pain, tingling, or numbness produced by an irritation of the nerve roots that
lead to the
sciatic nerve. The sciatic nerve is formed by the
nerve roots coming out of the spinal cord into the lower back. It goes down through the buttock, then its branches extend down the back of the leg to the
ankle and foot.
The most common cause of
sciatica is a bulging or ruptured disc (herniated disc)
in the spine pressing against the nerve roots that lead to the sciatic nerve.
But sciatica also can be a symptom of other conditions that affect the spine,
such as narrowing of the spinal canal (spinal stenosis), bone spurs (small, bony growths that form along joints)
arthritis, or nerve root compression (pinched nerve)
caused by injury. In rare cases, sciatica can also be caused by conditions that
do not involve the spine, such as tumors or pregnancy.
Symptoms of sciatica
include pain that begins in your back or buttock and moves down your leg and
may move into your foot. Weakness, tingling, or numbness in the leg may also
Sciatica is diagnosed
with a medical history and physical exam. Sometimes X-rays and other tests such as
magnetic resonance imaging (MRI) are done to
help find the cause of the sciatica.
In many cases, sciatica will
improve and go away with time. Initial treatment usually focuses on medicines
and exercises to relieve pain. You can help relieve pain by:
Additional treatment for sciatica depends on what is
causing the nerve irritation. If your symptoms do not improve, your doctor may
suggest physical therapy, injections of medicines such as steroids, stronger medicines such as muscles relaxants or opiates, or even
surgery for severe cases.
Other Works Consulted
American Academy of Orthopaedic Surgeons and American Academy of Pediatrics (2010). Lumbar herniated disc. In JF Sarwark, ed., Essentials of Musculoskeletal Care, 4th ed., pp. 952–956. Rosemont, IL: American Academy of Orthopaedic Surgeons.
Atlas SJ, et al. (2005). Long-term outcomes of
surgical and nonsurgical management of sciatica secondary to a lumbar disc
herniation: 10-year results from the Maine Lumbar Spine Study. Spine, 30(8): 927–935.
Ellenberg M, Honet JC (2008). Lumbar radiculopathy. In WR Frontera et al., eds., Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation, 2nd ed., pp. 241–246. Philadelphia: Saunders Elsevier.
March 12, 2012
William H. Blahd, Jr., MD, FACEP - Emergency Medicine
& Robert B. Keller, MD - Orthopedics
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