Sciatica

Common Causes of Sciatic Nerve Pain

What causes sciatica?

Sciatica can be caused by anything that irritates the sciatic nerve, an injury anywhere along the path of the nerve or a tight piriformis muscle pinching the nerve. Common causes of sciatica include:

• Degenerative disk disease: DDD is a common condition related to aging, in which the vertebrae start to break down, potentially putting pressure on the sciatic nerve.
• Herniated disk: Also known as a slipped, ruptured or bulging disk, this is one of the most common causes of sciatica and occurs if the herniated disk irritates or compresses the sciatic nerve.
• Facet joint damage: This is often caused by osteoarthritis and can lead to inflammation, stiffness, muscle spasming and pain. When damage to a facet joint pinches a nearby nerve, it can lead to sciatica.
• Piriformis syndrome: This is a condition that affects the neuromuscular system, and causes spasming of the buttocks, which may put pressure on the sciatic nerve.
• Pregnancy: During pregnancy, the mother’s uterus can place pressure on the sciatic nerve as it expands, causing compression.
• Spinal stenosis: Spinal stenosis occurs when the spinal canal in your lower back narrows, placing pressure on nearby nerve roots. It can be caused by the formation of bone spurs, thickening of a nearby ligament or degeneration of a lumbar disk or joint.
• Spondylolisthesis: This is a condition where a lumbar vertebra slips forward over the top of the vertebra below it. This places a lot of compressive force on the lumbar disk separating the two vertebrae. As the lumbar disk deteriorates, it can cause lower back pain. If the lumbar disk flattens from this force, it can lead to nerve compression and sciatica.

Signs & Symptoms of Sciatica

Sciatica is known for causing low back pain and leg pain. When left untreated, it can cause very severe pain, muscle spasms and more. Sciatica is known for these hallmark symptoms:

Radiating Pain

Pain in the lower back, leg, or one side of the buttocks is common with sciatica. This pain often begins at the base of the spine and travels downward through one of the legs. The pain may be burning, sharp or shooting, but it is never contained to one location.

One-Sided Pain

Another trademark of sciatica is one-sided pain. Most of the time, just one side of the body is affected by sciatic nerve pain, which radiates from the lower back, through one side of the buttocks, and down one leg. It is possible to have sciatica on both sides of the body, but this is rare.

Tingling or Numbness

Many sciatica patients describe a numb or tingling sensation on the affected side of the body, frequently saying it feels like pins and needles. Neurologic symptoms like these are due to the compression of the sciatic nerve, which causes a sensation very similar to when a limb “falls asleep.”

Muscle Weakness

Sciatica pain is frustrating enough on its own, but it can also cause weakness in the muscles of the affected leg due to the compression of spinal nerves. This can lead to difficulty lifting the foot, causing mobility issues and trouble walking.

Get immediate medical attention if you experience sudden numbness or weakness, pain after a severe injury or loss of bowel control.

Any of these symptoms may instead be caused by something other than sciatica. The only way to know what is causing a particular symptom is to see your doctor.

How Sciatica Is Diagnosed

Diagnosing the source of your pain starts with a thorough physical exam. Your doctor will ask you about your medical history and risk factors before examining your back, neck, arms, legs or other parts of the body to understand your symptoms. From there, your physician will recommend several possible tests for sciatica diagnosis, including:

• Straight leg raise (SLR): SLR is a reliable way to pinpoint the location and severity of your pain. It may be combined with a “slump test” in which you lower your chin to your chest. Both are considered “positive” if they recreate the radiating pain, tingling or numbness you’ve been experiencing.
• Imaging: It’s possible your physician will request X-rays, a CT scan or magnetic resonance imaging (MRI) in order to diagnose the underlying cause of your sciatica.
• Electromyography: An EMG test is used to confirm nerve compression by measuring electrical pulses in the muscles.

If you receive a sciatica diagnosis, our specialists work together to create a personalized treatment plan to help you find relief.

Treatment Options for Sciatica

Treatment plans vary depending on the type and severity of symptoms. In some cases, minor sciatica heals on its own with time. Other cases require a more aggressive approach to treatment. In all cases, the goal is to find and treat the underlying cause of the condition. Your health care team may use one or more of the following methods to treat and manage sciatica:

Non-Surgical Treatment

Most of the time, your physician will begin with a more conservative and non-invasive approach to sciatica treatment. Non-surgical treatments may include:

• Home care, including cold and heat therapy, exercises and sleeping with a pillow between your knees
• Over-the-counter anti-inflammatory medications
• Stretches and light physical activity
• Physical therapy
• Epidural injections for pain management

Surgical Treatment

While there is no specific surgery for sciatica, there are several surgical procedures that may be recommended to treat the underlying condition. These procedures can include:

• Microdiscectomy: Surgery that removes protruding or damaged material from herniated or bulging disks
• Laminectomy: A procedure to remove some or all of the lamina (vertebral bone) to relieve the pressure on the spinal cord or spinal nerves
• Spinal fusion surgery: A procedure that fuses two or more vertebrae together to alleviate pain

Across Houston, our patients have access to our expert neck, back and spine specialists so that you can get the best possible care personalized for your needs — without traveling far from home. Explore our footprint of locations in the Greater Houston area and suburbs below.