Shooting pain that radiates from your lower back into your thigh. Numbness or weakness in your leg that makes it difficult to walk. A sore buttock after helping your child move into their college dorm. What’s going on?
It might be sciatica, a condition that affects about 40% of people in the United States at some point in their lives. The good news is that sciatic pain can be treated – it may even resolve on its own, usually within 3-6 months.
What exactly is sciatica and what causes it? How do you know if you have sciatica? And when should you see a doctor? Below, we answer all these questions and more.
What is sciatica?
Sciatica is pain in your lower back, buttock and sometimes your leg. Sciatica can happen if your sciatic nerves – or the related nerve root – is irritated.
Where are the sciatic nerves located?
You have two sciatic nerves – one for each side of your body. The sciatic nerves form from nerve roots in the lower back and then continue down through your hips and buttocks. The branches of the sciatic nerves then extend into your legs, ankles and feet. When the nerves get compressed, irritated or pinched, you may have sciatica. But it’s also possible to have a compressed nerve without sciatica.
Is sciatica the same as a pinched nerve?
Not exactly. Sciatica is back and leg pain. A pinched sciatic nerve (also known as lumbar radiculopathy) is back and leg pain plus a nerve injury resulting from nerve compression.
Most people who have sciatic nerve pain don’t have a pinched nerve. But if you do have a pinched nerve (also called lumbar radiculopathy), it’s likely that you’ll also have additional symptoms such as leg weakness, numbness or tingling.
Who gets sciatica?
Sciatica is most common in people who are in their 40s or 50s. But it can affect everyone except the very young – it’s very rare in people who are younger than 20 unless it’s related to another injury.
Symptoms of sciatica
If you’re wondering if you have sciatica, the first thing to consider is the sciatic pain location. If you have sciatica, your symptoms will not be limited to your lower back – you’ll likely feel it in your hip, buttock and leg. And sometimes the pain in your leg will be worse than your back pain.
Rarely, people with sciatica may also have more serious symptoms. If you’re experiencing tingling or numbness in your legs that makes it hard to walk or move, you should make a doctor’s appointment. If you’re having difficulty controlling your bladder or bowels go to the emergency room right away.
What does sciatica feel like?
Sciatic pain can be different for everyone. Some describe the pain as a constant ache, or a shooting pain that comes and goes. Some people also say they feel sharp or burning pains when they’re sitting, standing or moving in a certain way. Others describe sciatic nerve pain as feeling like an electric shock.
Can sciatica cause pain on both sides of your body?
Sciatica usually only affects one side of your body. But it’s possible that you could have sciatica on both sides – it all depends on which nerves are irritated or compressed.
What causes sciatica?
Sometimes there isn’t a single cause that can be definitively pinpointed as the cause of someone’s sciatica. But doctors know there are some people who are more likely to experience sciatica if they have certain spinal changes or lifestyle factors. Here are some possible risk factors:
Age-related changes to your spine
As you get older, the shape of your spine and the space between your bones can change. For example, your spinal column may become narrower or the padding between your bones may get thinner.
Your nerves need space to move. When the area around them is too tight, your nerves may rub against the surrounding anatomy. The nerves may also not get the blood and oxygen they need, which can cause discomfort.
Genetics may also play a role in your level of risk for sciatica.
Herniated disc in your spine
Herniated discs are a very common spine condition. A herniated disc can also be referred to as a ruptured disc, bulging disc or slipped disc. Most of the time, herniated discs don’t cause problems.
Spinal discs are tough ligaments between your spine’s vertebrae that act as shock absorbers. Sometimes they form bumps or release chemicals, both of which can irritate the sciatic nerve root.
But the good news is that a disc herniation and any related symptoms often heal on their own within 3-6 months without surgery.
People may be more likely to experience back pain and sciatica during life changes like starting a new job, getting married or retiring.
Stress, excitement and anxiety can affect you physically. The muscle tightness you may feel in your shoulders, neck and back can affect the way you sit, stand and move, causing new or worse back pain.
Plus, activity levels and other lifestyle factors change during life transitions. New or unusual physical activities, sleeping in a new bed, eating differently or sitting more are all changes that may contribute to back pain and sciatica.
Sleep helps you recover from the physical and mental stress of the day – and prepare your mind and body for tomorrow. Poor sleep is linked to chronic inflammation and pain, making it more likely that your nerves get irritated. And if you don’t get enough sleep, fatigue can make it more difficult to do physical activity and more likely for you to be injured.
Too little (or too much) activity and movement
Movement and exercise are important for keeping your body in good working order.
At TRIA we often like to say: Motion is lotion. So, too much inactivity can cause joints and muscles to lose strength and flexibility. That’s why a sedentary lifestyle can increase your risk factors for a range of conditions, including sciatica.
On the other hand, large increases in activity are also linked with sciatica. Maybe a new job is requiring more bending, lifting and twisting, or you’ve started a higher intensity exercise program – big shifts in the amount of activity can put strain on your back.
There are many reasons not to eat a diet high in sugars, unhealthy fats, refined carbohydrates and processed meats – and avoiding sciatica may be one of them. An unhealthy diet can affect how well your immune system works and lead to low levels of inflammation that don’t go away. When tissues are inflamed it is much easier to develop pain.
Smoking and alcohol
The chemicals in cigarettes and alcohol cause inflammation in your body, which can make your nerves more sensitive and hurt more easily. This makes it more likely to develop painful sciatica that doesn’t go away quickly.
Certain medical conditions
If you have certain medical conditions, you’re also more likely to get sciatica.
Being very overweight
Being overweight increases your risks for several conditions – and sciatica may be one of them. For one, carrying around extra weight puts pressure on the lumbar region of your spine. And that extra pressure can increase your chances of certain sciatica risk factors such as herniated discs and lack of physical activity.
People who are overweight also usually have less muscle mass and are more likely to have tissue inflammation – both of which increase your chance of nerve irritation.
Pregnancy isn’t usually seen as a direct cause of sciatica. But people who are pregnant often have risk factors for sciatica, including poor sleep and the stress that comes with planning for an exciting life change.
Plus, most people experience back pain during pregnancy – and sometimes it might feel like sciatica depending on its location. One possible explanation for back pain is that a growing baby and expanding uterus put extra pressure on many body parts, including the pelvis, low back and spine.
You may also be more likely to get sciatica if you have nerve damage or neuropathy related to diabetes.
Sciatica from diabetes isn’t usually caused by pressure on the nerve root. Instead, it happens because high blood sugar levels can hurt nerves throughout your body – most often in your legs and feet. Also, when people with diabetes have sciatica, they often have other lifestyle risk factors such as less exercise, a poor diet and excess weight.
Does sciatica heal on its own?
Yes, it can. Sciatica often goes away on its own without medical treatment – but it can take some time. Getting help from a spine specialist can help you recover more quickly.
No matter what is causing your sciatica, you may notice that the pain comes and goes. Taking steps to treat sciatic pain at home is important for managing pain and promoting healing.
Over-the-counter pain relievers can help reduce pain and inflammation – but check with your primary care doctor to make sure that they are safe for you. You can also try cold packs for new injuries and hot packs if the pain has been around for a couple of days.
Stretching and activity will also be important for managing pain and working with a spine physical therapist can help. They can teach you targeted stretches and movements to strengthen your back and reduce sciatic nerve pain.
What are possible complications if sciatica isn’t treated?
While sciatica can go away on its own, if you ignore severe or ongoing symptoms of sciatica more serious complications can arise, including:
- Sciatica may turn into a chronic condition that’s difficult to manage, even with medication
- Nerve damage – people with diabetes are at higher risk
- Loss of feeling, motor control and strength in the affected leg or foot is possible, and in very rare cases, can result in paralysis
- Inability to control bowels or bladder
When should I see a doctor about sciatica?
Any time you have concerns about your health or you’re experiencing pain, it’s a good idea to seek medical help.
See a physical therapist if you experience any of the following:
- Sciatica symptoms lasting longer than three months
- Sciatica that comes back after it goes away
- Pain that’s interfering with your daily activities
- Pain that’s getting steadily worse
Make a primary care appointment for any of the following:
- Weakness or numbness in your leg
- Difficulty urinating
- Difficulty walking such as limping or dragging a foot
Go to the emergency room right away for any of the following:
- Sudden, severe pain in your low back or leg, combined with numbness or muscle weakness in your leg
- Trouble controlling your bladder or bowels
- Difficulty urinating
- Pain that follows an injury, such as a fall or traffic accident
How is sciatica diagnosed?
If you’re wondering if your back pain is sciatica, make an appointment with a physical therapist. During the appointment, they’ll ask you about your symptoms and check your muscle strength and reflexes. To get a better idea of when and where it hurts, they may also ask you to perform activities such as:
- Walking on your toes or heels
- Standing up from a squatting position
- Lifting each of your legs in the air while lying on your back
There’s a chance that the physical therapist may recommend imaging tests such as X-rays, magnetic resonance imaging (MRI), a computed tomography (CT) scan or electromyography (EMG). But these tests usually aren’t needed unless your pain is severe or if it hasn’t gone away with at-home treatment.
Take control of your sciatic back and leg pain
Seeing a physical therapist is usually the fastest way to overcome your sciatica pain. They can help diagnose what may be causing the pain, recommend a treatment plan and refer you to a spine specialist if needed.