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23 November 2009
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Man holding lower back

Sciatica

Dr Rob Hicks

Sciatica is a common form of back pain that affects the lower half of the body. It's caused by pressure on a nerve.


What is sciatica?

Sciatica is a common form of back pain that affects the lower half of the body. It's caused by pressure on a nerve.

Symptoms

Sciatica usually only affects one leg. The pain may be felt in the buttock, down the back of the leg, below the knee and in the foot. If there is back pain it is usually less severe than the pain down the leg. Such pain can be mild or severe; it may be persistent or come in spasms.

People with sciatica may also experience numbness, tingling and muscle weakness in the affected leg. It can be worse when you cough or move, and is sometimes accompanied by low back pain.

Causes and risk factors

The sciatic nerve is the main nerve in the leg and the largest in the body. It runs from the base of the spine, along the back of the thigh to the knee, where it divides into branches.

Sciatic pain is usually caused by compression of this nerve root at the point where it leaves the spine. Damage to the nerve can also cause pain.

In young and early middle-aged adults, the most common cause of sciatica is a prolapsed intervertebral disc in the lumbosacral area of the lower back.

In older people, changes in the spine due to conditions such as osteoarthritis may be responsible either by causing localised pressure on the nerve or by narrowing of the spinal canal – called spinal stenosis.

Other bone disease or local injury may also be responsible. Sometimes, just sitting awkwardly can cause sciatica.

More serious symptoms such as loss of sensation around the genital area and buttocks, difficulty passing water or opening your bowels, or progressive weakness all need urgent medical assessment

Treatment and recovery

Sciatica sometimes resolves without treatment. However, if it doesn't you may be prescribed the following:

  • Painkillers
  • Anti-inflammatory medication
  • Physiotherapy, osteopathy or chiropractic
  • Epidural injections

Surgery to correct the underlying cause may be required if these treatments don't resolve the problem. To minimise the risk of sciatica, keep to a healthy weight, learn to lift properly and avoid sitting in awkward positions for long periods of time. Taking regular exercise can also help to reduce the risk.

Advice and support

BackCare

Helpline: 0845 130 2704
Email: website@backcare.org.uk
Website: www.backcare.org.uk

This article was last medically reviewed by Dr Gill Jenkins in August 2009.


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