When to See a Doctor for Sciatica
Sciatica is a common cause of back and leg pain. The condition is caused by inflammation or injury of the sciatic nerve, which runs from the lower back, down the back of the legs, and into the feet. Common sciatica symptoms include pain, weakness or numbness in the lower back, buttock, leg or foot. The pain may be dull and deep or sharp and shooting; it may also come and go with movement. Sciatica can often be managed at home, but severe sciatica requires medical treatment.
Sciatica results from irritation of the sciatic nerve. Common causes of sciatica include:
Herniated or bulging disc: The spinal discs typically provide cushioning between the spinal vertebrae, or bony part of the spine. If one of these discs moves slightly out of place, it can put pressure on the sciatic nerve.
Degenerative disc disease: Over time, the spinal discs can wear out, leading to increased pressure on the sciatic nerve.
Osteoarthritis: Bone spurs can compress the sciatic nerve, causing sciatica symptoms.
Pregnancy: During pregnancy, your center of gravity changes, and your joints become increasingly elastic. These changes can result in sciatica back pain or sciatica nerve pain in your buttocks and legs. At times, the baby’s position might also put pressure on the sciatic nerve.
Injury: A back injury or pelvic fracture can cause sciatica.
Rarely, sciatica is caused by:
Spinal tumor: Benign or cancerous tumors located in the spinal column can irritate the sciatic nerve.
Spinal stenosis: Narrowing of the spinal canal–the “tunnel” that houses the spinal cord–can compress the sciatic nerve.
Nerve damage due to a disease, such a diabetes. Any disease that can damage the nerves could affect the sciatic nerve and cause sciatica.
Many cases of sciatica will resolve in a few days. If you experience sciatica symptoms, you can:
Rest: Decreasing your activity can help minimize additional irritation of the sciatic nerve and give the area time to heal. Bedrest, however, is not recommended. It’s best to get up and move around gently. Avoid any movements that lead to increased pain.
Stretch: Stretching exercises of the low back can help relieve nerve compression. Avoid twisting the back. Aim for slow, gradual stretches.
Use cold packs: Applying an ice pack (or bag of frozen veggies) to the irritated area can provide some relief. You can ice the area for 20 minutes at a time, a few times per day. Cold therapy is most helpful soon after symptoms begin.
Apply heat: If your symptoms have persisted for more than two or three days, try heat instead of cold. Use a heating pad or hot packs.
Take anti-inflammatory medication: Ibuprofen (Motrin, Advil) and naproxen (Aleve) are over-the-counter medicines that relieve pain and decrease inflammation.
If you continue to have pain and problems with movement after a few days of self-care, or if your symptoms get worse rather than better, it’s time to see a doctor for sciatica treatment.
You should seek immediate medical care (call 911) if you experience:
Loss of leg movement or sensation
Loss of bowel or bladder control
Family doctors and general practitioners can diagnose and treat simple cases of sciatica. Chiropractors and physical therapists also treat people with sciatica.
Approximately 40% of people will experience sciatica in their lifetimes. Report any episodes, even ones that resolve with self-care, to your primary healthcare provider. If you’re unsure if your symptoms are related to sciatica, or if your symptoms get worse despite home therapy, consult a physician.