Sciatica

Medically Reviewed by Poonam Sachdev on October 26, 2023
9 min read

Sciatica is a common type of pain affecting the sciatic nerve, a large bundle of nerves extending from your lower spinal cord, through your butt, and down the back of each leg.

The telltale sign of sciatica is pain that starts in your lower back and shoots down one leg, sometimes all the way into your foot. What causes sciatica differs from person to person, but it can happen with an injury or just with the wear and tear of aging. Certain conditions can make it worse. There are treatments for sciatica pain.


 

Everyone’s experience will be different, but sciatica typically affects your back, butt, leg, or foot. Symptoms may be constant or come and go. 

What are the red flags for sciatica? 

It depends on the sciatic nerve pain location, but common symptoms of sciatica include:

  • Lower back pain
  • Pain in the rear or leg that is worse when sitting
  • Hip pain
  • Burning or tingling down the leg
  • Weakness, numbness, or a hard time moving the leg or foot
  • A constant or shooting pain on one side of the rear, leg, or hip

Sciatica back pain and other sciatica symptoms can make it hard to walk or stand up easily. You may not be able to sit for long periods at work or while driving.

Sciatica pain: What does it feel like? 

Many people say it feels like a zap of electricity, but you can also get “pins and needles” in the affected leg, like a part of your body has fallen asleep. 

Sciatica usually affects only one side of the lower body. Often, the pain extends from the lower back all the way through the back of your butt and thigh and down through your leg. Depending on where the sciatic nerve is affected, the pain may also extend to the foot or toes. The pain may worsen when you cough or sneeze.

For some people, the pain from sciatica can be severe and disabling. But not everyone has unbearable sciatica pain. For others, the sciatica pain might be infrequent and irritating but has the potential to get worse.

Seek medical attention right away if you have:

  • Fever and back pain
  • Swelling or redness in your back or spine
  • Pain that moves down your legs
  • Numbness or weakness in the upper thighs, legs, pelvis, or bottom
  • Burning when you pee or blood in your pee
  • Serious pain
  • Loss of bladder or bowel control (leaking or not being able to make it to the toilet in time)

Sciatica results from irritation of the root(s) of your lower lumbar and lumbosacral spine.

A herniated disk causes most cases of sciatic pain.

Other common causes of sciatica include:

  • Lumbar spinal stenosis (narrowing of the spinal canal in your lower back)
  • Degenerative disk disease (breakdown of disks, which act as cushions between the vertebrae)
  • Spondylolisthesis (a condition in which one vertebra slips forward over another one)
  • Pregnancy
  • Muscle spasm in the back or buttocks

Risk factors, or things that may make you more likely to develop sciatica, include:

  • Aging (which can cause changes in the spine, like bone spurs or herniated disks)
  • Diabetes
  • Having a bigger body size
  • Being sedentary
  • Having weak core muscles (your glutes, abs, and back)
  • Wearing high heels all the time
  • Sleeping on a mattress that is too hard or too soft
  • Smoking
  • Your job, if it involves sitting or driving for long periods of time, twisting your back, or carrying heavy things

Endometriosis, a chronic inflammatory condition where tissue similar to the lining of the uterus grows on other parts of the body, may cause sciatic nerve pain or sciatica-like symptoms that come and go with your period. 

If you've had an injured lower back or spine, that can also make sciatica more likely.

The first thing your doctor probably will do is ask about your back and leg pain. Some of their questions might include: 

  • When did your symptoms start?
  • Do you have any recent injuries?
  • Do you have numbness or weakness in your legs?
  • Do certain positions help your discomfort?
  • Has the pain kept you from doing any activities?
  • Have any home remedies eased your pain at all?

They will also want to know about your lifestyle: 

  • Do you do a lot of physical work, like heavy lifting? 
  • Do you sit for long periods of time? 
  • How often do you exercise?
  • What kind of exercises do you do?

You'll also get a physical exam so they can check your reflexes and see how strong your muscles are. They might have you do certain activities, like walking on your heels or toes, to see what’s causing your pain.

If your pain is severe or causing symptoms like muscle weakness, the doctor might order imaging tests to check for bone spurs and herniated disks. You could get tests like:

  • X-ray, which makes pictures of the inside of your body, to check for bone spurs (growths of normal bone)
  • CT scan, which combines a series of X-rays to get a better look at your spinal cord and spinal nerves
  • MRI, which uses radio waves and magnets to create pictures of your insides to get a detailed look at your back and spine
  • Electromyography (EMG), which measures how fast nerve signals travel through your muscles. This is to see if a herniated disk is compressing nerves that control muscles. (A herniated disk is a torn or leaky disk between vertebrae in your spine. You may also hear it called a "slipped," "ruptured," or "bulging" disk.)

If those tests are inconclusive, you may need additional imaging.

Examples of sciatica treatment include:

Medication

Your doctor might first recommend over-the-counter anti-inflammatory drugs like ibuprofen or naproxen sodium. Follow the directions on the bottle for how to use them, or ask your doctor how much you should take. If those don’t help enough, they might give you prescription medication, such as:

  • Anti-inflammatory medications
  • Anti-seizure medications
  • Muscle relaxants
  • Opioids
  • Antidepressants

Physical therapy

A physical therapist can show you how to do exercises that will improve your posture, ease pressure on your sciatic nerve, and make you more flexible. They’ll teach you how to make the muscles that support your back stronger.

Steroid injections

Your doctor might recommend you get steroid injections like a cortisone shot. This medicine helps with inflammation around the nerve, which can help reduce pain for some people. If the shot works for you, the effects usually last a few months, but they’ll wear off over time.

Alternative therapies

Sometimes, people choose to treat their symptoms through non-standard methods. Alternative treatments may not be as helpful for sciatica pain compared to other kinds of lower back pain, but they might include:

  • Yoga
  • Acupuncture
  • Spine adjustments from a chiropractor
  • Massage therapy
  • Biofeedback

Surgery

If you have extreme pain that doesn’t get better on its own or with physical therapy, or you have weakness or a loss of bladder or bowel control, your doctor might recommend surgery. They’ll take out the bone spur or herniated disk that’s pressing on your nerves and causing your pain and other symptoms. 

Surgery is usually an option after you’ve tried nonsurgical treatments, but you can bring it up with your doctor at any point.

Types of surgery for sciatica commonly include: 

  • Diskectomy: when the doctor takes out small bits of the herniated disk
  • Laminectomy: a surgery that removes some bone from your lower spine
     

There are things you can do on your own to feel better. Some self-care treatments for sciatica pain include: 

Cold packs. Your doctor or physical therapist can show you how to use these and tell you what kind to get. But they might suggest you put a cold pack (or a pack of frozen peas wrapped in cloth) on your lower back several times a day for up to 20 minutes each time. 

Hot packs. If your pain doesn’t get better with a cold pack, your doctor might suggest you alternate with heat after a few days. If you use a heating pad, always use the lowest setting so you don’t burn your skin. 

Stretching and moving around. You can rest for a few days if you’re in a lot of pain, but movement is generally a good thing for sciatica pain. 

Stretches and low-impact movement like walking can help: 

  • Get your blood pumping, which may speed up the healing process
  • Shift your focus away from pain
  • Improve flexibility
  • Make your range of motion better

Tell your doctor if moving around makes you hurt a lot more. They can run some tests to make sure you’re not injured or making your sciatica worse. 

Sciatica exercises

Ask your doctor or physical therapist to go over which sciatica pain exercises might be right for you. 

Examples of stretches and exercises that may ease sciatica pain include:

  • Glute bridges
  • Lying knee-to-chest stretches
  • Clamshells
  • Bird dogs
  • Child’s pose stretch
  • Hamstring stretches
  • Pelvic tilts

Your doctor may also suggest some general stretches and strengthening exercises that target the muscles around your spine and in your butt that can press on your sciatic nerve.  

It depends on how serious your symptoms are and what’s causing your sciatica pain in the first place. For example, surgery to remove a herniated disk or repair another physical problem may help you feel better faster than physical therapy alone. 

But often, there’s no quick fix. A full recovery may take time (weeks to months) no matter which treatment you try. Work with your doctor to find the best plan for you. 

Will sciatica pain go away on its own? 

For many people with mild sciatica, symptoms usually get better within 3 to 6 weeks without any medical treatment. But if your sciatica pain is more severe or stems from a physical problem or injury, it can take months or longer to improve. 

In some cases, you may need surgery to heal or avoid nerve damage.  

Sciatica is common, but it often resolves on its own in a few weeks. Tell your doctor if your symptoms last longer than that or if you have severe pain, numbness, or muscle weakness. You may need medical treatment to help find and fix the problem or to prevent further health problems.  

Here are some answers to frequently asked questions about sciatica. 

What is the best way to fix sciatica?

There isn’t one treatment that works for everyone. What’s right for you depends on the cause of your sciatica pain, your overall health, and how serious your symptoms are. Your doctor can go over self-care tips, exercises for sciatica pain, or other medical treatment options. 

What causes sciatica to flare up?

Triggers are different for everyone. Your sciatica pain may get worse if you sit for long periods of time, have a bigger body size, lift heavy things, develop a herniated disk or bone spur, or have a health condition or injury that causes nerve damage. 

How do I get my sciatic nerve to stop hurting?

You may feel better if you move around, take anti-inflammatory drugs, stretch, or take other self-care measures for sciatica pain. If those don’t help, treatment for sciatica includes physical therapy, medication, and sometimes surgery. 

How do I know if I'm having sciatic nerve pain?

The best way to find out what’s going on is to work with your doctor. But some red flags for sciatica include lower back pain along with numbness or tingling in your butt or down the back of your leg. You may also get muscle weakness in the leg affected by sciatica. In serious cases, you may lose control of your bowel or bladder. 

Where is the sciatic nerve located left or right?

You have two sciatic nerves that run from your spine down the back of both your legs. There’s one big bundle of nerves that go from your butt down to your knee. That big nerve group branches off into a bunch of little nerves that go to your lower leg, foot, and toes.