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What Causes Sciatic Nerve Pain?

“Oh! My sciatica!”

Played for laughs in TV comedies, complaints about sciatica often go hand in hand with a dramatic grab towards the lower back — but the very real pain sciatica sufferers experience is no laughing matter. Named after the sciatic nerve, this painful condition has many possible causes and refers broadly to any discomfort or pain caused by the nerve.

The sciatic nerves are the largest in the body, branching off from nerves in the lower back to run down along an individual’s buttocks and into each leg. Sciatic pain can occur at any point along this path, but most commonly radiates from the lower back and buttock on one side of the body. According to the Harvard Medical School, nearly half of all people — some 40% — will experience sciatic pain and discomfort at some point in their lives. For many, the pain is acute, but for others, it becomes a frustrating chronic condition. What causes this pain to develop in the first place, and what can you do about it?

The Primary Causes of Sciatica

The length of the sciatic nerve and its connections to the rest of the body are a part of what makes treatment for sciatica a tricky process. Identifying the root cause is an important step on the road to providing relief from sciatica and nerve pain beyond treating the most problematic symptoms with medications such as OTC pain relievers. Some of the most likely culprits when you have this type of pain include:

  • Ruptured discs. All our vertebrae have cushions, or discs, of cartilage between them. When the integrity of the spinal canal breaks down, these discs can “rupture” and press out onto nerves. Ruptured discs in the lower back may press on your sciatic nerve.
  • Spinal stenosis. A term for when your spinal column narrows, causing compression of the nerves within, which may cause pain to radiate to and down the sciatic nerve.
  • Leg or lower back injury. Any injury which might damage the nerve could cause lingering pain, from falling down the stairs to suffering a sports injury.
  • Pregnancy. Bodily changes and the placement of the baby may aggravate sciatic pain, making it one of the most common complaints during pregnancy.
  • Inactivity and/or obesity. Sitting too often or with posture, combined with a high body weight, can cause extensive sciatic pain. Exercise and dietary change are important for reducing its occurrence in these scenarios.
  • Lifestyle habits. Certain jobs and physical activities can lead to repetitive strains that inflame the nerve.

Working closely with a physician will contribute to determining the cause of the pain you experience and the appropriate treatment pathway to follow.

Do I Have Sciatica? The Signs and Symptoms

When one considers all the many kinds of lower back pain you can experience, it might not seem easy to distinguish sciatica from other conditions. While pain in the general area of the nerve is often the clearest and simplest indicator, other symptoms can accompany the discomfort, which makes it more evident that the sciatic nerve is to blame. These symptoms include:

  • Buttock or leg pains that worsen into a persistent ache when sitting
  • Pains in the leg that continue when lying down
  • Tingling or shooting sensation down one leg
  • Numbness
  • Weakness or difficulty standing from a sitting position
  • Pain when walking or placing weight on the affected side

These symptoms may appear all together or in isolation, and in acute cases of sciatica, may come and go without warning. Over time, acute sciatica that reoccurs can worsen in severity in some cases. If you have frequent pain and discomfort in the regions as described, always seek an official diagnosis before making medical decisions.

How Do Doctors Treat Sciatica?

Though it may sometimes resolve on its own after a few weeks when there is not a more serious underlying cause, sciatica can be persistent and very frustrating. Once you have a confirmed diagnosis, what kinds of treatment options can you expect? We’ll address surgery specifically in a moment, but there are many non-surgical interventions to try first.

Your doctor may recommend one of several medications, based on your diagnosis. You may be prescribed OTC or prescription anti-inflammatory drugs and pain relievers or prescription muscle relaxers aimed at relieving the pressure causing your pain.

Efforts to treat the causes of your sciatic pain may also play a role so that you can reduce the chances you will experience the pain again. Your doctor may suggest one or several exercises for sciatica that can strengthen your lower back and body. Along with appropriate lifestyle changes, these exercises may mitigate your pain.

Is Surgery a Necessity?

In most cases, the answer is no — other therapies and treatment methodologies often yield better results and less pain than surgical intervention. However, there are cases where surgery should be a consideration, especially when the source of the pain is a herniated or ruptured spinal disc. In the most severe cases, patients may lose some mobility and contend with frequent lower body weakness. In these scenarios, surgical intervention may be necessary.

A procedure called a “microdiscectomy” is most common. Unlike a complete discectomy, which involves the removal of most of a disc, this process removes only a portion of the herniated disc to relieve the nerve pressure causing the pain. This modern procedure is not highly invasive and has a shorter recovery time than other back surgeries. However, it is an option typically only when other methods of treatment aren’t appropriate or have already failed to produce results.

Learn More About Your Next Steps with Dr Kushwaha

Sciatica may be a common condition, but that makes it no less frustrating to live with when you can’t sit without experiencing discomfort. The good news: most sciatica cases resolve on their own or with mild to moderate medical intervention. Understanding your options for the treatment of sciatica can be as simple as contacting Dr Kushwaha. Allow us to consider your condition and let’s work together today to find the solution that brings you much-needed relief.

About Vivek Kushwaha

Vivek P. Kushwaha attended the University of Texas at Austin where he earned his B.A. from the College of Natural Sciences. He then earned his medical degree from the University of Texas Medical School at San Antonio, Texas.

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