by Elizabeth Smoots, MD
The sciatic nerve begins from the lower spine on either side. It travels deep in the pelvis to the lower buttocks. From there, it passes along the back of each upper leg and divides at the knee into branches that go to the feet. Sciatica is an irritation of the sciatic nerve.
Sciatica is caused by irritation or pressure on the sciatic nerve. This can be the result of:
Risk Factors TOP
Sciatica is more common in men. Other factors that may increase your chance of sciatica include:
Lifestyle and personal health factors, such as:
Occupational factors, such as:
Health conditions, such as:
Sciatica causes symptoms that can range from mild to severe. Symptoms may include:
More serious symptoms associated with sciatica that may require immediate medical attention include:
You will be asked about your symptoms and medical history. A physical exam will be done. Your doctor will pay particular attention to your back, hips, and legs. The physical exam will include tests for strength, flexibility, sensation, and reflexes.
Imaging tests are used to evaluate the affected area:
Your doctor may also need to test your nerves. This can be done with a nerve conduction study.
The goal of treatment is to reduce sciatic nerve irritation.
Treatment options include:
Bed rest is not generally recommended. It may be suggested for no more than 1-2 days in those with severe pain. Activities may be restricted for a period of time and then resumed as soon as possible. Recovery time may be shortened by staying active and exercising.
Medications used to treat sciatica include:
Physical Therapy TOP
Physical therapy may include:
Alternative Therapies TOP
These therapies have not been proven by scientific studies to have an effect on sciatica. However, some people may find some pain relief from:
Sciatica tends to happen more than one time. To help reduce your chance of sciatica:
North American Spine Society
Ortho Info—American Academy of Orthopaedic Surgeons
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
Allen C, Glasziou P, et al. Bed rest: A potentially harmful treatment needing more careful evaluation. Lancet. 1999; 354:1229-1233.
Sciatica. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at:
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Updated December 2013. Accessed November 15, 2017.
Sciatica. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115166/Sciatica. Updated May 8, 2017. Accessed November 13, 2017.
Waddell G, Feder G, Lewis M. Systematic reviews of bed rest and advice to stay active for acute low back pain. Br J Gen Pract. 1997;47:647-652.
6/7/2007 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com: Peul WC, van Houwelingen HC, et al. Surgery versus prolonged conservative treatment for sciatica. N Engl J Med. 2007;356:2245-2256.
Last reviewed November 2017 by EBSCO Medical Review Board Teresa Briedwell, PT, DPT, OCS, CSCS
Last Updated: 12/20/2014
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