Sciatica

ExitCare ImageSciatica is pain, weakness, numbness, or tingling along the path of the sciatic nerve. The nerve starts in the lower back and runs down the back of each leg. The nerve controls the muscles in the lower leg and in the back of the knee, while also providing sensation to the back of the thigh, lower leg, and the sole of your foot. Sciatica is a symptom of another medical condition. For instance, nerve damage or certain conditions, such as a herniated disk or bone spur on the spine, pinch or put pressure on the sciatic nerve. This causes the pain, weakness, or other sensations normally associated with sciatica. Generally, sciatica only affects one side of the body.

CAUSES

  • Herniated or slipped disc.

  • Degenerative disk disease.

  • A pain disorder involving the narrow muscle in the buttocks (piriformis syndrome).

  • Pelvic injury or fracture.

  • Pregnancy.

  • Tumor (rare).

SYMPTOMS

Symptoms can vary from mild to very severe. The symptoms usually travel from the low back to the buttocks and down the back of the leg. Symptoms can include:

  • Mild tingling or dull aches in the lower back, leg, or hip.

  • Numbness in the back of the calf or sole of the foot.

  • Burning sensations in the lower back, leg, or hip.

  • Sharp pains in the lower back, leg, or hip.

  • Leg weakness.

  • Severe back pain inhibiting movement.

These symptoms may get worse with coughing, sneezing, laughing, or prolonged sitting or standing. Also, being overweight may worsen symptoms.

DIAGNOSIS

Your caregiver will perform a physical exam to look for common symptoms of sciatica. He or she may ask you to do certain movements or activities that would trigger sciatic nerve pain. Other tests may be performed to find the cause of the sciatica. These may include:

  • Blood tests.

  • X-rays.

  • Imaging tests, such as an MRI or CT scan.

TREATMENT

Treatment is directed at the cause of the sciatic pain. Sometimes, treatment is not necessary and the pain and discomfort goes away on its own. If treatment is needed, your caregiver may suggest:

  • Over-the-counter medicines to relieve pain.

  • Prescription medicines, such as anti-inflammatory medicine, muscle relaxants, or narcotics.

  • Applying heat or ice to the painful area.

  • Steroid injections to lessen pain, irritation, and inflammation around the nerve.

  • Reducing activity during periods of pain.

  • Exercising and stretching to strengthen your abdomen and improve flexibility of your spine. Your caregiver may suggest losing weight if the extra weight makes the back pain worse.

  • Physical therapy.

  • Surgery to eliminate what is pressing or pinching the nerve, such as a bone spur or part of a herniated disk.

HOME CARE INSTRUCTIONS

  • Only take over-the-counter or prescription medicines for pain or discomfort as directed by your caregiver.

  • Apply ice to the affected area for 20 minutes, 3–4 times a day for the first 48–72 hours. Then try heat in the same way.

  • Exercise, stretch, or perform your usual activities if these do not aggravate your pain.

  • Attend physical therapy sessions as directed by your caregiver.

  • Keep all follow-up appointments as directed by your caregiver.

  • Do not wear high heels or shoes that do not provide proper support.

  • Check your mattress to see if it is too soft. A firm mattress may lessen your pain and discomfort.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You lose control of your bowel or bladder (incontinence).

  • You have increasing weakness in the lower back, pelvis, buttocks, or legs.

  • You have redness or swelling of your back.

  • You have a burning sensation when you urinate.

  • You have pain that gets worse when you lie down or awakens you at night.

  • Your pain is worse than you have experienced in the past.

  • Your pain is lasting longer than 4 weeks.

  • You are suddenly losing weight without reason.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.