Sciatica, or sciatic nerve pain, describes a group of symptoms related to irritation or compression of the sciatic nerve. These symptoms most commonly include leg pain, lower back pain, shooting pains into the buttocks and hips, tingling in the extremities and muscle spasms and weakness. Anyone who has experienced sciatica knows how painful and debilitating an effect it can have on your quality of life. 

Fortunately, there are a wide range of effective treatment options that can help overcome sciatic nerve pain on a long-term basis. From over-the-counter medications, to epidural injections and back surgery, the right treatment plan varies on an individual basis. By learning more about the causes of sciatica and how different therapies treat this condition, you can be a more informed and involved patient. 

The USA Spine Care team is providing the following comprehensive guide to help you find the relief you deserve. We encourage you to reach out at any time if you have any questions or would like to learn more about the sciatica treatments available from our caring and expert team. 

Understanding sciatica

The sciatic nerve is the longest and widest nerve grouping in the body, providing sensory and motor information to much of the lower body. The sciatic nerve branches off from the spinal cord in the lower, or lumbar spine, as a number of nerve roots that then join together and travel down both halves of the lower body. As it extends down the buttocks, legs and down to the feet, it branches off in several locations, enabling us to feel and move the lower body. 

Sciatica can develop due to a number of specific conditions and injuries, including muscle strains and spine conditions. It is also common in pregnant women, as the extra weight of the growing baby combined with altered posture can put extra pressure on the sciatic nerve. Although cases of sciatic nerve pain related to muscle strain and pregnancy tend to improve in a relatively short period of time, spine-related cases of sciatica have a higher risk of becoming chronic and debilitating. 

Sciatic nerve pain and spine conditions

Because the sciatic nerve roots start in the lower spinal column, degenerative spine conditions that cause displacement of spinal anatomy can result in compression of the sciatic nerve and sciatica symptoms. In order to protect the spinal nerves while still allowing for flexibility, the spinal column consists of segments of vertebral bone that are connected by facet joints and cushioned by rubbery discs.

Like other parts of our body, the spinal joints and discs begin to break down with age as the body loses water content. This can result in the following common degenerative spine conditions:

• Spinal arthritis
• Herniated discs
• Bulging discs
• Degenerative disc disease
• Bone spurs 

Often, these conditions may not be painful by themselves, but they can cause narrowing, or stenosis, in the spine that in turn puts pressure on nerves. Spine conditions that develop in the lower spine very often put pressure on or irritate the sciatic nerve roots, causing sciatica. 

Diagnosing sciatica

Patients experiencing any sciatic nerve pain or sciatica-like symptoms that last for longer than a few days to a week should see a doctor for diagnosis and treatment. It is essential to find the correct source of sciatic nerve pain to ensure that any treatment has the best chance of offering long-term relief.

To do this, doctors will typically take the following steps:

• Ask questions about specific symptoms and how they are affecting activities
• Review you and your family’s medical history to identify an increased risk for sciatica
• Perform a physical examination, including tests such as the straight leg test to identify the source of symptoms
• Order diagnostic imagery, such as an MRI, to positively identify the source of sciatic nerve compression

Patients diagnosed with sciatica will typically begin treatment with a course of basic conservative therapies. 

Sciatic nerve pain is often relieved with basic conservative treatments

Common nonsurgical methods to relieve sciatic nerve pain include:

• Periods of rest
• Doctor-approved low-impact exercise and gentle stretching to strengthen supporting muscles and relieve pressure on the nerve
• Alternating hot and cold therapy to relieve inflammation and relax muscles
• Taking over-the-counter medication as needed

A spine healthy lifestyle that includes managing weight, improving posture and eating a nutrient-rich diet will also be recommended for sciatica patients. 

Exploring next steps for sciatica treatment — epidural injections and physical therapy

If sciatic nerve pain persists, physicians and back pain specialists may recommend more involved treatment. Two therapies that work well together are epidural injections and physical therapy. 

Physical therapy can be highly effective in relieving sciatica by improving strength and stability in the lower back while increasing range of motion and function throughout the lower body. However, many patients with sciatic nerve pain find completing a course of sessions difficult due to the pain and limited mobility. 

By significantly relieving pain and inflammation on a medium-term basis, epidural injections can help patients complete a physical therapy program and break out of dangerous cycles of sedentary behavior. While doctors don’t recommend more than two epidural injections to treat sciatica, many patients report finding lasting relief after receiving a complementary course of epidural injections and physical therapy. 

When to consider back surgery for a spine condition causing sciatica

If sciatic nerve pain is being caused by a spine condition that is causing narrowing and sciatic nerve compression that has not responded to conservative treatment, your doctor may recommend back surgery. The goal of back surgery for sciatica is to access the spine and remove the damaged or displaced tissue that is causing narrowing and compression.

Traditional approaches to sciatica surgery involved full open spine procedures with large incisions and significant muscle disruption. Thanks to advances in minimally invasive techniques, surgeons can now perform back surgery to relieve sciatica on an outpatient basis. This in turn can contribute to a shorter recovery time with less risk of complications. 

Learn more about sciatic nerve pain relief from the experts at USA Spine Care

At USA Spine Care, our world-class treatment professionals and state-of-the-art facilities have helped thousands of patients with sciatica find the relief they deserve. No matter where you are in your treatment journey, we’ll help you develop a customized plan to find relief and a return to an active lifestyle. From epidural injections and physical therapy to back surgery, we’re passionate about finding the right mix of care for your needs. 

Contact us today to learn more. 

Sciatica Quick Answers

Does sciatica go away on its own?

Sciatica can improve on its own, depending on the specific cause of sciatic nerve compression and the individual patient. For example, if the underlying cause of sciatica-like symptoms is a muscle strain, such as the piriformis muscle in the buttocks, then pain will improve as the muscle heals. If a degenerative spine condition is the underlying cause, there is a higher likelihood that the condition becomes chronic, lasting for months or years. 

Does physical activity help sciatica?

Psychical activity and exercise can be beneficial for sciatic nerve pain for a number of reasons, including strengthening supporting muscles, improving circulation and releasing pain-relieving endorphins. However, for a patient with sciatica, physical activity should only be performed correctly and with the clearance of a physician. Learning therapeutic exercises from a qualified professional, such as a physical therapist is one of the best ways to ensure activity does not worsen sciatica. 

How long does sciatica last?

A specific instance of sciatica can last anywhere from weeks to years, depending on the underlying cause and patient’s state of health. In younger patients, an individual instance of sciatic nerve pain can improve in a short period of time. However, due to aging, sciatica can become chronic in older patients as spinal anatomy breaks down and loses elasticity, putting more pressure on the sciatic nerve. 

How do you treat sciatic nerve pain?

Sciatic nerve pain often responds favorably to basic conservative treatments. This includes rest, hot and cold compression therapy, therapeutic exercise, over-the-counter medication, posture improvement and activity modification. Epidural steroid injections can help patients in more serious pain regain mobility and complete rehabilitation programs that may not have been possible otherwise. If conservative options have been fully explored without bringing the relief necessary for a good quality of life, doctors may suggest the possibility of back surgery.