A herniated disk, enlarged facet joint, spinal stenosis or piriformis syndrome can cause sciatica. Sciatica describes the pain caused by a compressed sciatic nerve. Compression of the sciatic nerve may result in a burning, shooting or aching pain in your lower back, legs and hip. The cause of your sciatica will determine your treatment options. Depending on the extent of your injury, alleviating the pain may require surgery.
Your lower back contains five to six vertebrae made of bone. Intervertebral disks separate each vertebra, and facet joints connect the vertebrae together. Intervertebral disks are soft gel filled sacs that cushion your vertebrae. Facet joints allow the spine to bend and twist. Spinal cord nerves run down the center of the vertebrae in your lower back. Among these nerves, you will find the sciatic nerve.
Sciatica is a symptom, caused by compression of or injury to the sciatic nerve. The sciatic nerve runs from the lower back, down the back of your leg and into your foot. If fluid, bone, muscle or a joint compresses the sciatic nerve, you may experience back, hip and leg pain. Prolonged sitting and standing or physical activity can aggravate an injured sciatic nerve.
When an intervertebral disk in your lower back ruptures, the fluid within the disk exerts pressure on the spinal cord. If the fluid compresses the sciatic nerve, the pain will show up in your leg and lower back. Intervertebral disks rupture from traumatic injury or degeneration. Some people with herniated disks will respond to nonsurgical treatment measures like physical therapy or steroid injections. If you do not respond to conservative treatment, your physician may recommend a surgical procedure called microdiscectomy. During a microdiscectomy, a surgeon will remove any object exerting pressure on the sciatic nerve. With either method of treatment, approximately 5 percent of people will experience a recurrent disk herniation, reports the American Academy of Orthopaedic Surgeons.
Facet Joint Syndrome
Arthritis or traumatic injury can cause the facet joints in your spine to swell. Enlarged facet joints put pressure on the spinal cord. Sciatic nerve pain from enlarged facet joints in your lower back will shoot through the lower back and down the back of your leg. Treatments for enlarged facet joints include, physical therapy, steroid injections and anti-inflammatory medication.
Within the buttock muscles, you will find the piriformis muscle. Piriformis syndrome occurs when the piriformis muscle compresses the sciatic nerve. People with piriformis syndrome experience pain in the hip, lower back and legs. Common causes for piriformis syndrome include weak gluteus maximus muscles, improper foot alignment and stiff joints. Your physician may suggest stretching, physical therapy or surgery for extreme cases of piriformis syndrome.
As you age, your spinal cord canal narrows and can possibly compress the sciatic nerve. People with lower back spinal stenosis experience pain in the hip, legs, lower back and buttocks. Spinal stenosis commonly occurs in people over age 60. Treatment for spinal stenosis includes epidural steriod injections, physical therapy, anti-inflammatory medications and spinal cord decompression.
Is This an Emergency?
- National Institutes of Health: Sciatica
- Spine Universe: Lumbar Spine
- American Academy of Orthopaedic Surgeons: Lumbar Disk Herniation
- Cedars-Sinai: Facet Joint Syndrome
- Drnickcampos.com: Piriformis Syndrome: A Real Pain In The Butt
- Rice University: The Piriformis Syndrome
- Spine-Health: What Is Spinal Stenosis