Sciatica. It's not a new trendy restaurant in New York or LA, or a new SciFi program on your favorite cable channel. Sciatica is something much less sexy. Sciatica might actually be the cause of that the sharp pain you occasionally feel in your backside, or traveling down your hip or leg. What is sciatica? What does this pain mean?
Sciatica occurs when there is pressure or damage to the Sciatic nerve. This large nerve starts in your lower spine and runs down the back of each leg. It controls the muscles of the back of your knee and lower leg. It also provides sensation to the back of your thigh, part of your lower leg, and the sole of your foot.
Sciatica is usually caused by another problem, such as a slipped disk, spinal stenosis or narrowing of the spinal column, piriformis syndrome, the narrowing of muscle in your buttocks, a pelvic injury or fracture, and perhaps even tumors.
Your pain may feel like a mild tingling, a dull ache, or a burning sensation. Sometimes the pain can be so bad you might not be able to move. The pain will usually occur on one side, perhaps as a sharp pain in one part of your hip or leg, or maybe you will notice the numbness. The pain may get worse after you stand or sit, at night, when you sneeze, cough, or laugh, or when you bend backwards or walk forward.
For treatment, your doctor will perform a careful physical exam. Your doctor might find you have weakness when you bend your knee or move your foot, trouble bending your foot inward or downward, weak reflexes, or pain when you lift your leg straight up off the examination table while lying down.
Your doctor may also do other tests to find what's causing your sciatica, including blood tests, x-rays, and other imaging tests.
Treatment will focus on what causes your sciatica. Sometimes you may not need treatment because your pain will go away on its own. Your doctor will likely first recommend that you take steps to calm your symptoms and reduce inflammation, such as applying heat or ice to the painful area. You might try ice for the first 48 to 72 hours after you feel pain, then use heat afterwards. Your doctor might also tell you to take over-the-counter pain relievers.
If conservative measures don't help your problem, your doctor may recommend you have injections to reduce inflammation around your sciatic nerve and other medicines to reduce the stabbing pain. Physical therapy may be a viable option, so talk to your healthcare provider about this option.
Whatever you do, don't stay in bed all day. You need to reduce your normal activity for the first few days after you start having pain, but getting no activity will only make your pain worse. After a few days, try gradually returning to your normal routine. But, avoid heavy lifting or twisting your back for at least 6 weeks. Make sure you start exercising again though after 2 to 3 weeks. Remember, include exercises to strengthen your abdomen or belly and improve the flexibility of your spine.
Review Date: 9/22/2016
Reviewed By: C. Benjamin Ma, MD, 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.