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sciatica diagram

sciatic nerve diagram

 

Sciatica Definition

Sciatica is a symptom of a medical condition, such as a lumbar herniated disc, degenerative disc disease, or spinal stenosis. Sciatica is not a proper medical condition all by itself.

Sciatica Nerve Pain
Sciatica is often characterized by one or a combination of the following symptoms:

  • Constant pain ( or shooting pain) in only one side of the buttock or leg (pain in both sides are rare)
  • Pain increases when sitting.
  • Leg pain that can feel as if it’s burning, or tingling.
  • Weakness, numbness or difficulty moving the leg or foot
  • You may experience a sharp pain making it difficult to stand up or to walk.
  • Specific sciatica symptoms can be different in location and severity, depending upon the condition causing the sciatica (such as a lumbar herniated disc ).
  • Sciatica Pain can be severe but usually is only temporary with no permanent tissue damage.
    Lower back pain is common, but not always present. Weakness or numbness may occur in various parts of the leg and foot.

Sciatica Treatment
Because sciatica is a symptom of another medical condition, the underlying cause should be identified and treated.
In some cases, no treatment is required and recovery occurs on its own.
Conservative (non-surgical) treatment is best in many cases. Your doctor may recommend the following steps to calm your symptoms and reduce inflammation:
Apply heat or ice to the painful area. Try ice for the first 48 to 72 hours, then use heat.
Take over-the-counter pain relievers such as ibuprofen (Advil, Motrin IB) or acetaminophen (Tylenol).
Measures to take care of your back at home:
Bed rest is not recommended.
Reduce your activity for the first couple of days. Then, slowly start your usual activities.
Do not do heavy lifting or twisting of your back for the first 6 weeks after the pain begins.
Start exercising again after 2 to 3 weeks. Include exercises to strengthen your abdomen and improve flexibility of your spine.
Physical therapy may also be recommended. Additional treatments depend on the condition that is causing the sciatica.

If these measures do not help, your doctor may recommend injections of certain medicines to reduce swelling around the nerve. Other medicines may be prescribed to help reduce the stabbing pains due to nerve irritation.
Nerve pain is very difficult to treat. If you have ongoing problems with pain, you may want to see a neurologist or a pain specialist to ensure that you have access to the widest range of treatment options.

Outlook (Prognosis)
Often, sciatica gets better on its own. But it is common for it to return.
Possible Complications
More serious complications depend on the cause of sciatica, such as slipped disc or spinal stenosis. Sciatica can lead to permanent numbness or weakness of your leg.
When to Contact a Medical Professional
Call your doctor right away if you have:

  • Unexplained fever with back pain
  • Back pain after a severe blow or fall
  • Redness or swelling on the back or spine
  • Pain traveling down your legs below the knee
  • Weakness or numbness in your buttocks, thigh, leg, or pelvis
  • Burning with urination or blood in your urine
  • Pain that is worse when you lie down, or awakens you at night
  • Severe pain and you cannot get comfortable
  • Loss of control of urine or stool (incontinence)
    Also call if:
  • You have been losing weight unintentionally (not on purpose)
  • You use steroids or intravenous drugs
  • You have had back pain before, but this episode is different and feels worse

This episode of back pain has lasted longer than 4 weeks

Prevention

Prevention varies, depending on the cause of the nerve damage. Avoid prolonged sitting or lying with pressure on the buttocks.

Alternative Names

Neuropathy – sciatic nerve; Sciatic nerve dysfunction; Low back pain – sciatica

References

Chou R, Atlas SJ, Stanos SP, Rosenquist RW. Nonsurgical interventional therapies for low back pain: a review of the evidence for an American Pain Society clinical practice guideline.Spine.http://www.ncbi.nlm.nih.gov/pubmed/19363456

Chou R, Qaseem A, Owens DK. Diagnostic imaging for low back pain: advice for high-value health care from the American College of Physicians. Ann Intern Med.http://www.ncbi.nlm.nih.gov/pubmed/21282698

Chou R, Qaseem A, Snow V, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med.http://www.ncbi.nlm.nih.gov/pubmed/17909209

Update Date 9/8/2014

Updated by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.