Sciatica

Sciatica is nerve pain from an injury or irritation to your sciatic nerve. In addition to pain, it can involve tingling or numbness in your back or butt that may radiate down your leg. You may also feel symptoms in your feet or toes.

Sciatica is very common. Many adults will experience it at some point in their lives. It’s one of the most common causes of leg pain seen in medical care.

Types of sciatica

There are two main types. No matter which type you have, the symptoms often feel the same. These include:

• True sciatica: This type happens when an injury or condition directly affects the sciatic nerve.
• Sciatica-like conditions: These conditions feel like sciatica but have other causes. They relate to nearby nerves or the group of nerves that form the sciatic nerve.

Healthcare providers often use the term “sciatica” for both types. The difference usually matters most when your provider recommends treatment.

What is the sciatic nerve?

The sciatic nerve is a long nerve in your lower body. It’s the largest nerve you have. There’s one on each side.

The nerve plays a major role in how your lower body feels and moves. It connects your lower back to your hips, butt and legs.

Where is the sciatic nerve?

The sciatic nerve starts near the base of your spine in your lower back. It passes through your pelvis and butt. It then runs down the back of each thigh and into your lower leg.

The nerve begins narrow in your lower back and gets slightly wider as it travels down your leg. At its widest point, it’s about the size of a penny.

What is the purpose of the sciatic nerve?

It helps your legs and feet move. It also helps you feel sensations like touch, pain and temperature in your legs. Even though it passes through your butt, it doesn’t control those muscles.

Your sciatic nerve provides two types of functions:

• Motor function: It helps the muscles in your legs and feet move.
• Sensory function: It helps you feel sensations in your legs.

Sciatica symptoms

You may feel sciatica pain in your lower back, butt or legs. Symptoms range from mild to severe and may include:

• Pain (burning or electric shock feeling that shoots down one leg and may get worse when you cough, sneeze, bend or lift your legs while lying on your back)
• Numbness
• Tingling (pins and needles) feeling

Serious symptoms to look out for include:

• Muscle weakness
• Loss of bladder control
• Loss of bowel control

What causes sciatica?

Sciatica happens when something pinches, presses on or irritates your sciatic nerve or its nerve root. It can also happen when conditions affect the group of nerves in your lower back that form the sciatic nerve.

Conditions that can cause sciatic nerve pain include:

• Cauda equina
• Degenerative disk disease
• Foraminal stenosis
• Herniated disks
• Osteoarthritis
• Pregnancy
• Spinal stenosis
• Spondylolisthesis
• Tumors, cysts or other growths

In some cases, providers can’t find a clear cause.

Risk factors

Certain factors may increase your risk. These include:

• Past or current injuries: Injuries to your lower back or spine can raise your risk.
• Aging and wear on the spine: As you get older, spinal disks and joints can wear down. This can lead to pinched nerves or other spine problems. It rarely happens before age 20 unless it’s related to an injury.
• Extra body weight: Carrying extra weight may put more stress on your lower back and spine.
• Weak core muscles: Weak muscles in your abdomen and back may offer less support for your spine.
• Your job or daily activities: Heavy lifting, frequent bending or sitting for long periods can strain your lower back.
• Poor posture or lifting form: Using poor body mechanics during work or exercise may increase your risk.
• Diabetes: Type 2 diabetes may damage nerves.
• Low physical activity: Sitting too much and not moving enough may affect spine health.
• Tobacco use: Nicotine can reduce blood flow and increase chronic pain risk.

Complications

With treatment, most people recover fully. In some cases, symptoms can last longer and lead to ongoing pain.

If a nerve is badly damaged, muscle weakness may occur. One example is foot drop. This makes it hard to lift the front of your foot when walking.

In rare cases, nerve damage may be permanent. This could cause lasting numbness or loss of feeling in your affected leg.

How doctors diagnose sciatic nerve pain

A healthcare provider uses several steps to diagnose sciatica. First, they’ll ask about your symptoms and review your medical history. Then, they’ll perform a physical exam.

The physical exam may include:

• Watching how you walk: Changes in your walking pattern can give clues about nerve pain.
• Straight leg raise test: You’ll lie on an exam table with your legs straight. Your provider will slowly lift one leg at a time. They’ll ask when pain or other symptoms begin. This helps identify which nerve may be involved.
• Strength and flexibility checks: These tests help your provider see how well your muscles move and respond.

What tests diagnose sciatica?

Your provider may order tests to confirm the diagnosis or rule out other conditions. Tests usually aren’t done right away unless you have severe or worsening symptoms. Tests may include:

• Spine X-rays or computed tomography (CT) scans
• Magnetic resonance imaging (MRI) scans
• Nerve conduction velocity studies
• Electromyography
• Myelogram

Sciatica treatments

Treatment for sciatica focuses on easing pain and helping you move more easily.

If symptoms are mild, you can start with self-care. Moderate to severe pain, numbness, tingling or muscle weakness needs medical care.

Self-care options

Many people start treatment with steps they can do at home. Your provider might recommend the following for mild symptom management:

• Cold and heat: Ice may help reduce pain and swelling during the first few days. Heat may help after that. Use either for about 20 minutes at a time.
• Over-the-counter medicine: Anti-inflammatory medicines may reduce pain and swelling.
• Gentle movement and stretching: Stretching and light activity may relieve pressure on the nerve.

If symptoms don’t improve after a few weeks, talk with a healthcare provider.

Medical treatments

If self-care doesn’t help or symptoms are more severe, your provider may recommend:

• Prescription medicines: These may help with pain, muscle spasms or nerve pain.
• Physical therapy: Guided exercises may improve strength and reduce nerve pressure.
• Spinal injections: These may offer short-term pain relief in some cases.

Sciatica stretches

During physical therapy, your therapist may teach you exercises to do in their office and at home. They’ll show you how to perform them safely. Here are some examples:

• Bridging: Lie on your back with your knees bent and your feet flat on the floor, about hip-width apart. Tighten your belly and squeeze your butt muscles. Lift your hips until your body forms a straight line. Hold for a few seconds, then slowly lower your hips down.
• Cat-and-camel (cat-cow): Start on your hands and knees with your hands under your shoulders and your knees under your hips. Slowly round your back toward the ceiling. Then, let your belly drop and lift your chest and tailbone. Move slowly and breathe as you switch between positions.
• Knee-to-chest: Lie on your back with your legs straight or your knees bent. Bring one knee toward your chest. Hold behind your thigh or over your shin until you feel a gentle stretch. Lower your leg and switch sides.
• Lower back extension: Lie on your stomach with your hands under your shoulders (push-up position). Keep your hips relaxed on the floor. Gently press up to lift your chest and slightly arch your lower back. Slowly lower your chest back down.

Surgery

Surgery is usually a last option. Providers may suggest it if pain is severe, nerve damage is a concern or if other treatments don’t help.

Common procedures include:

• Diskectomy: This surgery removes part of a disk that presses on a nerve.
• Laminectomy: This surgery removes bone that presses on spinal nerves.

What is the recovery time?

Recovery time varies based on your symptoms and their cause. It can also depend on the type of treatment you use.

Many cases improve within four to six weeks without medical treatment. More severe cases may take longer and can last several weeks or months.

If symptoms last longer than a few weeks or get worse, it’s important to talk with a healthcare provider.

What can I expect if I have sciatica?

Mild cases often improve over time with self-care. Most people feel better without needing surgery.

Talk with a healthcare provider if pain doesn’t improve after a few weeks or if recovery feels slower than expected.

How long does sciatic nerve pain last?

Sciatica often doesn’t last longer than six weeks. When it does, your healthcare provider may recommend more involved treatments, like therapy or surgery.

What’s the outlook for this condition?

The outlook is usually very good. Most people recover without long-term problems. Ongoing issues are more likely only if symptoms are severe.

How can sciatic nerve pain be prevented?

Not all causes of sciatica pain can be prevented. These tips may help lower your risk:

• Use good posture: Sit, stand, lift and sleep in ways that support your back.
• Avoid tobacco: Nicotine can reduce blood flow and weaken your spine.
• Maintain a healthy weight: Extra weight can put more strain on your lower back.
• Stay active: Regular movement, stretching and core-strength exercises help support your spine.
• Prevent falls: Wear supportive shoes and keep walkways clear and well-lit.
• Let your body recover: Don’t push through back pain. Choose low-impact activities like walking, swimming or yoga when needed.

Can sciatica occur down both legs?

Sciatica usually affects one leg at a time. In rare cases, it can affect both legs.

Can weight gain during pregnancy cause sciatic nerve pain?

Sciatica is common during pregnancy, but it’s not usually caused by weight changes alone.

Pregnancy hormones can loosen ligaments in your spine. This can make your spine more flexible and increase pressure on your nerves. The growing fetus can also press on your sciatic nerve.

There are ways to ease pain during pregnancy. Options may include:

• Physical therapy
• Massage
• Warm showers
• Heat
• Certain medications
• Using good posture

Pain often improves after birth.

How can I tell if pain in my hip is a hip issue or sciatic pain?

Hip problems often cause pain in your groin. Pain may also occur when you put weight on your leg or move your hip.

Sciatic pain usually starts in your lower back. It may travel into your hip or down your leg. Numbness, tingling and weakness also point more toward sciatica.

Should I rest if I have sciatica?

Short periods of rest may help during the first day or two. Too much rest may make pain worse and slow recovery.

Light movement can help you stay flexible and strong. A healthcare provider can help you find the right balance between rest and activity.