The Complete Guide to Sciatica - Types, causes and treatments
What causes sciatica and how to treat it
If you have ever suffered from sciatica you will know how painful and disruptive it can be. Sciatica can stop you being able to do the most basic things such as walking, bending or sitting and severely interrupt your life. Find out what causes sciatica and what can be done to fix it.
In this blog we will look at:
- What is the sciatic nerve?
- What actually is sciatica?
- What are the types of sciatica?
- Who is at risk?
- What causes sciatica?
- What are the symptoms?
- How is sciatica diagnosed?
- What are the non surgical treatment options?
- What are the surgical options?
- Which health care professions do what?
- How long will it take to get better?
If you suffer from sciatica it’s vital that you understand what is the cause of your sciatica, the assessment and treatment options available to you and who you should see to regain your health.
WHAT IS THE SCIATIC NERVE?
The sciatic nerve is the name of the longest nerve in your body. It is actually made up of two nerve roots that exit from the lower lumbar spine and three nerve roots that exit from the sacrum.
It travels from your low back out through your buttocks and down your thigh to your knee, calf, foot and toes. Your brain connects with the muscles in the lower leg and feet via the sciatic nerve, controlling muscle activity and sensation in your leg. It is vital for the control of your movement, sensation and balance.

WHAT IS SCIATICA?
Sciatica is actually the term that we use to describe any pain or symptoms, such as tingling or numbness that travel down the path of the sciatic nerve. Just like the word “headache” it is not an actual diagnosis of your problems, just an accurate description of the location of your pain.
Sciatic pain can be anything from a mild ache in the to levels of pain of such severe intensity simple tasks such as walking, bending, sitting or even just standing up can be difficult and in some cases impossible.
What are the types of sciatica?
There are two types of sciatica:
- Neurogenic
- Referred
Neurogenic
The discs between the vertebra can bulge, herniate or sequestrate (burst) causing direct pressure on the nerves leaving the spine. Pressure directly onto the spinal cord from within the spine can also compromise the function of the sciatic nerve. Tight muscles through the buttocks and top of the legs can also irritate and put pressure on the sciatic nerve.
In most of these cases the leg pain is worse than the back pain and described as a sharp, burning, shooting pain. It is often associated with a feeling of numbness, pins and needles, hot and cold sensation and muscle weakness.
With neurogenic sciatica there are usually abnormal neurological exam findings such as a loss the normal reflexes, muscle weakness and sensory changes.
Referred
In some cases the pain is worse in the back than it is in the leg and doesn’t usually have a shooting quality to it. Abnormal neurological findings, such as reflex changes, objective weakness and sensory changes, are unlikely to be present.
Who is at Risk for Sciatica?
It is estimated that over 40% of the population will experience sciatica at some time. The most common age for developing sciatica is between 40 to 50 years of age however it can affect any age group.
The major risk factors associated with sciatica are patients who have
- Pre-existing spinal degeneration
- Loss of normal spinal movement
- A Sedentary Lifestyle
- Employment involving in heavy work especially lifting
- Diabetes
What Causes Sciatica?
1. Disc Bulge or Herniation
Disc herniation
The intervertebral disc is constructed of outer rings of cartilage inside of which there is a soft centre called the nucleus pulposus.
When the disc bulges (prolapses) the nucleus polyposis has shifted with the disc however it remains contained within the outer cartilage rings. A bulging disc is very common in patients over 40 years of age.
When the disc herniates (sequestration) this soft material escapes out of the disc through tears that occur in the outer fibers of the cartilage called annular tears. The nerve roots are extremely sensitive and the subsequent sciatic pain is caused by irritation of the spinal nerve roots, inflammation caused by proteins contained in disc material or a combination of both. They are caused by pre-existing weakness in the annulus or a sudden increase in pressure through the disc, poor posture over time damaging the discs, a sudden unexpected load or a motor vehicle accident.
2. Degenerative Joint Disease
When there is degeneration (arthritis) in the spine and the intervertebral discs the spaces between the vertebra are narrowed. This can lead to nerve root irritation and sciatic pain in one or both legs. If the disc is damaged severely inflammatory proteins from inside the centre of the disc can irritate the nerve root causing sciatic pain.
3. Spinal Stenosis
The spinal canal is pathway the spinal cord passes through as it travels down inside the spine. In the case of spinal stenosis the canal has become narrowed and the restricted space inside the canal can put pressure on the spinal chord cause sciatica.
There are many different causes of spinal stenosis including spinal degeneration, damage to the spinal joints between the vertebra and cysts or tumors growing within the spinal canal.
4. Abnormal Spinal Movement
5. Sacroiliac Joint Dysfunction
6. Piriformis Syndrome
7. Spondylolithesis
The most common causes of a spondylolisthesis are trauma to the spine, arthritis and degeneration, pathology (such as cancer or infection), and previous surgical procedures to the spine.
8. Pregnancy
9. Muscle Strain
10. Tumors, Fractures, Infection
11. Ankylosing Spondylitis
WHAT ARE THE SYMPTOMS OF SCIATICA
The symptoms of Sciatica are usually a combination of
- Sharp, shooting or searing pain in the leg
- Numbness or pins and needles in leg and foot
- Weakness when moving the leg or foot ,
- Electric shock sensation in back or legs
- Burning or prickling sensations
- Inability to bring the foot upwards (walk on heels)
- Weakness in lifting the big toe or ankle up
- Pain and/or numbness on top of the foot, particularly between the big toe and second toe.
- Pain and/or numbness to the lateral, or outside, of the foot;
- Difficulty raising the heels off the ground
These symptoms will vary depending on many different factors, including the cause and location of the symptoms. While these symptoms can be severe and debilitating, it is rare that the sciatic nerve is permanently damaged.
The location of sciatic pain is:
- Buttocks
- back of the thigh
- back and outside of the calf,
- foot and toes.
The symptoms are usually only experienced in one leg but can occur in both.
With sciatica most patients will find that:
- Pain that is worse when sitting or standing
- Pain improves when lying down or walking
- It difficult to stand up or walk normally
- Pain is aggravated by sneezing or coughing
Cauda Equina Syndrome
Rarely people suffering sciatica can also experience a loss of bowel or bladder control or a progressive weakness or loss of sensation in their legs. These are symptoms of a possible cauda equina syndrome. This condition is very serious and anyone experiencing these symptoms should contact their doctor urgently. If the nerve is compressed and the pain and symptoms are severe, surgery may be warranted.
How Do You Find the cause of sciatica?
A thorough history and examination must be completed to determine the cause of your sciatica.
History
Often specific information at this stage starts to point to the location of the cause. Certain symptoms are unique depending on the underlying cause of the sciatica. For example, bending the body backward or walking more than a short distance will often aggravate sciatic symptoms when spinal stenosis is the cause. Bending the body forward may trigger symptoms if the cause is a lumbar herniated disc.
Functional Exam
Neurological Exam
Orthopaedic Exam
Tests
The most common tests include:
- X-rays
- Computer Tomography (CT scan)
- Magnetic Resonance Imaging (MRI)
- Blood tests
These tests help find the cause and also rule out any other pathologies as the cause of your symptoms so the most appropriate treatment can be given.
HOW DO YOU TREAT SCIATICA
Many people who experience sciatica get better within a few weeks or months using a functional approach to treatment without surgery.
Nonsurgical Treatment for Sciatica
If you suffer from sciatica its most likely started from a functional, mechanical problem in your spine. The initial aim of your treatment is to remove the irritation of the nerve, reduce inflammation in the area and improve the movement in your spine.
It is important to stop you aggravating the problem further by avoiding activities such as bending, lifting and prolonged sitting. In severe cases you will need painkillers and anti-inflammatory medication to help control the symptoms while the cause is removed. Initially stretching exercises are also an important part of your treatment.
The most important thing is that once your condition has stabilised your health care practitioner designs an individual treatment program and exercise regime to remove the underlying cause of your sciatica.
There is a broad range of treatment options available and sciatica generally responds best to a combination of the treatments below.
Spinal Manipulation and Mobilisation
Poor biomechanical function in the lower back is usually involved of the cause of sciatic pain. Spinal manipulation and mobilisation aims to restore normal balanced movement to the spine which will remove the irritation of the sciatic nerve and stop the sciatica. It is normally combined with specific flexibility and strengthening exercises to surrounding musculature to achieve the best long term improvement possible. Chiropractors, osteopaths, doctors and physiotherapists who have completed further training in this area.
Pain Medications
Massage
Exercise
TENs and Ultrasound
Heat/Ice
Epidural Steroid Injections
Acupuncture and Dry Needling
Surgical Treatment for Sciatica
For the small number of people that when the pain is severe or does not get better with conservative treatment, a more structured treatment approach, and possibly surgery, may be the best option for finding pain relief and preventing or minimizing future pain and/or dysfunction.
Surgery should be a last resort and is sometimes necessary, especially if bowel and bladder control is affected. If your chiropractor has any doubts about the cause of your problems or whether they can help you they will refer you to your doctor or a spinal surgeon for another opinion.
Surgery for sciatica is considered when the patient has the following:
- Severe leg pain that has persisted for greater than six weeks
- Pain that is not relieved after all non surgical treatment such as chiropractic, drug treatment and injections
- Severe Limitations on the patient’s ability to participate in normal everyday activities
The most common types of surgery
Microdisectomy
Laminectomy
Spinal Fusion
Disc Replacement
Who treats sciatica?
Chiropractors
Chiropractors aim to restore the normal spinal function to your spine, strengthen the surrounding muscles and balance the neurological control of the region. This is achieved by using specific spinal techniques and a specific rehabilitation exercise program
Clinically chiropractors generally find that most of their patients suffering from sciatica get relief after a period of chiropractic care, exercises, rest and avoiding any aggravating activities.
Doctor
Physiotherapists
Massage Therapists
How long will it take to get better?
The healing process takes time and varies from person to person, often depending on the severity of the condition and the history of the complaint. However, how active and compliant you are in your own treatment will influence your recovery time.
The recovery time can take days weeks or even months depending on the cause of your pain and will vary from perosn to person.
what to do if you have sciatica?
If you are experiencing sciatic pain it is important to achieve an accurate diagnosis prior to commencing any treatment. This is achieved through a thorough examination process that allows your chiropractor or other health professional to discover the cause of your sciatica and design the best treatment for you.
Discover how chiropractic can help your sciatica.
Copyright Ansell Chiropractic ©2016
34 Comments
Submit a Comment
34 Comments
-
Christine bayley on April 26, 2017 at 5:02 pm
Thanks for this information very informative and happy with my treatment when visiting your service
-
pointless on May 21, 2018 at 7:28 am
Hi there to every οne, it’s actually a fastidious for me to
visit this wеb рage, it inclᥙdes useful Informatіon. -
Dumisani Winfred Mashabane on August 15, 2018 at 12:24 pm
Swollen or abscess on the right buttock irritated me for over a year without knowing,but I felt it when moving my hand on the buttock, and informed my doctor who used a sonar. Thanks for this information that I now know what causes my sciatica. Still waiting for further treatment.
-
Lynda Blanton on September 14, 2018 at 3:31 am
I do believe this article is award worthy in the fact that it provides the best information all in one page then any other site I’ve come across so far. This is amazingly well written and complete in information regarding what has become the most crippling issue of my adult life…From the heart, I say thank you for taking the time to include such a good amount of information and presenting it in an easy to use and read manner…Truly fantastic job…Thank you Thank you Thank you
-
Eric Ward on October 2, 2018 at 3:23 pm
I was worried about the ankle/foot restrictive movement (muscle weakness) I encountered, But thanks to this article my worries are put to rest. Thank you.
-
john Hunt on October 8, 2018 at 10:18 am
The information you have supplied has been very important to me as i really had little knowledge of my problem.Thank you.
-
LES BROwN on October 24, 2018 at 2:38 am
Hi, just wanted to tell you, I loved this blog post.
It was inspiring. Keep on posting!-
Tom on August 3, 2019 at 10:06 pm
Great thank.you
-
-
LES BRoWN on October 25, 2018 at 6:00 pm
Hey I know this is off topic but I was wondering if you knew of
any widgets I could add to my blog that automatically tweet
my newest twitter updates. I’ve been looking for a plug-in like this
for quite some time and was hoping maybe you would have some experience with something like this.
Please let me know if you run into anything. I truly enjoy reading your blog and I look forward to your new
updates. -
Lisa payne on October 26, 2018 at 12:02 am
I appreciate the concise way the information is presented and the images are very helpful for understanding what’s going on. Thanks.l
-
Dining Room on November 4, 2018 at 3:53 am
Greetings! I’ve been reading your blog for some time now and finally got
the bravery to go ahead and give you a shout out from
Atascocita Texas! Just wanted to mention keep up the fantastic
work! https://www.houzz.com/user/clairbrookfield -
Dining Room on November 4, 2018 at 3:54 am
Greetings! I’ve been reading your blog for some
time now and finally got the bravery to go ahead and give you a shout out
from Atascocita Texas! Just wanted to mention keep up the fantastic work! https://www.houzz.com/user/clairbrookfield -
Warren on November 11, 2018 at 10:56 pm
This information was very helpful. I was relieved when i found treatment so i can get back to my everyday life. THANKS!!
-
Raymond Morgan on November 25, 2018 at 5:19 pm
Thank you for the information. I will use the suggestions to achieve relief of my searing Sciatic pain.
-
alimony on December 11, 2018 at 2:58 am
There iѕ certaіnly a ⅼot to know about this subject.
I love all of the points you’ve made. -
http://www.gloucestercarrecovery.com on December 17, 2018 at 5:20 pm
You can definitely see your enthusiasm wihin the article you write.
The arena hopes for even more ppassionate writers like you who aren’t
afraid to say how they believe. At all times go after your heart. -
DR. KYLE on January 16, 2019 at 4:40 pm
Thank you for sharing such great information. It’s a pleasure to visit here. You can also visit us in DR. KYLE .
-
Stanley Osovsky on February 2, 2019 at 11:44 am
Thank you very much for very valuable information.
-
LES BROWn on February 26, 2019 at 12:56 pm
That is very fascinating, You’re a very professional blogger.
I’ve joined your rss feed and stay up for in quest of more
of your great post. Additionally, I have shared your web
site in my social networks -
Richard on March 12, 2019 at 1:00 am
Fantastic guide that answers all my questions.
-
Pervinder Sanghera on May 3, 2019 at 6:11 am
Thank you for such a comprehensive and well explained article. My mother in law is suffering from sciatica and this has elegantly explained her pathology and treatment options.
-
OthmanSweiti on June 22, 2019 at 10:36 pm
Many thanks for this very useful details, it has clarified many points about the Scaitica, the one I am suffering from right now…hope you will add more line to advise people on how to avoid sciatica….thanks again. Othman Sweiti.
-
Dr. Gady Abramson on August 8, 2019 at 6:23 am
Hey! Amazing article. You’ve covered everything on sciatic that everyone should know about it. I’ve subscribed to your mail list, so whenever you post a new article I can keep an update of it. Keep sharing such articles. Cheers!.
-
Rolando on August 30, 2019 at 7:04 am
It’s actually a cool and useful piece of info.
I am happy that you just shared this helpful info with us.
Please keep us informed like this. Thank you for sharing. -
June Patterson on November 15, 2019 at 3:07 pm
Very informative information. This site has described the symptoms I have experienced with my condition. I have an appointment with an orthopedic doctor next week, this article will help me to understand what the doctor is explaining to me.
-
Jeremy on March 10, 2020 at 8:21 pm
Hello,
thank you for the great article. Some of the stuff I really didnt know and had first time heard of. I also found a great article about treating sciatica on this site. If someone wants to read more 🙂
https://sciaticapain.co.uk/best-sciatica-treatment-over-the-counter-in-2020/ -
Morehealthis.Com on April 4, 2020 at 9:42 am
Because symptoms can be similar in other conditions, radiologic tests such as MRIs may be required to rule out other causes of sciatic nerve compression, such as a herniated disc .
-
Nannymed on May 3, 2020 at 10:25 am
Other unpleasant sensations, like tingling and numbness, can also join the pain. This tingling feeling can manifest in the leg or foot, and sufferers often describe it as pins and needles, burning or prickling. Affected areas of the body may also go numb. People who suffer from sciatica may also experience weakness in the affected areas of the body. For example, you might have a hard time lifting your big toe or ankle. In severe cases, sciatica may affect bowel and bladder control.
-
Paul on November 7, 2020 at 10:18 am
Into my 18th month of hip to foot travelling pain (dull) which has varied from quite mild to severe. CT indicated L4 bulge. Sciatica indicated by previous docs but new one thinks it isn’t???. No spring chicken.. Also occasional “wetness” sensation lower leg and tingling.Awaiting a further CT next week.
Thanks for all the saelent info, all in one place. WishI lived in townsville.
Cheers Paul -
Downtown Pain Physicians on December 2, 2020 at 10:44 pm
Very informative
-
Melanie on March 27, 2021 at 10:48 am
Such great information for clients! Great blog!
Thanks for this information very informative and happy with my treatment when visiting your service
Hi there to every οne, it’s actually a fastidious for me to
visit this wеb рage, it inclᥙdes useful Informatіon.
Swollen or abscess on the right buttock irritated me for over a year without knowing,but I felt it when moving my hand on the buttock, and informed my doctor who used a sonar. Thanks for this information that I now know what causes my sciatica. Still waiting for further treatment.
I do believe this article is award worthy in the fact that it provides the best information all in one page then any other site I’ve come across so far. This is amazingly well written and complete in information regarding what has become the most crippling issue of my adult life…From the heart, I say thank you for taking the time to include such a good amount of information and presenting it in an easy to use and read manner…Truly fantastic job…Thank you Thank you Thank you
I was worried about the ankle/foot restrictive movement (muscle weakness) I encountered, But thanks to this article my worries are put to rest. Thank you.
The information you have supplied has been very important to me as i really had little knowledge of my problem.Thank you.
Hi, just wanted to tell you, I loved this blog post.
It was inspiring. Keep on posting!
Great thank.you
Hey I know this is off topic but I was wondering if you knew of
any widgets I could add to my blog that automatically tweet
my newest twitter updates. I’ve been looking for a plug-in like this
for quite some time and was hoping maybe you would have some experience with something like this.
Please let me know if you run into anything. I truly enjoy reading your blog and I look forward to your new
updates.
I appreciate the concise way the information is presented and the images are very helpful for understanding what’s going on. Thanks.l
Greetings! I’ve been reading your blog for some time now and finally got
the bravery to go ahead and give you a shout out from
Atascocita Texas! Just wanted to mention keep up the fantastic
work! https://www.houzz.com/user/clairbrookfield
Greetings! I’ve been reading your blog for some
time now and finally got the bravery to go ahead and give you a shout out
from Atascocita Texas! Just wanted to mention keep up the fantastic work! https://www.houzz.com/user/clairbrookfield
This information was very helpful. I was relieved when i found treatment so i can get back to my everyday life. THANKS!!
Thank you for the information. I will use the suggestions to achieve relief of my searing Sciatic pain.
There iѕ certaіnly a ⅼot to know about this subject.
I love all of the points you’ve made.
You can definitely see your enthusiasm wihin the article you write.
The arena hopes for even more ppassionate writers like you who aren’t
afraid to say how they believe. At all times go after your heart.
Thank you for sharing such great information. It’s a pleasure to visit here. You can also visit us in DR. KYLE .
Thank you very much for very valuable information.
That is very fascinating, You’re a very professional blogger.
I’ve joined your rss feed and stay up for in quest of more
of your great post. Additionally, I have shared your web
site in my social networks
Fantastic guide that answers all my questions.
Thank you for such a comprehensive and well explained article. My mother in law is suffering from sciatica and this has elegantly explained her pathology and treatment options.
Many thanks for this very useful details, it has clarified many points about the Scaitica, the one I am suffering from right now…hope you will add more line to advise people on how to avoid sciatica….thanks again. Othman Sweiti.
Hey! Amazing article. You’ve covered everything on sciatic that everyone should know about it. I’ve subscribed to your mail list, so whenever you post a new article I can keep an update of it. Keep sharing such articles. Cheers!.
It’s actually a cool and useful piece of info.
I am happy that you just shared this helpful info with us.
Please keep us informed like this. Thank you for sharing.
Very informative information. This site has described the symptoms I have experienced with my condition. I have an appointment with an orthopedic doctor next week, this article will help me to understand what the doctor is explaining to me.
Hello,
thank you for the great article. Some of the stuff I really didnt know and had first time heard of. I also found a great article about treating sciatica on this site. If someone wants to read more 🙂
https://sciaticapain.co.uk/best-sciatica-treatment-over-the-counter-in-2020/
Because symptoms can be similar in other conditions, radiologic tests such as MRIs may be required to rule out other causes of sciatic nerve compression, such as a herniated disc .
Other unpleasant sensations, like tingling and numbness, can also join the pain. This tingling feeling can manifest in the leg or foot, and sufferers often describe it as pins and needles, burning or prickling. Affected areas of the body may also go numb. People who suffer from sciatica may also experience weakness in the affected areas of the body. For example, you might have a hard time lifting your big toe or ankle. In severe cases, sciatica may affect bowel and bladder control.
Into my 18th month of hip to foot travelling pain (dull) which has varied from quite mild to severe. CT indicated L4 bulge. Sciatica indicated by previous docs but new one thinks it isn’t???. No spring chicken.. Also occasional “wetness” sensation lower leg and tingling.Awaiting a further CT next week.
Thanks for all the saelent info, all in one place. WishI lived in townsville.
Cheers Paul
Thanks Paul
Very informative
Glad you found it informative. Have a great weekend
Such great information for clients! Great blog!
Thanks for the feedback Melanie