What You Need to Know About Sciatica

The term sciatica describes the symptoms of leg pain—and possibly tingling, numbness, or weakness—that originate in the lower back and travel through the buttock and down the large sciatic nerve in the back of each leg.

Sciatica (pronounced sigh-at-eh-kah) is not a medical diagnosis in and of itself—it is a symptom of an underlying medical condition. Common lower back problems that can cause sciatica symptoms include a lumbar herniated disc, degenerative disc disease, spondylolisthesis, or spinal stenosis.

Sciatica Nerve Pain

Sciatica is often characterized by one or more of the following symptoms:

• Constant pain in only one side of the buttock or leg (rarely in both legs)
• Pain that is worse when sitting
• Leg pain that is often described as burning, tingling, or searing (versus a dull ache)
• Weakness, numbness, or difficulty moving the leg, foot, and/or toes
• A sharp pain that may make it difficult to stand up or walk
• Pain that radiates down the leg and possibly into the foot and toes (it rarely occurs only in the foot)

Sciatic pain can vary from infrequent and irritating to constant and incapacitating. Symptoms are usually based on the location of the pinched nerve.

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While symptoms can be painful and potentially debilitating, it is rare that permanent sciatic nerve damage (tissue damage) will result, and spinal cord involvement is possible but rare.

The Sciatic Nerve and Sciatica

The sciatic nerve is the largest single nerve in the body and is made up of individual nerve roots that start by branching out from the spine in the lower back and then combine to form the “sciatic nerve.” Sciatica symptoms occur when the large sciatic nerve is irritated or compressed at or near its point of origin.

• The sciatic nerve starts in the lower back, typically at lumbar segment 3 (L3).
• At each level of the lower spine a nerve root exits from the inside of the spinal canal, and each of these respective nerve roots then come together to form the large sciatic nerve.
• The sciatic nerve runs from the lower back, through the buttock, and down the back of each leg.
• Portions of the sciatic nerve then branch out in each leg to innervate certain parts of the leg—the thigh, calf, foot, and toes.

The specific sciatica symptoms—the leg pain, numbness, tingling, weakness, and possibly symptoms that radiate into the foot—largely depend on where the nerve is pinched. For example, a lumbar segment 5 (L5) nerve impingement can cause weakness in extension of the big toe and potentially in the ankle.

The Course of Sciatica Pain

Sciatica rarely occurs before age 20, and becomes more commonplace in middle age. It is most likely to develop around age 40 or 50.

Perhaps because the term sciatica is often used loosely to describe leg pain, estimates of its prevalence vary widely. Some researchers have estimated it will affect up to 43% of the population at some point.1, 2

Often, a particular event or injury does not cause sciatica—rather it tends to develop over time.

The vast majority of people who experience sciatica get better within a few weeks or months and find pain relief with nonsurgical sciatica treatment.1 For others, however, the leg pain from a pinched nerve can be severe and debilitating.

Seeing a doctor for sciatica pain is advised, both for learning how to reduce the pain and to check for the possibility of a serious medical issue.

When Sciatica Is Serious

Certain sciatica symptoms, while rare, require immediate medical, and possibly surgical, intervention. These include, but are not limited to, progressive neurological symptoms (e.g. leg weakness) and/or bowel or bladder dysfunction (cauda equina syndrome). Infection or spinal tumors can also cause sciatica.

Because sciatica is caused by an underlying medical condition, treatment is focused on addressing the cause of symptoms rather than just the symptoms. Treatment is usually self-care and/or nonsurgical, but for severe or intractable pain and dysfunction it may be advisable to consider surgery.

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