Most of us have had back trouble of some kind or another, whether it’s mild discomfort or terrible pain that knocks you off your feet. But with sciatica, you’ll likely know right away that this is something different.
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.
Sciatica is triggered when something -- usually a herniated disk but sometimes a bone spur – puts pressure on your sciatic nerve, which runs from your lower back down to your legs and feet. This can happen with an injury or just with the wear and tear of aging.
Mild sciatica usually responds well to do-it-yourself treatment, like over-the-counter medicines and hot and cold packs. But if your back pain lasts for more than a week or gets worse, it’s time to call the doctor. If you have pain that comes on suddenly, is caused by an injury, or makes you lose control of your bladder or bowels, these are emergencies and you should call your doctor immediately.
The first thing your doctor probably will do is ask questions about your back pain: 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?
He 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?
Next he’ll want to give you a physical exam to try to figure out which nerve is causing your problem. He may have you do some exercises to see if they make your pain worse, such as rising from a squat, walking on your toes and heels, and raising one leg while lying on your back.
If your pain is ongoing (chronic) or severe, your doctor might also get some imaging tests done. X-rays, CT scans, and MRIs can look for herniated disks or bone spurs that clearly would be causes of sciatica. An electromyography (EMG) test can also tell him what nerves in your back are being compressed.
If your doctor diagnoses you with sciatica, the good news is that most cases clear up in a few weeks without surgery. If over-the-counter drugs haven’t made a dent in your pain, your doctor probably will prescribe anti-inflammatories or muscle relaxants. You might also need to do physical therapy or get steroid injections to help relieve your discomfort. The conversation about surgery will start only after you’ve tried everything else.