them.

Your doctor may recommend more aggressive treatment, such as prescription anti-inflammatory medications, oral steroids or epidural steroid injections. Physical therapy may help relieve the current episode and prevent new ones in the future.

Self Care Tips

• Bed rest for more than one day may make the pain worse. Try to keep moving if possible, but don't do anything strenuous at first.
• Applying cold packs or warm compresses may provide relief to some people.
• Once the initial pain is gone, physical therapy may be helpful. Speak with your doctor to devise a plan that is right for you.
• Sleep on a firmer mattress for a few nights and see if you feel better. Be sure to use a pillow, too.
• Use a seat cushion if you sit at work all day. Get up from time to time and walk a little.
• Maintaining proper posture is important when you are sitting or standing, especially for prolonged periods.

Your doctor may suggest surgery, depending on the cause of your sciatica or if your symptoms aren't relieved in three months with medication or physical therapy. The vast majority of people get better in a few weeks without surgery, though.

Related Articles Acute Lower Back Pain Getting Your Back on Track Your Back Hurts: Why Me?

External Source American Academy of Orthopaedic Surgeons. Sciatica. Accessed May 3, 2007.

This article was reviewed and updated June 2007.

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