The sciatic nerve branches to each leg from the lower back, threading through the hips and buttocks. In the leg, the sciatic nerve branches into the peroneal and tibial nerves. Sciatica is pain initiated by the sciatic nerve. Sciatica propagates along the length of the sciatic nerve and corresponding branches. Pain is perceived from the lower back and buttock to the leg. Sciatic nerve pain is not a disorder; it is a symptom. Sciatica indicates various disorders, including a herniated disk. Sciatica may last a couple months or longer.
Causes
The sciatic nerve controls several leg muscles and provides sensation to the feet, calf and thigh. Sciatica occurs when the nerve is compressed in the spine. A herniated disk commonly causes sciatica. The spine contains a column of disks filled with a gel-like substance. Herniation occurs when the disk tears and the gel seeps out, compressing the surrounding nerves. Other causes for sciatica include lumbar spinal stenosis, spondylolisthesis, piriformis syndrome, spinal tumors, trauma, sciatic nerve tumors or other conditions that affect bone, muscle and joints.
Type of Pain
Sciatic nerve pain has a distinct pathway. Sciatica radiates from the lumbar region, through the buttock and along the back side of the leg. Pain varies widely among patients, from a slight ache to an intense, sharp sensation that burns. In some cases, pain feels like an electric shock. Pain may be accompanied by weakness of the muscles, numbness, tingling sensations and incontinence.
Risk Factors
Lifestyle choices, health problems and inherent qualities are risk factors for sciatic nerve pain. Common risk factors include age, occupation, prolonged sitting and diabetes. Spinal deterioration due to the aging process may contribute to sciatica. Sciatic nerve pain may result from work that involves heavy lifting or sitting for long periods. In addition, people who have sedentary lifestyles are at risk due to prolonged sitting. Patients with diabetes are at risk to develop sciatica.
Examination
Various tests and procedures are used to diagnose sciatic nerve pain. Examination attempts to link pain with the nervous system and pinpoint the sciatic nerve as the cause for pain. Medical history is taken to assess current risk factors. A physical exam provides preliminary information on the spine and legs. Muscle assessment tests evaluate reflex response and muscle strength. Imaging tests may be prescribed to corroborate findings, including spinal x-ray, magnetic resonance imaging (MRI), or computerized tomography (CT).
Treatment and Prevention
Over-the-counter medications, exercise, stretching and cold and hot packs provide initial treatment for sciatica. Additional treatment options include physical therapy, rehabilitation and prescription drugs. Physical therapy helps patients build strength and prevents the additional injury. Rehabilitation trains patients on posture, building muscle strength and flexibility. Prescription drugs, such as narcotics and anticonvulsant drugs, are used to ease pain. Epidural steroid injections provide relief for cases of extreme pain. Surgery may be used to correct herniated disks.
