Sciatica causes, symptoms and management

August 19, 2024

Providence Health Team

[8 MIN READ]

Sciatica refers to pain that occurs along the sciatic nerve from your lower back down the back of each leg. Pain comes from irritation, inflammation, pinching or compression of this nerve.
Signs of sciatica can include pain in the lower back or shooting down the leg, tingling, weakness in the leg or numbness in the back, legs or hips.
Treatments for sciatica include medicine, physical therapy, steroid injections and surgery. Most people feel relief with treatment and time, and about 80%-90% don’t need surgery.

Sciatica causes, symptoms, diagnosis and treatment

Sciatica is a common condition that affects about 40% of people in the United States. It can be painful, but most mild cases go away with treatment and time (usually four to six weeks). Surgery usually isn’t necessary.

Here is an overview of the causes and symptoms of sciatica, along with treatment options.

Understanding sciatica

Sciatica refers to pain that occurs along the sciatic nerve, which runs from your lower back through your butt and down the back of each leg. It is the longest and widest nerve in the body, ending just below the knee. Because of the location of the nerve in the hip, some people call it the “sciatic joint.” But the correct names are sacroiliac joint and sciatic nerve.

Sciatic pain comes from irritation, inflammation, pinching or compression of this nerve. It usually affects only one side of your body. In rare cases, it can occur in both legs.

Who is most likely to experience sciatica?

Sciatica can affect anyone, but some factors can increase your risk. These include:

Age: People between 30 and 50 are more likely to have sciatica
Job: Heavy lifting, twisting or sitting for long periods can cause strain
Injury: A previous spine or back injury can raise risk
Lifestyle: Sedentary living can weaken muscles and cause poor posture
Pregnancy: The weight of a fetus can put pressure on the sciatic nerve
Smoking: Tobacco can affect circulation and risk of chronic pain
Type 2 diabetes: Diabetes can cause nerve damage, including sciatic pain

Primary causes of sciatica

Sciatica can result from conditions that affect the sciatic nerve. Among the primary ones:

Herniated disc: This occurs when a soft disc between the vertebra (bones of the spine) moves out of place and puts pressure on the sciatic nerve. It’s the most common cause of sciatica.
Piriformis syndrome: Muscle spasms in the piriformis muscle in the butt can irritate the sciatic nerve. However, according to Mark Matusak, D.O., a primary care sports medicine physician at Providence Medical Institute, “The frequency of this condition as the cause of sciatica is debated and may be over diagnosed.”
Spinal stenosis: Wear and tear and inflammation can cause the spinal canal to narrow. This may compress the spinal cord and sciatic nerve and lead to pain.
Traumatic injuries: Accidents may cause a sudden pull on the nerves or direct compression of the sciatic nerves, which can result in sciatic pain.

Vitamin deficiency and sciatica

Vitamins play an important role in nerve health, and deficiencies can lead to health problems, including sciatica. “Vitamin deficiency may contribute to nerve pain, but typically does not cause an isolated sciatic nerve problem,” Dr. Matusak says. “Common vitamins that can be helpful for nerve health include vitamin B1 (thiamin), B6, B9 (folate) and B12.”

Research also suggests that a deficiency of vitamin D may be linked to chronic pain like sciatica. And vitamins C and E are antioxidants that help protect nerves from damage. Beyond vitamins, studies show that magnesium can also support sciatic nerve healing.

Common symptoms of sciatica

People may experience sciatica differently. Some may feel sudden symptoms, or they can come on gradually. They can be mild and infrequent or severe and constant.

Common symptoms include:

Numbness: Loss of feeling in the back, legs or hips
Pain: Stabbing pain in the lower back, butt, or that radiates down the back of your leg
Pins and needles: Burning sensation, electric shock feeling or tingling down the back of the leg
Weakness: Difficulty moving the leg or foot or walking

If you experience severe pain, tingling, muscle weakness or incontinence, talk to your doctor right away.

Diagnosing sciatica

Your doctor will ask you about your medical history and symptoms. It’s important to be very specific about what you are feeling and where.

They may watch how you walk and check your flexibility and strength. You may also do a straight leg raise test. This is where you lie down and your doctor slowly lifts your affected leg to see when your pain occurs.

Other ways to diagnose sciatica include:

Electromyography: Measures how fast nerve signals travel through your muscles
Imaging tests (X-rays, CT scans and MRI scans): Show internal views of the spine and hip
Myelogram: Uses a contrast material and X-rays or CT scans to get pictures of the spine

Treating sciatica

Sciatica treatment includes many options, and most people find relief. “Sciatica can improve and even go away with the proper treatment addressed at the underlying cause,” Dr. Matusak says.

Self-treatment options

Mild cases of sciatica often improve with the following:

Heat: A heating pad may alleviate pain
Ice: Cold packs may reduce pain and swelling
Over-the-counter medicine: Nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin and ibuprofen may decrease pain, swelling and inflammation
Physical activity: Yoga, low-impact exercise and stretches (see below) may help

Effective stretches for sciatica relief

Dr. Matusak says that the most effective stretches to address sciatica pain may vary based on the cause of the condition. “A physical therapist can tailor a program to address strength imbalances and restricted motion,” he adds.

Common stretches to help sciatica include:

Basic seated stretch: Sit on a chair with your feet flat on the floor. Cross your right ankle over your left knee. Lean forward and hold for 15-30 seconds. Repeat on the other side.
Hamstring stretch: Sit on the floor with both legs straight. Extend your arms and lean forward with a flat back, drawing your chest toward your thighs. Hold for 15-30 seconds and repeat.
Piriformis stretch: Lie on your back with your knees bent and feet flat on the floor. Cross your right ankle over your left knee. Use your hands to pull your left thigh toward your chest. Hold for 15-30 seconds and repeat on the other side.

Professional treatment methods

If your sciatic pain doesn’t go away after about eight weeks, or if it is severe, your doctor may suggest additional treatment options. These include:

Physical therapy: Exercises and stretches reduce pressure on the sciatic nerve
Prescription medicines: Painkillers, muscle relaxers and other medicines may decrease symptoms
Steroid injections: Shots may offer short-term pain relief
Surgery: Diskectomy removes part or all of a herniated disk; laminectomy removes a portion of the vertebra

Surgery may be an option if non-surgical treatments haven’t helped. It also may be recommended when sciatica is severe and affects your ability to work or live normally. Talk with your doctor about what treatment is best for you.

Alternative therapies

Non-traditional treatments may provide relief as well. Among them:

Acupuncture: May reduce muscle spasms and inflammation
Biofeedback: May help you manage pain and deal with stress
Chiropractic: May improve your posture and mobility
Massage: May decrease muscle spasms and promote relaxation

Living with sciatica

Most people recover fully from sciatica. But it can come back, and sometimes it may become chronic.

Being physically active and maintaining a healthy weight can help you cope with sciatica or prevent recurrence. Eating a nutritious diet and avoiding smoking are also recommended.

Contributing caregiver

Mark Matusak, D.O., is a primary care sports medicine physician at Providence Medical Institute in Torrance, California.

Find a doctor

If you are looking for a primary care provider, you can search for one who’s right for you in our provider directory.

Download the Providence app

It’s all in the app: easily stay connected with Providence and your health. With the Providence app, you can schedule appointments, have virtual visits from the comfort of your own home, get health recommendations personalized for you, access your health records and so much more. Learn more and download the app.