Sciatica

Sciatica is a term used to describe the pain that follows the path of the sciatic nerve. This nerve originates in the lower back and travels through the buttocks, extending down into the leg and foot. This may cause sharp, shooting pain, tingling, numbness, or weakness in the lower extremities. Early diagnosis and treatment can relieve discomfort, restore mobility, and prevent long-term nerve problems.

What Causes Sciatica?

Sciatica is a symptom caused by irritation or compression of the sciatic nerve itself, or more commonly, the nerve roots that compose the nerve in the lumbar spine.

Common spinal causes include:

• Herniated disc in the lumbar spine pressing on a nerve root
• Spinal stenosis, or narrowing of the spinal canal
• Degenerative disc disease or age-related wear and tear
• Spondylolisthesis, where one vertebra slips forward over another
• Enlarged joints or cysts between the vertebrae, causing nerve compression

Other non-spinal causes (less common):

• Piriformis syndrome (compression from buttock muscles)
• Injury or trauma to the Sacrum or Pelvis
• Hip arthritis or injury
• Direct compression during pregnancy
• Shingles (viral infection), which is typically accompanied by a skin rash

What Are the Symptoms?

Sciatica symptoms usually affect one side of the body and may include:

• Sharp, shooting pain radiating from the lower back to the buttocks and down the leg
• Numbness, tingling, or “pins and needles” in the leg or foot
• Weakness in the affected leg
• Difficulty moving the foot of the affected leg
• Pain that worsens when sitting, coughing, or sneezing
• Burning or shock-like sensations along the nerve path

Symptoms can range from mild to severe and may come and go depending on activity.

When Should I See a Specialist About Sciatica?

You should contact a spine or orthopedic specialist if you experience:

• Leg or back pain lasting more than a few weeks
• Sudden, severe pain after an injury
• Numbness, tingling, or weakness in your leg or foot
• Pain that interferes with walking, working, or sleeping

If you experience a loss of bladder or bowel control, you should seek emergency medical attention immediately.

Getting help early can prevent worsening symptoms and permanent nerve damage.

How Is Sciatica Diagnosed?

To diagnose sciatica, a specialist will:

• Review your medical history and symptom patterns
• Perform a physical exam to check strength, reflexes, and flexibility
• Order imaging tests such as X-rays, MRI, or CT scans to identify the cause of nerve compression

How Is Sciatica Treated?

Most people with sciatica improve with nonsurgical treatment. The right plan depends on the underlying cause and severity of symptoms.

Nonsurgical Treatments

• Rest and avoiding activities that worsen symptoms
• Anti-inflammatory medications (NSAIDs) or muscle relaxants
• Heat or ice therapy for pain relief
• Physical therapy to strengthen core and back muscles
• Steroid injections to reduce inflammation around the nerve

Most patients notice significant improvement within 6 to 12 weeks.

Surgical Treatments

Surgery may be necessary if:

• Pain or weakness persists after several months of nonsurgical care
• Symptoms are severe or disabling
• Imaging shows a herniated disc or spinal stenosis compressing the spinal nerves

Common procedures include:

• Microdiscectomy: Removes the part of a disc pressing on the nerve
• Laminectomy: Removes part of the vertebral bone to relieve spinal canal narrowing

Both are typically minimally invasive and highly effective.

What Are the Risks of Spinal Sciatica Surgery?

While generally safe, risks may include:

• Infection
• Bleeding or blood clots
• Nerve injury (rare)
• Recurrent symptoms if another disc or area compresses the nerve
• Persistent pain or stiffness

Working with an experienced spine surgeon and sticking to your rehabilitation plan can help minimize these risks.

What Does Recovery from Spinal Sciatica Surgery Involve?

Recovery may include:

• Short-term rest, followed by a gradual return to daily activity
• Physical therapy to restore mobility and build strength
• Avoiding heavy lifting or twisting until cleared by your doctor
• Work towards long-term improvement of posture and core stability

How Long Does Recovery Take?

• Microdiscectomy: 4 to 6 weeks for daily activities
• Laminectomy or more extensive surgery: 3 to 6 months for full recovery

Athletes or physically demanding workers may need longer before returning to peak activity.

What Is the Outlook for Sciatica?

Most people recover fully from sciatica with the proper nonsurgical or surgical care. Early treatment, ongoing physical therapy, and healthy lifestyle habits help prevent recurrence and support long-term back health.