What Causes Sciatica Pain? A Doctor Shares Risk Factors and the Best Treatment Options

If you’ve experienced sciatica before, you know the stubborn pain can ruin your whole week. Sciatica is a type of back pain that occurs when there’s pressure on the sciatic nerve, which extends from the lower back through the heel of each foot. When the sciatic nerve gets irritated, inflamed, pinched or compressed, it can cause pain that starts in the lower back and radiates through the buttock and the back of the thigh. So what causes sciatica to flare up? And what’s the best treatment for sciatica? Here’s what you need to know.

What does sciatica pain feel like?

Sciatica pain can start as a tingling or burning sensation in the lower back. But the hallmark symptom is pain that radiates through the buttock or shoots down the affected leg. This can range from mild to excruciating.

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“What I often hear from patients is that the pain feels ‘sharp’ or ‘stabbing’ — even similar to an electric shock,” says Lindsay Zilliox, MD , a neurologist and associate professor at the University of Maryland School of Medicine. “Another common description is that the pain feels like when an extremity ‘falls asleep,’ with a burning sensation or numbness.”

What causes sciatica?

Sciatica isn’t actually a medical condition — it’s a symptom that something is putting pressure on the sciatic nerve. One of the most common causes of sciatica is a herniated disk. The vertebrae that make up your spinal column are cushioned by soft disks. If a disk “slips” or ruptures, it can put painful pressure on the sciatic nerve.

Degenerative disk disease, a condition in which wear-and-tear on the spine causes backaches, can also contribute to pain in the spinal nerves. Spinal disks gradually wear down over time, which is a normal part of aging. But for some people, this can cause the vertebrae to rub together or press against nerves, including the sciatic nerve.

Other possible causes include pregnancy or underlying back issues like spinal stenosis or bone spurs. In rare cases, sciatic nerve pain may be caused by a tumor putting pressure on it.

Risk factors for sciatic nerve pain

Sciatica is incredibly common, affecting up to 40% of people at some point in their lives. But there are a few risk factors for sciatica that can up your odds of a flare-up.

• Age. According to a study in the Journal of Clinical Orthopaedics and Trauma , sciatica is most common between the ages of 35 and 55.
• Weight. Excess weight can put stress on your back and compress your spine, contributing to sciatica pain.
• Occupation. Any job that involves a lot of lifting, twisting or bending can lead to sciatica pain. Prolonged sitting, like from a desk job or driving gig, can also compress your spine.
• Prior back problems. “A history of back problems is definitely a predictor, along with poor core and lower back strength and bad posture,” Dr. Zilliox says.

Treatment options for all causes of sciatica

If you’re dealing with sciatica pain, you’re probably wondering how to get relief as quickly as possible. “The crucial first step is to rest for a few days,” Dr. Zilliox says. But too much inactivity can actually slow the healing process.

So as soon as you’re able to, start incorporating some gentle movement and simple stretches for sciatica . A physical therapist can help guide you through proper stretching techniques for sciatica relief, Dr. Zilliox says.

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Additional treatment options for sciatica include ice and heat , simple care measures that can help take the edge off the pain. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen and naproxen sodium may also help relieve inflammation.

If that doesn’t help, your primary care doctor may be able to suggest nerve pain medications, muscle relaxers or injections, Dr. Zilliox says. And if you notice any worrisome symptoms like muscle weakness or changes in bladder function, seek medical care ASAP.

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This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan .