Orthopedist examining patient's back

What is sciatica?

Sciatica is a common condition that causes discomfort along the path of the sciatic nerve, which runs from your lower back through your hips, buttocks and down each leg. This pain may come with numbness, tingling or muscle weakness. It usually happens when the nerves that form the sciatic nerve become irritated or experience pressure, often from a herniated disc, spinal stenosis or another spine-related issue.

The sciatic nerve is the longest and thickest nerve in your body—about 2 centimeters wide, roughly the size of a penny. Despite being called a single nerve, it's actually made up of a group of nerves that branch from five nerve roots in your lower spine.

You have two sciatic nerves, one on each side. Each one travels through your hip and buttock, down the back of your leg and ends just below your knee. From there, it branches into smaller nerves that reach your lower leg, foot and toes.

Sciatica symptoms

Sciatica can cause discomfort anywhere along the path of the sciatic nerve. Sometimes, doctors may refer to this as radiculopathy. Pain usually happens on just one side of the body but can be bilateral. It might start in your lower back and travel down through your buttocks and the back of your leg.

Pain from sciatica can feel sharp, burning or achy, or can feel like a shooting pain. The discomfort might get worse when walking or running, straightening your leg or making sudden movements like sneezing or coughing.

Other symptoms of sciatica include:

  • Numbness down your leg
  • Tingling or a feeling of pins and needles in the back of your leg
  • Weakness or heaviness in your leg or foot
  • Bowel or bladder function problems

When to see a doctor

Mild sciatica often improves with self-care, but you should see a doctor if your pain lasts longer than a week, gets worse over time or makes it hard to go about your daily activities. Seek medical attention right away if you have sudden severe pain in your lower back or leg, numbness or muscle weakness, or trouble controlling your bladder or bowels. These could be signs of a more serious condition that needs immediate treatment. Pain associated with a fever can be particularly worrisome.

What causes sciatica?

Doctors can’t always identify the cause of sciatica, but it typically is caused by compression of the sciatic nerve root. Stretching of the nerve and a viral infection of the nerve can cause the symptoms as well.

Compression can happen for many reasons. For people under 40, the most common reason is a herniated disc. For older adults, arthritis and bone spurs often lead to sciatica. Other causes include:

  • Spinal stenosis (narrowing of the spinal canal)
  • Injuries that put pressure on the nerves
  • Pregnancy, which stresses the lower back

Sciatica risk factors

Sciatica can result from conditions that put pressure on the sciatic nerve. A range of factors can put you at higher risk for these conditions, including your age, general health, lifestyle habits and even your occupation.

Risk factors for sciatica include:

  • Age: Sciatica can develop due to age-related wear on the spine. People ages 30 to 50 are most likely to develop sciatica.
  • Your job: Jobs that require lifting and bending or frequently lifting heavy loads without proper technique can put pressure on the sciatic nerve.
  • Lack of movement: Prolonged sitting or standing and lack of aerobic exercise can cause stiffness and increase your risk.
  • Weight: Being overweight or obese can put pressure on your spine.
  • Diabetes: High blood sugar can damage nerves, including the sciatic nerve.
  • Poor posture: Slouching or improper lifting can strain the lower back.
  • Pregnancy: Added weight, posture changes and looser ligaments can increase pressure on the sciatic nerve.

Making simple lifestyle changes can go a long way in preventing sciatica. Regular exercise, practicing good posture and reaching and maintaining a healthy weight can help you prevent sciatica. If you’re at risk or have concerns, talk to your primary care provider.

How is sciatica diagnosed?

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Sciatica can sometimes go away on its own, but getting the right diagnosis helps you find relief and prevent symptoms from getting worse. It also helps your doctor create a treatment plan that works for you, so you can get back to doing the things you enjoy.

To diagnose sciatica, your doctor will talk with you about your symptoms, do a physical exam and may order imaging or other tests to find out what’s causing the pain. Your doctor will need to know specific details such as where it starts, where does it travel to, what makes it better or worse. The more information you can provide will make it easier to diagnose and generate a treatment plan.

Medical history and exam

Your doctor will start by asking about your symptoms—what kind of discomfort you’re having, where you feel it and if you’ve noticed tingling, numbness or muscle weakness. They’ll also ask about your health history, including any back injuries or conditions that might affect your spine.

Next, your doctor may ask you to do some simple movements like walking on your toes or heels, raising your legs one at a time or squatting. These movements help find out which nerves are involved and whether your muscles and reflexes are being affected.

Imaging tests

If your symptoms don’t improve after several weeks or if they’re severe, your doctor may recommend imaging tests to see what’s going on inside your spine. These tests can show problems like a herniated disc, bone spur or narrowing of the spine that may be pressing on your sciatic nerve.

Common imaging tests include:

  • X-ray: An X-ray takes pictures of your bones and can show changes in your spine, like arthritis, bone spurs or disc problems. While it won’t show nerves, it can help rule out other causes of back pain.
  • Computed tomography (CT) scan: A CT scan provides more detailed images than an X-ray and is often used to see bone structures. In some cases, your doctor may use a special dye with the scan (called a CT myelogram) to highlight your spinal cord and nerves.
  • Magnetic resonance imaging (MRI) scan: This type of imaging is useful for looking at the spinal cord and nerves and can help doctors pinpoint which nerve roots are being compressed.

Nerve and muscle tests

If your doctor wants to learn more about how your nerves and muscles are working, they may recommend electrodiagnostic tests. These tests help confirm whether a nerve is being compressed and show how severe the problem might be.

  • Electromyography (EMG): This test measures the electrical activity in your muscles when they’re at rest and when they’re moving. It helps your doctor find out if a nerve is damaged or if your symptoms might be coming from a muscle condition.
  • Nerve conduction study: Often done alongside an EMG, this test measures how fast and how well electrical signals move through your nerves. If a nerve is pinched or damaged, the signals will move more slowly or be weaker. This can help your doctor figure out exactly where the problem is happening.

Sciatica treatment

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Treatment for sciatica focuses on relieving pain, improving movement and helping you get back to daily activities. Many people start feeling better with simple at-home care and lifestyle changes. If your pain lasts or gets worse, your doctor may recommend other treatments, including medication, physical therapy, spinal injections or, in some cases, surgery.

Lifestyle changes and at-home remedies

Staying active is one of the best things you can do for sciatica. Movement helps reduce inflammation and stiffness. While resting for a day or two might help during a pain flare-up, staying in bed too long can weaken your core muscles and make pain worse.

Try to stay as active as your pain allows. Gentle stretches, short walks and low-impact activities like swimming or using a stationary bike can help.

Other helpful at-home tips include:

  • Using hot or cold packs to ease pain
  • Practicing good posture when sitting or standing
  • Avoiding heavy lifting or twisting movements
  • Sleeping on a firm mattress with a supportive pillow

Medication

Several types of medicine can help manage discomfort while your body heals. Your doctor may suggest:

  • Over-the-counter pain relievers: Medications like acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen, aspirin or naproxen, can reduce pain and inflammation.
  • Nerve pain medications: Anti-seizure medicines and certain antidepressants, which are available by prescription, can lessen nerve pain.
  • Corticosteroids: Spinal injections or pills may help pain that doesn’t get better with other pain relievers.

Always talk to your healthcare provider before starting any new medication, especially if you have other health conditions or take other prescriptions.

Physical therapy

Physical therapy is an effective way to treat sciatica, especially if your symptoms last more than a few weeks or keep coming back. A physical therapist will work with you to create a personalized treatment plan that targets the source of your pain and helps you move more comfortably.

Your plan may include:

  • Stretching and strengthening exercises to ease pressure on the sciatic nerve and support your lower back
  • Posture training to help you sit, stand and move in ways that protect your spine
  • Manual therapy and other techniques like heat, ice or electrical stimulation to reduce pain and improve mobility
  • Everyday movement tips to help you safely return to your normal activities

With regular sessions and home exercises, physical therapy can help you feel better, move more comfortably and lower your risk of future flare-ups. Your primary care provider can help you get started with a referral.

Alternative therapies

Some people find relief with integrative therapy, especially when used along with other care options. These alternative therapies may include:

  • Chiropractic care: Spinal adjustments may help relieve pressure on the sciatic nerve
  • Acupuncture: Inserting very fine needles into specific areas of the body may help reduce nerve pain
  • Massage therapy: Targeted massage can ease muscle tension and improve circulation
  • Yoga or gentle movement classes: These can help improve flexibility and core strength in a low-impact way

Always talk to your doctor before trying alternative therapies to make sure they’re safe for you.

Surgery

Surgery is usually considered only when other treatments haven’t worked, and your discomfort is severe, long-lasting or affecting your ability to function. If you’ve had symptoms for more than three months without relief, your doctor may recommend surgery based on the cause of your sciatica. Your doctor will talk with you about the risks and benefits of surgery based on your health and the cause of your symptoms.

Two common procedures for sciatica include:

  • Discectomy: This surgery removes part or all of a herniated disc that’s pressing on a nerve. It’s often done through small incisions using minimally invasive techniques, which usually means a shorter recovery time. In some cases, a discectomy may be combined with a laminectomy.
  • Laminectomy: This procedure involves removing part of the vertebral bone (called the lamina) or bone spurs to relieve pressure on spinal nerves.

Minimally invasive surgery for sciatica involves techniques that ease pressure on the sciatic nerve using smaller incisions compared to other standard open procedures. By limiting disruption to surrounding tissues, this method may lessen discomfort, shorten recovery time and help you resume daily activities sooner.

Find specialized sciatica care near you

At Baylor Scott & White, we offer several locations for specialized care and treatment of sciatica, including neurology centers across North and Central Texas. Our experienced team is ready to provide personalized care to help improve your quality of life. Whether you're seeking diagnosis, treatment or require ongoing support, we're by your side.

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Frequently asked questions

  • What kind of doctor treats sciatica?

    Sciatica is often treated by your primary care provider, who can also refer you to a specialist if needed. Depending on your symptoms, you may see an orthopedic doctor or neurologist for more targeted care.

  • Is walking good for sciatica?

    Yes, walking can help with sciatica by improving blood flow, strengthening muscles and reducing pain. It’s a low-impact exercise that supports healing and mobility. However, avoid walking during severe flare-ups or if it worsens your pain. Always listen to your body and consult your doctor if needed.

  • Can acupuncture help sciatica?

    Yes, acupuncture can help reduce sciatica pain by boosting your body’s natural pain relief, improving blood flow and relaxing tight muscles. It may work better than medications with fewer side effects. You may need several sessions, and it’s most effective when combined with other treatments. Always talk to your doctor first.

  • Can sciatica cause groin pain?

    Yes, sciatica can cause groin pain, though it's less common. Since the nerves serving the lower back, hips and groin share roots, compression or irritation of the sciatic nerve can cause pain to radiate into the groin. Muscle spasms and referred pain may also contribute to groin discomfort.

  • Does sciatica cause hip pain?

    Yes, sciatica can cause hip pain. The sciatic nerve runs through the hip, so when it’s irritated or compressed, it can cause pain that spreads to the hip. You might also feel tingling or numbness. However, other conditions like arthritis or bursitis can also cause hip pain. Talk to your doctor to find out the cause and get the right treatment.

  • Can sciatica pain go away?

    Yes, sciatica pain usually goes away within a few weeks to a few months with conservative treatments like rest, pain relievers and physical therapy. If symptoms last longer than three months, it may become chronic and require more intensive treatment. See a doctor if pain is severe or worsens.

  • Does heat help sciatica?

    Yes, heat therapy can help relieve sciatica pain by relaxing muscles and reducing stiffness. It increases blood flow, which can ease tension. However, it’s important to use it carefully to avoid irritation or swelling. Check with your doctor to make sure it’s the right treatment for you.

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