Sciatica: Symptoms, Causes and How It Is Treated

What sciatica feels like

Sciatica usually affects one side. The leg pain is often worse than the back pain and is described as burning, shooting or electric. It can come with pins and needles, numbness or a feeling of heaviness in the leg or foot.

Symptoms often get worse with sitting, bending forward, coughing or sneezing, and ease with walking or lying in certain positions.

What causes it

Anything that compresses or irritates the nerve roots in the lower back can cause sciatica. Chemical irritation from a nearby disc can be enough, even without much pressure on the nerve.

• Disc bulge or herniation, the most common cause in adults under 50
• Narrowing of the spaces the nerves pass through (stenosis), more common after 50
• Muscle tightness in the buttock irritating the nerve, sometimes called piriformis syndrome
• Pregnancy, from changes in posture and pressure on the pelvis

What helps

Bed rest slows recovery. Gentle walking, regular changes of position and avoiding long periods of sitting usually help the nerve settle.

An assessment finds which movements calm your symptoms and which aggravate them. Treatment combines hands-on techniques to ease muscle guarding and joint stiffness, nerve gliding exercises, and a progressive strengthening plan for the back and hips so the problem is less likely to return.

Red flags: when to seek urgent medical care

Go to a doctor or emergency department immediately if sciatica comes with:

• Numbness around the genitals, buttocks or inner thighs
• New difficulty passing urine, or loss of bladder or bowel control
• Weakness in the leg or foot that is getting worse, such as a foot that drops when you walk
• Symptoms in both legs at the same time