Sciatica is a condition involving irritation or compression of the sciatic nerve. This large nerve extends from the spinal column, through the hips and buttocks, and down each leg.

Depending on the cause of sciatica, the symptoms may be temporary or chronic. Most cases resolve within a few weeks without the need for medical intervention. Less commonly, a person may require prescription medication or surgery to resolve the issue.

This article outlines sciatic pain, overviews some common causes of sciatica, and offers tips for treating and preventing the condition. Finally, we answer some frequently asked questions about sciatic pain.

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Sciatic nerve pain ranges from mild to severe and can become debilitating. Severe sciatic pain can interfere with a person’s ability to walk and perform daily activities.

Sciatic pain can vary from person to person but often presents as a sudden pain or sensation that radiates from the lower back or hip and down into the leg.

People with sciatica may describe one or more of the following pains or sensations in their buttocks, leg, or foot:

  • burning
  • stabbing
  • shooting
  • tingling
  • an electric shock sensation
  • numbness
  • weakness

Sciatic pain often worsens when a person sneezes, coughs, or moves. Standing or sitting for long periods can also cause a flare-up.

Many acute and chronic cases stem from a herniated disk. This is where the soft tissue that cushions the individual bones of the spine slips out of place.

Other conditions of the spine or buttock that can cause sciatica include:

  • Spinal stenosis: Narrowing of the section of the spine where nerves pass through.
  • Spondylolisthesis: A condition in which one of the individual spine bones or “vertebrae” slips forward.
  • Degenerative disk disease: Degeneration of the soft tissue disks between the vertebrae.
  • Osteoarthritis: A type of degenerative arthritis resulting from wear and tear.
  • Piriformis syndrome: A condition in which the piriformis muscle in the buttock compresses or presses on the sciatic nerve.
  • Spinal injury: Injury to the spine can cause damage or inflammation that compresses the sciatic nerve.
  • Spinal tumor: A tumor within the spine can pinch the sciatic nerve.

The following may also cause sciatica:

For many people, sciatic pain is temporary and resolves within 4–6 weeks.

Often, lifestyle changes and over-the-counter (OTC) pain medications are sufficient to relieve pain and prevent further damage. Less commonly, surgery may be necessary to alleviate pain and correct an underlying problem.

Approximately 80–90% of people with sciatic pain respond to conservative treatments, including:

  • Temperature therapy: Applying an ice pack to the affected area for no more than 20 minutes at a time can help to reduce pain and inflammation. Applying a heat pack several times a day may also help to soothe the pain.
  • Over-the-counter pain medication: An OTC nonsteroidal anti-inflammatory drug (NSAID) can help to alleviate pain and inflammation. Examples include ibuprofen and naproxen.
  • Massage therapy: A massage from a trained professional can improve blood circulation and reduce muscle tension.
  • Stretching or exercising: Gentle stretching exercises can help relieve sciatic pain and improve mobility.

Other treatments for sciatic pain include:

People who continue to experience disabling pain after 3 or more months of nonsurgical treatment may require surgery. Surgical options for sciatic pain include:

  • Lumbar laminectomy: This procedure involves removing the lamina, a thin bone covering the back of the spinal cord. Removal of this bone helps to relieve pressure on the nerves causing sciatic pain.
  • Discectomy: This procedure removes a herniated disc between the vertebrae to ease nerve compression and improve back function.

Some cases of sciatic pain are unpreventable. However, a person can take the following steps to reduce their risk factors for sciatica:

  • maintaining a moderate weight
  • being physically active
  • warming up before engaging in physical activity
  • avoiding sitting for long periods
  • practicing good posture while sitting or standing
  • avoiding repetitive movements of the lower back, such as excessive bending or heavy lifting, which can strain the lumbar region and cause inflammation

Below are some answers to frequently asked questions about sciatic pain.

When should I go to the ER for sciatic pain?

People should seek emergency medical attention if they experience any of the following:

  • bilateral sciatica, which is sciatic pain in both legs
  • severe or worsening weakness or numbness in both legs
  • numbness around the genitals or anus
  • difficulty urinating, or inability to control urination
  • inability to identify the need for a bowel movement, or inability to control bowel movements

Any of the above could indicate a serious back problem that requires emergency medical treatment.

What can the ER do for severe sciatica?

People who attend the ER for severe sciatic pain may receive one or more forms of pain relief.

Treatment options may include:

The sciatic nerve is a long nerve that extends from the spine, through the hips and buttocks, and down each leg. Irritation or compression of the sciatic nerve can cause sciatic pain, numbness, or weakness in these areas.

The most common cause of sciatic pain is a herniated disk. Other spine conditions can also increase the risk of sciatica, as can inflammatory conditions, infection, and pregnancy.

Most cases of sciatica resolve without treatment within a few weeks. However, some people may require medication or surgery to relieve their symptoms.