Whenever a nerve is compressed, irritated, or otherwise inflamed, it usually causes an array of symptoms. In many cases, this results in chronic pain radiating from the affected nerve, and might cause other effects such as tingling sensations within the body or on the skin, or a loss of sensation in the affected area.

Sciatic nerve pain is caused by compression of on or more of five spinal nerves that extend through the lower back and gluteal regions. When these nerves become compressed or the areas around them are inflamed, this usually causes radiating pain in the lower back, the buttocks, and depending on which specific nerve is affected, pars of the leg or foot. The nerves affected are either lumbar nerves (L4 or L5), or sacral nerves (S1, S2, S3), or the sciatic nerve. Sciatica is sometimes confused with pseudosciatica, a condition where referred pain is experienced as a result of damage to the lower back’s facet joints, or because of compression of peripheral sections of the nerve due to soft tissue tension.

The extent of the compression of the nerve affects the severity and range of symptoms that are experienced. More extensive cases usually involve pain, but also include numbness, muscle weakness, a ‘pins and needles’ sensation throughout the affected area, and difficulty moving or controlling leg motion. For some people, exposure to cold weather can worsen symptoms.

Usually, sciatic nerve pain is restricted to one side of the body.

It is important to understand that the term sciatica does not describe the actual cause of nerve compression. Instead, sciatica is a term that describes the symptoms present when a sciatic nerve is compressed. The reason for the compression is usually related to a different diagnosis.

Causes of Sciatic Nerve Pain

Sciatic nerve pain is caused by compression of the lumbar, sacral, or sciatic nerves mentioned above. The cause of compression varies greatly. For instance, sciatic nerve pains can be induced by compression of a dorsal nerve root as a result of a spinal disk bulge or spinal disk herniation. Other causes include roughened, enlarged, or misaligned vertebrae, or because of spinal disk degeneration. Sometimes, sciatic nerve pain will dissipate if tears in disks heal.

Sciatica can also be caused by tumors that apply pressure to the nerve as they grow on the spine or nerve roots. Spinal tumors often cause a range of extra symptoms, such as severe back pain that extends outwards to the hips and downwards to the feet, loss of bladder or bowel control, and muscle weakening. Sometimes, trauma to the spine – caused by accidents such as vehicle collisions or workplace accidents – can also induce sciatica.

Lumbar spinal stenosis – where the spinal canal (where the spinal cord runs between vertebrae) narrows and applies pressure to the spinal cord can also result in sciatic nerve pain. This narrowing can be caused by bone spurs, inflammation, or herniated disks.

Some people – about 15% of the population – experience sciatica as the result of the way that their sciatic nerve grew. In these cases, the nerve runs through the muscle tissue known as the piriformis, instead of behind it in the usual fashion. This means that when the piriformis muscle shortens or experiences a spasm, it compresses or strangles the sciatic nerve. Muscle shortening or spasms are usually caused by injury or overuse. This condition is known as piriformis syndrome, but is also called ‘wallet sciatica’, because a wallet placed in the rear pocket will compress the buttocks muscles and the sciatic nerve when it is sat upon.

How is Sciatic Nerve Pain Diagnosed?

Sciatic Nerve Pain

Further testing might be necessary depending on the severity of the condition. Use of computer tomography or MRI (magnetic resonance imaging) can be used to diagnose sciatica. In severe cases, magnetic resonance neurography will be used to diagnose sciatica. Magnetic resonance neurography might be necessary in order to diagnose piriformis syndrome.

How is Sciatic Nerve Pain Treated?

In the case where the sciatic nerve pain is caused by a prolapse of the lumbar disk or a hernia of the lumbar disk, 9 out of 10 cases will resolve themselves over time without clinical treatment. However, if the condition is caused by epidural abscess, tumors, or cauda equine syndrome, then clinical treatment is almost always necessary.

For alleviating symptoms, medications are often prescribed, but the results are often mixed. Many clinical studies have obtained mixed results (or even completely negative results) when tracking the impact of analgesics and anti-inflammatory drugs on pain caused by sciatica. Bear in mind that this does not meant that medication will necessarily always be ineffective. In addition, some doctors prescribe muscle relaxants to alleviate symptoms.

Clinical studies of sciatica patients have also revealed that there is very little difference in outcome between recommendation by doctors to either stay active or to seek prolonged bed rest, and it is unclear whether the use of physical therapy exercises are any more effective than bed rest alone.

Most sciatica that does not dissipate on its own is treated by optional surgical intervention. Though a variety of surgeries are performed, all focus on treating the underlying cause of the condition by alleviating disk herniation. Clinical studies show that in the short term, this is the most effective treatment for pain relief, though very little difference is seen in long-term follow-ups of patients.

Sciatic Nerve Pain

Sciatic Nerve Pain affects people for different reasons

The main cause of sciatic nerve pain is compression of the lower vertebrae, so sitting for long periods of time will often make it worse.  People who sit for long periods of time at a desk or driving vehicles tend to suffer from sciatica more than people who are able to get up and move around more frequently.  People who are overweight also suffer from sciatic nerve pain more than people who are average weight, as the excess pounds can put extra pressure on the lower vertebrae.  During pregnancy, women often complain of sciatica as they near the ends of their pregnancies.  The reason it is so common in pregnancy is the baby often puts strain on the lower back, as well as the extra weight and shifting center of gravity as the baby grows.

Treatment for sciatica in its acute phase usually focuses around symptom management.  In most cases, anti-inflammatory medications or other pain relievers are recommended for pain.  Patients are recommended to lie on their side with a pillow between their knees to help relieve pressure from the lower back.  People who suffer from sciatica as a result of prolonged sitting are recommended to get up and stretch deeply for several minutes every hour in order to elongate the back again and alleviate pressure on the lumbar region.

Sciatic nerve pain is extremely uncomfortable

It is characterized by a radiating pain down one or both of the buttocks into the leg and the foot.  Sufferers also often complain of numbness and tingling or weakness in one or both legs, depending on what side the sciatica is on.  People who sit for prolonged periods of time, as well as pregnant or overweight people are more likely to suffer from sciatic nerve pain than anybody else.  Treatment is usually fairly simple and revolves around making the patient comfortable and alleviating pain.  Once a sciatica flare up goes away, prevention is key.  Patients are encouraged to avoid sitting for so long, and to stretch frequently.  Patients who are overweight are encouraged to lose weight in order to prevent more flare ups of sciatic nerve pain.