Pronounced: sigh-AT-i-kuh
Sciatica is irritation of the sciatic nerve that passes down the back of each thigh.
The sciatic nerve arises from the lower spine on either side and travels deep in the pelvis to the lower buttocks. From there, it passes along the back of each upper leg and divides at the knee into branches that go to the feet.
Sciatica typically causes pain that shoots down the back of one thigh or buttock. Sciatica pain is often burning, tingling, or numbness on one side of the leg. Pain may also be present on one side of the buttocks that worsens when seated for a long time.
Anything that causes irritation or puts pressure on the sciatic nerve can cause sciatica, including:
These factors increase your chance of developing sciatica. Tell your doctor if you have any of these risk factors:
Sciatica causes symptoms that can range from mild to severe.
Typical symptoms include:
More serious symptoms associated with sciatica that may require immediate medical attention include:
The doctor will ask about your symptoms and medical history, and examine your back, hips, and legs. The physical exam will include tests for strength, flexibility, sensation, and reflexes.
Other tests may include:
The goal of treatment is to reduce sciatic nerve irritation.
Treatment options include:
Prolonged bedrest is usually not advised. However, your doctor may recommend resting in bed for 1-2 days. Too much bed rest can weaken muscles and slow healing. Doctors generally recommend staying active within the limits of your pain and avoiding activities that worsen back pain.
Medications used to treat sciatica include:
Physical therapy may be done at home or at work. It may include the following:
These therapies have not been proven by scientific studies to have an effect on sciatica. However, some people may find some pain relief from the following:
Surgery may be done to relieve pressure on the sciatic nerve. This is performed in emergency situations or if conservative treatments fail. Common surgical procedures are microdiskectomy and lumbar laminectomy .
Talk to your doctor about the right treatment plan for you. For example, a study found that after one year, there was little difference between patients that had microdisketomy and those that had conservative treatment (such as rest, physical therapy, and medications). But, people that had surgery did report faster recovery time. *¹
If you are diagnosed with sciatica, follow your doctor's instructions .
Sciatica tends to recur. The following steps may help keep it from coming back or, in some cases, from happening in the first place:
RESOURCES:
American Association of Neurological Surgeons
http://www.neurosurgery.org/
Sciatica.org
http://www.sciatica.org/
CANADIAN RESOURCES:
Health Canada
http://www.hc-sc.gc.ca/index_e.html/
Healthy U
http://www.healthyalberta.com/
References:
Allen C, Glasziou P, Del Mar C. Bed rest: a potentially harmful treatment needing more careful evaluation. Lancet. 1999;354:1229-1233.
American Association of Neurological Surgeons website. Available at: http://www.neurosurgery.org .
Berkow R, Beers M, Fletcher A. Low back pain. The Merck Manual of Medical Information . New York, NY: Pocket; 1999.
Sciatica. Postgrad Med. July 1997.
Waddell G, Feder G, Lewis M. Systematic reviews of bed rest and advice to stay active for acute low back pain. Br J Gen Pract. 1997;47:647-652.
*¹6/7/2007 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Peul WC, van Houwelingen HC, van den Hout WB, et al. Surgery versus prolonged conservative treatment for sciatica. N Engl J Med. 2007;356:2245-2256.
Last reviewed February 2009 by Jill D. Landis, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2007 EBSCO Publishing All rights reserved.