Sciatica

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KEY POINTS

• The sciatic nerve is a large nerve that runs from your lower spine down your leg to your foot. Sciatica is pain that starts from your lower back or hip and goes down your leg.
• You may start feeling better within a few days of a back strain or injury if you don't strain your back again and if you take medicine for pain and inflammation.
• Ask your healthcare provider if there are activities you should avoid and when you can return to your normal activities.

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What is sciatica?

Sciatica is pain that starts from your lower back or hip and goes down your leg.

What is the cause?

The sciatic nerve is a large nerve that runs from your lower spine down your leg to your foot. Anything that irritates or puts pressure on this nerve can cause sciatica. The most common causes are:

• A disk that bulges or is pushed out of place in your spine by injury or a severe strain. Disks are rubbery cushions between the bones of the spine (vertebrae). A bulging (herniated) disk can pinch the nerves that pass through the bones of the spine.
• Frequent lifting or carrying of heavy objects
• Spending a lot of time bending over, or sitting or standing in one position
• A problem that causes the bones, joints, disks, or muscles to break down, such as arthritis or osteoporosis
• Spondylosis (hardening and stiffening of the spine)
• Spinal stenosis (a narrowing of the spinal canal that can squeeze the spinal cord and nerves)
• Infection or a tumor

What are the symptoms?

Symptoms may include:

• Pain that goes from your lower back and buttocks to your leg or ankle
• Numbness or tingling in your leg
• Weakness in your leg muscles

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Usually you will not need X-rays or other types of scans in the early part of your treatment. If the pain does not get better in a few weeks, or if your symptoms get worse, you may have tests such as:

• X-rays
• CT scan, which uses X-rays and a computer to show detailed pictures of your spine
• MRI, which uses a strong magnetic field and radio waves to show detailed pictures of your spine

How is it treated?

You will probably start feeling better within a few days of a back strain or injury if you don't strain your back again and if you take some medicine for pain and inflammation. Treating the pain right away can help keep it from becoming chronic, ongoing pain. Often the pain is gone in a week or two.

Your healthcare provider may recommend:

• Rest. It's best to try to stay somewhat active, so try not to rest in bed longer than 1 to 2 days or the time your provider recommends.
• Exercise. Your provider may recommend physical therapy or exercises that you can do at home to strengthen your belly and back muscles to avoid further injury.
• Medicine. Several types of medicines may help relax muscles or treat the pain. Take all medicine as recommended by your healthcare provider.
• Surgery. Depending on the cause of your back pain and if you keep having symptoms, you may need to have surgery.

How can I take care of myself?

To help relieve pain:

• Take pain medicine as directed by your healthcare provider.
• Put an ice pack, gel pack, or package of frozen vegetables, wrapped in a cloth to protect your skin, on the painful area every 3 to 4 hours for up to 20 minutes at a time.
• Put a hot water bottle or electric heating pad on your back. Cover the hot water bottle with a towel or set the heating pad on low so you don’t burn your skin. Do not fall asleep on a heating pad.
• Try putting moist heat on the injured area for 10 to 15 minutes at a time before you do warm-up and stretching exercises. Moist heat may help relax your muscles and make it easier to move your body. Moist heat includes heat patches or moist heating pads that you can purchase at most drugstores, a wet washcloth or towel that has been heated in the dryer, or taking a hot shower.
• Get a back massage by someone trained in giving massages.
• Change your position often throughout the day. Try to alternate sitting and standing. If you must stand for a long time, try putting one foot on a low stool. If you must sit for a long time, a cushion on the painful side may help.
• If you smoke, stop. Smoking decreases blood flow to muscles and disks in and around your spine. Injuries take longer to heal in people who smoke.

Ask your healthcare provider:

• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

How can I help prevent sciatica?

If you have had sciatica, you are likely to get it again. To help keep from having it again:

• Keep your abdominal and back muscles strong. Get some exercise every day and include stretching and warm-up exercises suggested by your provider or physical therapist.
• Practice good posture.
  • Stand with your head up, shoulders straight, chest forward, weight balanced evenly on both feet, and pelvis tucked in.
  • Whenever you sit, sit in a straight-backed chair and hold your spine against the back of the chair.
  • Use a footrest for one foot when you stand or sit in one spot for a long time. This keeps your back straight.
• Protect your back.
  • When you need to move a heavy object, don't face the object and push with your arms. Turn around and use your back to push backwards so the strain is taken by your legs.
  • When you lift a heavy object, bend your knees and hips and keep your back straight. If you do a lot of heavy lifting, wear a belt designed to support your back. Avoid lifting heavy objects higher than your waist. Ask your healthcare provider how much weight is safe for you to lift.
  • Carry packages close to your body, with your arms bent.
  • Lie on your side with your knees bent when you sleep or rest. It may help to put a pillow between your knees. Put a pillow under your knees when you sleep on your back.
• Lose weight if you are overweight to reduce the strain on your back and legs.