While most adults have experienced an occasional twinge of back pain, sciatica (or lumbar radiculopathy) can be prolonged and much more intense.
The sharp pain usually starts on one side of the back and spreads down to the leg.
Depending on the severity of the flare up and the nerves affected, sciatica can also cause symptoms other than pain, including mild numbness and weakness in one leg.
The long-term effects of sciatica can be painful and debilitating if it is ignored or left untreated.
Sciatica can be triggered by something as small as a sneeze or a sharp movement. Some report periodic flare-ups, especially with increased age, so it’s important to deal with this condition even if the immediate symptoms subside on their own.
In this article, I’ll explain what sciatica is, what causes it to occur, and what can trigger its onset.
I’ll also outline some additional symptoms of sciatica, and discuss various treatment options.
What is Sciatica?
Many people who say they’ve thrown out their back are actually experiencing sciatica: This painful condition is the result of irritation of the sciatic nerve, and the spinal nerve roots that compose it.
While “irritation” might not sound like a big deal, the sciatic nerve is the body’s longest and widest nerve.
It extends from the top of the leg and down to the foot, meaning an irritation can cause pain from the lumbar area of the lower back all the way down the leg.
This is also what distinguishes sciatica from other types of back pain.
Instead of a throbbing discomfort isolated to one area, sciatica is frequently described as a sharp, shooting pain that travels down the leg and can be accompanied by tingling, numbness, or weakness.
What Causes Sciatica?
How does your sciatic nerve become irritated or get pinched?
The initial cause can vary, and is dependent on individual factors like height and carrying excess weight.
People between 30-50 years old are most likely to experience sciatica pain, but younger people aren’t immune—especially if they’re involved in sports.
The sciatic nerve can be irritated or compressed by several conditions of the spine, including:
- Slipped or herniated disc in the lumbar region
- Spinal stenosis, or the narrowing of the spinal canal
- Osteophyte formation
- Spondylolisthesis, or a slipped vertebrae
- Degenerative disorders, including foraminal stenosis
Other risk factors for developing sciatica include poor posture, improper lifting techniques, or a prior car accident or fall.
What Triggers Sciatica?
Normal, day-to-day activities—actions like lifting heavy weights, twisting the spine too quickly, poor sleeping positions, and even sneezing—can trigger spinal irritation and sciatica.
But common, every day habits can also lead to sciatica.
Limiting some of the following habits and behaviors could reduce sciatic flare-ups:
- Shoe selection: Wearing high heels, or other shoes that aren’t cushioned, transfers the impact of steps from legs to the back and hips.
- Back pocket obstructions: Sitting for extended periods of time with a hard object in the back pocket, like a wallet or keys, has been known to aggravate the piriformis muscle. The sciatica nerve runs under this muscle.
- Clothing choices: Tight fitting pants or underwear with strict elastic bands can place enough pressure on the sciatic nerve to trigger pain and flare-ups.
- Weight: Excess weight puts more pressure on your back and therefore also on the sciatic nerve.
Untreated sciatica can lead to other serious conditions of the back, including increased pain, a slipped disc, and in extreme examples, myelopathy, otherwise known as the compression of the spinal cord.
Additional Symptoms of Sciatica
While it can be difficult to differentiate back pain from lumbar radiculopathy, the following symptoms indicate an issue with the sciatic nerve:
- Pain that feels like a bad charley horse in the leg
- Other cramps that last for an extended period of time
- “Knife-like,” or electrical-feeling, sharp pain
- Isolated pain when moving, sneezing, or coughing
- Weakness and numbness in the affected area
- An unrelenting “pins and needles” sensation, or other burning and tingling
Many of the same at-home treatments that a patient uses to combat general back pain are applicable to sciatica.
A few steps to alleviate the pain include:
- Pay attention to what activities you can tolerate: Monitor which movements and activities cause pain, like certain positions for sitting, standing, or walking. Try to stay within pain-free movements. Avoid movements that worsen the pain, like bending over or lifting weights.
- Take over-the-counter pain medications: Options include ibuprofen (Advil), acetaminophen (Tylenol), or naproxen (Aleve).
- Use a warm compress: Place a warm towel or hot water bottle on your back to help relax the muscles and soothe some of the pain.
- Don’t remain in bed too long: Motion helps reduce inflammation, and too much rest can worsen back stiffness, muscle spasm and sciatica.
Patients that still don’t notice any progress after a few days of sciatic pain should consult their primary doctor or spine specialist.
There are several treatment plans that your doctor may recommend before surgery.
These include physical therapy exercises to stabilize the spine, as well as epidural steroid and nerve root injections to reduce inflammation and swelling.
Approximately 80-90% of patients with sciatica get better over time without surgery, typically within several weeks.
This recovery is due to the spine often being able to reabsorb the disc material causing symptoms. But some sciatica sufferers may need surgery.
Surgical treatment can be varied depending on what causes the sciatica, but it typically involves either decompressing the nerve or stabilizing the spine.
The herniated disk might be removed to stop it from pressing on the nerve.
While surgery is usually not necessary for treating sciatica, those who have exhausted home treatment options and are still dealing with sciatic pain should see a doctor.
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Radiculopathy, Weill Cornell Brain And Spine Center. (2020). https://weillcornellbrainandspine.org/condition/radiculopathy
Radiculopathy, Johns Hopkins Medicine. (2021). https://www.hopkinsmedicine.org/health/conditions-and-diseases/radiculopathy
Lumbar Radiculopathy (Nerve Root Compression), Emory Healthcare. (2019). https://www.emoryhealthcare.org/orthopedics/lumbar-radiculopathy.html
Wallet Neuritis - An Example of Peripheral Sensitization. (2018). https://pubmed.ncbi.nlm.nih.gov/28294069/
Sciatica, American Academy of Orthopaedic Surgeons. (2013). https://orthoinfo.aaos.org/en/diseases--conditions/sciatica