Sciatica

What You Need to Know About Sciatica

By: Stephen H. Hochschuler, MD

Additional Sciatica Info:

The term sciatica describes the symptoms of leg pain and possibly tingling, numbness or weakness that travels from the low back through the buttock and down the large sciatic nerve in the back of the leg.

The vast majority of people who experience sciatica get better with time (usually a few weeks or months) and find pain relief with non-surgical sciatica treatment. For others, however, sciatica can be severe and debilitating.

Article continues below

The clinical diagnosis of sciatica is referred to as a "radiculopathy", which means simply that a disc has protruded from its normal position in the vertebral column and is putting pressure on the radicular nerve (nerve root) in the lower back, which forms part of the sciatic nerve.

An important thing to understand is that sciatica is a symptom of a problem — of something compressing or irritating the nerve roots that comprise the sciatic nerve — rather than a medical diagnosis or medical disorder in and of itself. This is an important distinction because it is the underlying diagnosis (vs. the symptoms of sciatica) that often needs to be treated in order to relieve sciatic nerve pain.

Sciatica occurs most frequently in people between 30 and 50 years of age. Often a particular event or injury does not cause sciatica, but rather it tends to develop as a result of general wear and tear on the structures of the lower spine.

Sciatica symptoms

For some people, the pain from sciatica can be severe and debilitating. For others, the pain might be infrequent and irritating, but has the potential to get worse.

While sciatica can be very painful, it is rare that permanent nerve damage (tissue damage) will result. Most sciatica pain syndromes result from inflammation and will get better within two weeks to a few months. Also, because the spinal cord is not present in the lower (lumbar) spine, a herniated disc in this area of the anatomy does not present a danger of paralysis.

Sciatica symptoms that may constitute a medical emergency include:

Progressive weakness in the leg
Bladder/bowel incontinence or dysfunction.

Common Causes of Sciatica:

Patients with either of the above symptoms may have cauda equina syndrome and should seek immediate medical attention. In general, patients with complicating factors should contact their doctor if sciatica occurs, including people who: have been diagnosed with cancer; take steroid medication; abuse drugs; have unexplained, significant weight loss; or have HIV.

Sciatica medical definition: radiculopathy

To clarify medical terminology, the term sciatica (often misspelled as ciatica, cyatica or siatica) is often used very broadly to describe any form of pain that radiates into the leg. However, this is not technically correct. True sciatica occurs when the sciatic nerve is pinched or irritated and the pain along the sciatic nerve is caused by this nerve (radicular pain) and is called a radiculopathy. When the pain is referred to the leg from a joint problem (called referred pain), using the term sciatica is not technically correct. This type of referred pain (e.g. from arthritis or other joint problems) is quite common.

Sciatica treatment

Practical point:
Symptoms of sciatica pain can vary greatly but usually decrease after a few weeks or months with non-surgical treatment.

Sciatica nerve pain is caused by a combination of pressure and inflammation on the nerve root, and treatment is centered on relieving both of these factors. Typical sciatica treatment include:

Non-surgical sciatica treatments, which may include one or a combination of medical treatments and alternative (non-medical) treatments, and almost always includes some form of exercise and stretching. The goals of non-surgical sciatica treatment should include both relief of sciatica pain and prevention of future sciatica symptoms.
Sciatica surgery, such as microdiscectomy or lumbar laminectomy and discectomy, to remove the portion of the disc that is irritating the nerve root. This surgery is designed to help relieve both the pressure and inflammation and may be warranted if the sciatic nerve pain is severe and has not been relieved with appropriate manual or medical treatments.