Sciatica

Sciatica refers to pain that radiates along the path of the sciatic nerve — the longest and thickest nerve in your body. The sciatic nerve runs from your lower back, through your hips and buttocks, and down each leg. **Key Facts:** - **Not a diagnosis:** Sciatica is a symptom of an underlying problem - **One-sided:** Usually affects only one leg - **Pain path:** Lower back → buttock → back of thigh → calf → foot - **Common cause:** [Herniated disc](/condition/herniated-disc) pressing on nerve - **Recovery:** Most cases improve with conservative treatment **How Sciatica Differs from [Back Pain](/condition/back-pain):** - [Back pain](/condition/back-pain): Stays in the back - Sciatica: Travels down the leg following the nerve - See our [sciatica vs back pain comparison](/compare/sciatica-vs-back-pain) **Common Causes:** - [Herniated disc](/condition/herniated-disc) (most common) - Spinal stenosis - Piriformis syndrome - Degenerative disc disease - Spondylolisthesis **Related Conditions:** - [Back pain](/condition/back-pain) — sciatica often accompanies lower back pain - [Herniated disc](/condition/herniated-disc) — most common cause of sciatica - [Arthritis](/condition/arthritis) — can cause spinal changes leading to sciatica - [Fibromyalgia](/condition/fibromyalgia) — chronic pain condition - [Piriformis syndrome](/condition/piriformis-syndrome) — buttock muscle irritating sciatic nerve **Warning:** Sudden loss of bladder/bowel control with sciatica is a medical emergency (cauda equina syndrome).

**How Sciatica Develops:** **The Sciatic Nerve:** Your sciatic nerve is the largest nerve in your body, formed by nerve roots from your lower spine (L4-S3). It runs through your buttock, down the back of your thigh, and branches into your lower leg and foot. **1. [Herniated Disc](/condition/herniated-disc) (Most Common):** The soft center of a spinal disc pushes through the outer layer and presses on the nerve root, causing inflammation and pain that travels down the nerve path. **2. Spinal Stenosis:** Narrowing of the spinal canal (often from [arthritis](/condition/arthritis)) puts pressure on the sciatic nerve roots, especially when standing or walking. **3. Piriformis Syndrome:** The piriformis muscle in your buttock spasms or tightens, compressing the sciatic nerve that runs beneath or through it. **4. Degenerative Changes:** Age-related changes to the spine, including disc degeneration, bone spurs, and [arthritis](/condition/arthritis), can narrow the spaces where nerves exit. **Risk Factors:** - Age 30-50 (disc problems most common) - Sedentary lifestyle - Occupations with heavy lifting or prolonged sitting - [Obesity](/condition/obesity) (extra stress on spine) - [Diabetes](/condition/type-2-diabetes) (increases nerve damage risk) - [Back pain](/condition/back-pain) history

**Conservative Treatment (First 6-12 Weeks):** **Activity Modification:** - Stay active (avoid bed rest) - Avoid aggravating activities - Gentle walking encouraged - Gradually return to normal activities **Pain Management:** - NSAIDs (ibuprofen, naproxen) — first choice - Acetaminophen for pain - Ice/heat therapy - Muscle relaxants if spasms present **Physical Therapy (Very Effective):** - Stretching exercises (piriformis, hamstring) - Core strengthening - McKenzie method - Nerve gliding exercises - Posture training **For Persistent Pain:** - Gabapentin or pregabalin for nerve pain - Epidural steroid injections - Trigger point injections **Surgery (Last Resort):** - Considered if conservative treatment fails after 6-12 weeks - Progressive neurological deficits - Severe, disabling pain - **Microdiscectomy** — most common surgery for [herniated disc](/condition/herniated-disc) **Prognosis:** - 80-90% improve with conservative care - Most recover within 6-12 weeks - Recurrence is common (up to 30%) **Related Resources:** - [Back pain treatment](/condition/back-pain) - [Herniated disc](/condition/herniated-disc)