Sciatic neuropathy refers to nerve damage to the sciatic nerve. It can cause pain, weakness, and numbness. Damage to the sciatic nerve may occur from injury or trauma, compression of the sciatic nerve, surgery, or reduced blood flow.

Neuropathy is damage to the nervous system and results in abnormal functioning of the nerves.

Sciatic neuropathy is a type of peripheral neuropathy. Peripheral neuropathy is any damage that occurs in the peripheral nervous system, which includes all the nerves outside of the spinal cord and brain, or the central nervous system.

Peripheral nerves send signals to the central nervous system and carry signals to the rest of the body, which allows the body to function properly.

The sciatic nerve travels from the back of the pelvis and down the back of the thigh. The sciatic nerve is the largest nerve in the body and the major nerve in the leg.

This article looks at sciatic neuropathy symptoms, causes, diagnosis, treatment, and outlook.

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Sciatic neuropathy is damage to the sciatic nerve and can cause pain, weakness, and numbness.

Sciatica is pain that begins from the sciatic nerve. Another term for sciatica is lumbar radiculopathy. It is a symptom of a condition and not a condition on its own.

In many cases, a herniated disk may cause sciatica.

Sciatica can cause lower back pain, which may radiate down a buttock and back of a thigh or from a buttock to a foot. In severe cases, people may experience numbness or weakness.

Symptoms of sciatic neuropathy may affect the lower body, such as the lower back, buttocks, thighs, and lower legs. Symptoms can include:

  • pain
  • weakness
  • numbness
  • tingling

Sciatic neuropathy may vary in pain intensity for each individual case. People may also experience changes in sensitivity, such as increased response to touch or temperature or movement problems and muscle weakness.

Nerve pain can cause stabbing, shooting, or burning sensations and may worsen at night. Some people find that severe symptoms affect their quality of life and mental health.

Common causes of sciatic neuropathy include:

  • hip surgery
  • trauma affecting the sciatic nerve
  • nerve compression
  • nerve injury
  • reduced blood flow

Other possible causes include:

  • injections into the gluteal muscle
  • compartment syndrome, which increases pressure in a muscle and reduces blood flow
  • infections
  • inflammation
  • intraneural tumors
  • vascular causes
  • gynecological causes
  • piriformis syndrome — when the piriformis muscle in the buttocks compresses the sciatic nerve
  • radiotherapy
  • pressure ulcers

According to a 2019 article, the treatment of sciatic neuropathy can include pain medications to treat painful symptoms. These include:

In some cases, a doctor will prescribe a combination of anti-inflammatory medication alongside mild exercise to relieve symptoms.

The above article suggests that treatment of sciatic neuropathy with medication alone may not be the most effective option.

If other treatments are not effective, perineural corticosteroid injection may be an effective option and provide excellent pain relief. Perineural injection therapy (PIT) uses an injection of medication, such as corticosteroids, to the affected area, which may help to lessen neuropathic pain.

An injection of dextrose can help to release nerve compression. A doctor may use ultrasound to guide them to the correct injection site.

In some cases, people require surgery. Doctors may use nerve repair or nerve grafts to restore normal nerve function.

Nerve repair uses stitches to rejoin nerve endings in a cut nerve. Nerve grafts use a donor section of nerve tissue from another area of the body or a cadaver to rejoin nerve endings. Doctors may use nerve grafts if the damage is too large to repair with stitches.

A doctor may use imaging tests such as MRI scans to diagnose sciatic neuropathy. Magnetic resonance neurography (MRN) can show images of the nerves and may help doctors find abnormalities in the sciatic nerve.

Doctors sometimes use electrodiagnostic tests to diagnose sciatic neuropathy. These include:

  • Electromyography (EMG): A doctor places small needles into the muscles to measure their electrical activity. This helps show how well the nerves are functioning and supplying the muscles.
  • Nerve conduction studies (NCS): A doctor will place electrodes on the skin along the pathway of the nerve and use an electric current to stimulate the nerve. The speed at which the electrical current travels through the nerve can indicate the health of the nerve and where damage occurs.

The outlook for sciatic neuropathy depends on the underlying cause and severity of nerve damage.

In some cases, medications and gentle exercise will help to improve symptoms.

If medications and physical therapies are not effective, treatment with perineural steroid injection is sometimes a suitable option. In a 2019 case report, perineural steroid injection resulted in significant pain reduction for sciatic neuropathy.

For people who require surgical procedures to repair nerve damage, the outlook of surgery can depend on the location of the nerve damage within the sciatic nerve, as well as the extent of the damage.

Sciatic neuropathy is nerve damage affecting the sciatic nerve, which runs down the back of the thigh. People may experience pain, weakness, or numbness in the lower body.

Treatment for sciatic neuropathy depends on the location and extent of sciatic nerve damage. Treatment options include pain relief medication, exercise, nerve injections, and surgery.

The outlook depends on the underlying cause. Treatment may help to relieve symptoms or repair nerve damage.