Frequently Asked Questions about Sciatica

Sciatica is a collection of symptoms that occur when the sciatic nerve in your lower back is compressed or injured. Symptoms include lower back pain, pain that radiates into your hips and down one or both legs, leg weakness and numbness, tingling sensations in your legs and pain that worsens when you sit or stand for too long. Typically, with sciatica it is difficult to get comfortable in any position.

The sciatic nerve exits the base of your spine. If the vertebrae in this area have shifted out of alignment, the bones may be pressing on the nerves and causing pain. This may occur through an injury or over time from repetitive activities or poor posture. If a disc has herniated, or slipped out between the vertebrae, your sciatic nerve may not have enough space.

Sciatica can also 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) caused by 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 occur.

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:

– Avoiding sitting (unless it is more comfortable than standing).
– Alternating lying down with short walks. Increase your walking distance as you are able to without pain.
– Using a heating pad on a low or medium setting for 15 to 20 minutes every 2 or 3 hours.
Try a warm shower in place of one session with the heating pad. You can also buy single-use heat wraps that last up to 8 hours. You can also try an ice pack for 10 to 15 minutes every 2 to 3 hours. There is not strong evidence that either heat or ice will help, but you can try them to see if they help you.

Ask your doctor if you can take acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil) or naproxen (Aleve). 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 opioids, or even surgery for severe cases. Anecdotal evidence suggests that medical marijuana, ingested or applied topically, may help alleviate the symptoms of Sciatica.