The sciatic nerve begins from the lower spine on either side. It travels deep in the pelvis to the lower buttocks. From there, it passes along the back of each upper leg and divides at the knee into branches that go to the feet. Sciatica is an irritation of the sciatic nerve.
Sciatica is caused by irritation or pressure on the sciatic nerve. This can be the result of:
Sciatica is more common in men. Other factors that may increase your chance of sciatica include:
Lifestyle and personal health factors, such as:
Occupational factors, such as:
Health conditions, such as:
Sciatica causes symptoms that can range from mild to severe. Symptoms may include:
More serious symptoms associated with sciatica that may require immediate medical attention include:
You will be asked about your symptoms and medical history. A physical exam will be done. Your doctor will pay particular attention to your back, hips, and legs. The physical exam will include tests for strength, flexibility, sensation, and reflexes.
Imaging tests are used to evaluate the affected area:
Your doctor may also need to test your nerves. This can be done with a nerve conduction study.
The goal of treatment is to reduce sciatic nerve irritation.
Treatment options include:
Bed rest is not generally recommended. It may be suggested for no more than 1-2 days in those with severe pain. Your doctor may recommend that you restrict certain activities for a period of time and then resume them as soon as possible. You may be able to shorten your recovery time by staying active and exercising.
Medications used to treat sciatica include:
Physical therapy may include:
These therapies have not been proven by scientific studies to have an effect on sciatica. However, some people may find some pain relief from:
Surgery may be done to relieve pressure on the sciatic nerve. This is performed in emergency situations or if other treatments fail. Common surgical procedures are microdiscectomy and lumbar laminectomy.
Sciatica tends to happen more than one time. To help reduce your chance of sciatica:
North American Spine Society
Ortho Info—American Academy of Orthopaedic Surgeons
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
Allen C, Glasziou P, et al. Bed rest: A potentially harmful treatment needing more careful evaluation. Lancet. 1999; 354:1229-1233.
Sciatica. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00351. Updated December 2013. Accessed December 1, 2015.
Sciatica. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115166/Sciatica. Updated February 8, 2016. Accessed September 12, 2016.
Waddell G, Feder G, Lewis M. Systematic reviews of bed rest and advice to stay active for acute low back pain. Br J Gen Pract. 1997;47:647-652.
6/7/2007 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Peul WC, van Houwelingen HC, et al. Surgery versus prolonged conservative treatment for sciatica. N Engl J Med. 2007;356:2245-2256.
Last reviewed December 2015 by Teresa Briedwell, PT, DPT, OCS, CSCS
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.