Understanding Sciatic Nerve Pain – How to Relieve Sciatica Symptoms

Sai-attica. Sky-attica. Skee-attica. 

No matter how you pronounce it, one thing everyone can agree on is that living with it is miserable (and in case you’re wondering, our doctors say the correct pronunciation is sai·a·tuh·kuh.) 

Sciatica is a pain condition where pain starts in the lower back and radiates along the sciatic nerve, usually as a result of an injury or irritation. The sciatic nerve runs from the lower back through the glutes, down the back of the leg. In short: sciatica is pain that starts in the back and doesn’t quit until it’s reached the heels. And as you can imagine, it’s no fun at all.  

Unlike localized pain conditions or injuries, sciatica can be unpredictable, causing buttock pain one day and leg pain the next – or an unpleasant combination of both.  

The sciatic nerve is the longest and thickest nerve in your body (up to 2 centimeters wide). In fact, it’s so thick because it’s not just one nerve but a bundle of nerves that come from five nerve roots branching off from your spinal cord. And you don’t just have one – you have two, one running down each leg.  

Common Symptoms of Sciatica  

The chief symptom of sciatica is pain, usually resulting from pressure on the affected nerve (or nerves – sciatica in one leg? Ouch. But sciatica in two?! No thank you.) Most people describe their sciatica pain as burning. It can also feel similar to an electric shock. Pain is often intense, and can be localized – say, in the buttock – or can shoot or radiate down the leg on the affected side (or sides – again, no thanks.)  

Sciatica pain is usually exacerbated by movements like coughing, sneezing, bending or lifting your legs upward – especially when lying on your back. Severe cases can also be accompanied by tingling or a “pins and needles” sensation (paresthesia) – like that feeling you get when your leg, foot, or hand falls asleep.  

Sciatic nerve pain can also lead to numbness if the pressure on the sciatic nerve prevents signals from your back or leg from reaching your brain. Muscle weakness is also common in people experiencing sciatica (particularly more severe cases.) This is an indication that muscle command signals are having trouble reaching their destination – your back or legs. Most people are also surprised to learn that in very severe cases of sciatica, nerve damage can even result in incontinence. 

How Many Types of Sciatica Are There?  

Most people think of Sciatica as a singular condition, but there are two conditions that cause sciatica pain:   

• True sciatica. This is any condition or injury that directly affects your sciatic nerve. 

• Sciatica-like conditions. These are conditions that feel like sciatica – they result in the same symptoms – but happen for other reasons than direct sciatic nerve damage. 

Healthcare providers tend to refer to both types as just “sciatica.” While pain is pain to you, the difference does matter to your provider, who will use the differentiation to determine the proper course of treatment. 

What Causes Sciatica 

Sciatica is really a series of symptoms – versus, for example, herniated disc, which is an injury that can result in sciatica. Any condition that affects the sciatic nerve or the five spinal nerves that bundle to form the sciatic nerve, can be called sciatica.  

Conditions that can cause sciatica symptoms (injury to or irritation of the sciatic nerve include: 

• Herniated discs: A herniated disc, also known as a slipped or ruptured disc, occurs when the soft, jelly-like center of a spinal disc (the nucleus pulposus) pushes through a crack in the tougher outer layer (annulus fibrosus), potentially irritating nearby nerves and causing pain, numbness, or weakness 

• Degenerative disk disease: In this condition, your spinal discs begin to wear down, irritating nearby nerve  

• Spinal stenosis: a condition where the spinal canal, the bony tunnel that protects the spinal cord and nerve roots, becomes narrowed, irritating nearby nerves.  

• Foraminal stenosis: a condition where the spaces (foramina) between the vertebrae in the spine become narrowed, putting pressure on the nerve roots that exit the spinal cord 

• Spondylolisthesis: a condition where one vertebra in your spine slips forward over the vertebra below it, often causing lower back pain and potentially leg pain or numbness 

• Osteoarthritis: a degenerative joint disease that occurs when the cartilage that cushions the ends of bones wears down over time 

• Injuries: Traumatic injuries (such as car accidents, falls, and contact sports), fractures or dislocations, can directly damage the nerve or cause fragments of bone to compress it.  

• Pregnancy: As pregnancy progresses and your abdomen expands, the curve of your spine becomes more pronounced and your body works harder to distribute the additional weight and maintain balance, putting pressure on your sciatic nerve. 

• Tumors, cysts or other growths: these growths can cause sciatica pain by directly compressing or irritating the sciatic nerve.  

• Conus medullas syndrome: a neurological condition resulting from compression or injury to the conus medullaris, the terminal portion of the spinal cord, often causing symptoms like severe back pain, bowel and bladder dysfunction, and potential weakness or numbness in the lower limbs 

• Cauda equina syndrome: Cauda equina syndrome is a medical emergency that happens when an injury or herniated disk compresses nerve roots at the bottom of your spinal cord. The cauda equina nerves communicate with your legs and bladder. It causes back pain, weakness and incontinence. Surgical treatment is required to prevent permanent complications. 

Are You At Risk for Sciatica? 

Because there are so many causes of sciatica, it can happen to almost anyone Here are some of the potential risk factors to watch out for: 

• A current or previous injury. Injuries to your spine or lower back increase your risk of sciatica. 

• Normal wear-and-tear. As we age, wear-and-tear on the spine can lead to pinched nerves, herniated disks and other conditions that can cause sciatica. 

• Excess weight or obesity. Excess body weight requires your back muscles to work harder, leading to back strains, pain and other issues. 

• Weak core muscles. The muscles of your back and abdomen (stomach area) make up your core. A strong core helps anchor and protect your back muscles. 

• Lifting, bending, and sitting. Heavy lifting, a lot of bending, or working in awkward or unusual positions may increase your risk of low back problems. Prolonged sitting — especially without proper back support — may also increase your risk of sciatica. 

• Diabetes. Type 2 diabetes increases your risk of diabetes-related peripheral neuropathy. That damages your nerves, including any of the nerves that can cause or contribute to sciatica. 

• Tobacco Use. Nicotine use can affect circulation and increase your risk of chronic pain. That includes conditions like sciatica. 

When to See a Doctor About Your Sciatica  

Sciatica usually does not have long-term complications; most people recover fully, many without treatment. However, serious complications are possible – including chronic (long-term) pain. Issues like permanent nerve damage and chronic muscle weakness, such as a “drop foot,” can result from sciatica. 

Both your DC and an orthopedic physician can properly diagnose sciatica and prescribe a course of treatment. If your sciatica isn’t severe, it may respond to a regimen of heat, ice, and light rest (too much prolonged inactivity can worsen sciatica.)  

Routine exercise, dropping any excess weight, and practicing good ergonomics can all help prevent sciatica and its related causes – and make you feel better all around.