Sciatica is a common neurological condition described as pain, numbness, weakness, or tingling radiating from the lower back to the leg. The symptoms usually occur on one side and vary from mild to unbearable.
It is important to understand that sciatica is not a disease itself. It is rather a symptom caused by an underlying condition. In most cases the underlying condition is a herniated disc, other degenerative disc diseases or spinal stenosis.
Sciatica can be caused by any underlying condition that squeezed the sciatic nerve. The sciatic nerve is a large nerve that starts in the lower back and runs down the back of each leg. It controls the muscles and the sensation of the leg and foot.
• Bulging or herniated disk in the back (most common)
• Other degenerative disk disorders
• Lumbar spinal stenosis
• Piriformis syndrome
• Tumor and others
The symptoms are depending on anatomical structure and the function of the sciatic nerve (see above). The following symptoms may occur in the lower back, the buttock, the hip and the leg:
• Pain: Often the pain is described as a sharp pain. The pain can be so severe that movements may be difficult.
• Tingling, burning, numbness or other sensory symptoms
• Weakness of the muscles and problems to move the leg
Symptoms may worsen when you cough, sneeze, or laugh, or when you sit or stand for long periods of time. Being overweight is a risk factor.
As a first step, it is important to find the underlying condition causing the sciatica. A neurologist can find the location of the lesion by the symptoms presented. Depending on the location (L4, L5, S1) symptoms in the leg may vary. The treatment depends on the underlying condition and the severity of symptoms. If the symptoms are very mild and there is no danger of worsening, the symptoms may improve on its own.
Depending on the underlying condition the treatment may include:
• Physiotherapy: Initially it is important to reduce any movement that puts pressure on the sciatic nerve. Moreover, strengthening and stretching exercises may applicable. Applying heat or icing brings relief in some patients.
• CBT: Large studies could show that Cognitive behavioral therapy is effective in reducing the pain and coping with the symptoms.
• Injections: In severe cases injections that reduce the pain and inflammation may help.
• Surgery: Surgery should always be the last option and is not required in the vast majority of cases.
Read more about specific treatment of slipped or bulging disk here.
Usually sciatica has a very good prognosis. The sooner the underlying condition is diagnosed and the sooner the correct treatment starts, the better the outcome.