Sciatica (sy-AT-i-ka) is a form of lower back pain that usually moves from the buttocks down the back of the leg.
Sciatica is most common in people who are 30 to 70 years of age, and it affects about three times as many men as women. The following groups are at risk:
There are many ways the sciatic nerve can become compressed, but the exact cause is often unknown. The most common causes of sciatica are a herniated disk or a tumor within the spine. Disks are the pads between the bones of the spine, called vertebrae. They are filled with a gelatin-like substance that cushions the vertebrae from the impact of walking, running, lifting, and similar activities. A disk that has torn and has this gelatin-like material oozing out of it is said to be herniated.
Other common causes of sciatica include bony irregularities of the vertebrae such as spondylolisthesis * . Spinal stenosis * is a less common cause. In some cases, diabetes or alcoholism can cause sciatica.
Sciatica is diagnosed through a medical history and a physical examination. Sciatica often clears up within several days to a week. It is usually treated with bed rest for a day or two (only if people cannot bear the pain), local heat, massage, pain relievers, and muscle relaxants. Sciatica tends to return and can become chronic * . Chronic sciatica is treated by trying to alleviate the cause of the pain. People with this problem are advised to lose weight, increase their muscle tone and strength, and improve their posture. Surgery may be necessary in cases in which there is no relief from pain, and in cases of disk disease or spinal stenosis.
Several surgical interventions are available for treating sciatica. The goal of surgery is to eliminate the source of pressure on the sciatic nerve.
Laser discectomy is the removal of herniated disk material using a laser technique. During this procedure, laser energy is introduced under fluoroscopic guidance to remove tissue that has been pressing on nerves and causing pain or numbness.
Microdiscectomy is the removal of herniated disk material using a surgical microscope. Because this technique involves a microscope, the incision remains small, which helps reduce disturbance of surrounding tissue. Radiofrequency ablation uses radiofrequency energy to heat up and break bonds of small nerve-tissue areas, creating small openings and decreasing pain for months and sometimes years.
Sciatica or recurrence of sciatica can sometimes be prevented by standing, sitting, and lifting properly; exercising; and working in a safe environment. People can use chairs, desks, and equipment that support the back or help maintain good posture, and they can take precautions when lifting and bending.
See also Pain • Slipped (Herniated) Disk
Laroche, Francoise and Serge Perrot, eds. Managing Sciatica and Radicular Pain in Primary Care Practice. New York: Springer Healthcare, 2013.
PubMed Health. “Sciatica.” U.S. National Library of Medicine. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024494/%20 (accessed July 6, 2016).
American Chiropractic Association. 1701 Clarendon Blvd., Arlington, VA 22209. Telephone: 703-276-8800. Website: http://www.acatoday.org (accessed July 6, 2016).
National Institute of Arthritis and Musculoskeletal and Skin Diseases. 1 AMS Cir., Bethesda, MD 20892-2520. Toll-free: 877-226-4267. Website: http://www.niams.nih.gov (accessed July 6, 2016).
* spondylolisthesis (spon-di-lo-lis-THEE-sis) is a condition in which one vertebra slips over the other.
* spinal stenosis (SPY-nal ste-NOsis) is the narrowing of the spinal canal.
* chronic (KRAH-nik) means lasting a long time or recurring frequently.