The scoop on sciatica pain
Fun fact: The sciatic nerve is the largest nerve in the human body. It runs from the lower back down each side of your body, along the back of the hips, butt cheeks, and knees, down the back of the calf, and into the foot. It provides both sensory and motor nerve function to the legs and feet.
Not-so-fun fact: Sometimes this nerve can get compressed in the spine at one of the roots – where it branches off the spinal cord – and cause pain that radiates down the length of the nerve. This is a dreaded condition known as sciatica. It is estimated that between 10 and 40 percent of people will experience sciatica in their lifetime.
“Sciatica is the body telling you the sciatic nerve is unhappy,” says E. Quinn Regan, MD, an orthopaedic surgeon. “When the nerve is compressed at the root, it becomes inflamed, causing symptoms,” Dr Regan says. These symptoms can range from mild to debilitating.
While sciatica can often resolve on its own, easing symptoms and feeling better usually requires some attention and careful behaviour modifications. Rarely, you may need more medical intervention to recover fully.
Here’s everything you need to know about sciatica, including symptoms, how it’s diagnosed, how it’s treated, and what you can do to prevent it from recurring.
Symptoms of sciatica
Sciatica is quite literally a pain in the butt. The telltale symptom of sciatica is pain that radiates along the nerve, usually on the outside of the butt cheek and down the back of the leg. It usually only happens on one side of the body at a time. Sciatica doesn’t necessarily cause lower back pain, though it can.
Dr Regan says that people with sciatica describe the pain as electric, burning, or stabbing, and in more severe cases, it can also be associated with numbness or weakness in the leg. If sciatica causes significant muscle weakness, to the point of losing function, and/or the pain is so bad you can’t function, it’s time to get immediate help, Dr Regan says.
Another symptom that warrants a trip to the ER and immediate medical intervention: bowel or bladder incontinence. “That means there’s a massive compression, and the pressure is so severe it’s harming the nerves that go to the bowel and bladder,” says orthopaedic surgeon Dr Brian A. Cole. This is rare, but when it happens, it’s imperative to decompress the nerve immediately, he says.
The main causes of sciatica
The most common cause of sciatica is a herniated or slipped disc. A herniated or slipped disc happens when pressure forces one of the discs that cushion each vertebra in the spine to move out of place or rupture. Usually it’s caused when you lift something heavy and hurt your back, or after repetitive bending or twisting of the lower back from a sport or a physically demanding job.
Sciatica also can be caused by:
- a bone spur (osteophyte), which can form as a result of osteoarthritis
- narrowing of the spinal canal (spinal stenosis), which happens with normal wear-and-tear of the spine and is more common in people over 60
- spondylolisthesis, a condition where one of your vertebrae slips out of place
- a lower back or pelvic muscle spasm or any sort of inflammation that presses on the nerve root
Some people are born with back problems that lead to spinal stenosis at an earlier age. Other potential, yet rare, causes of sciatic nerve compression include tumours and abscesses.