by Elizabeth Smoots, MD
Sciatica is an irritation of the sciatic nerve. The sciatic nerve leave the spine in the low back. There is one on the left and one on the right. The nerve travels deep into the pelvis to the lower buttocks. From there, it passes down the back of each thigh. Then the nerve divides at the knee into branches that go to the feet.
Sciatica is caused by pressure on the nerve. This can be the result of:
Risk Factors TOP
Factors that may increase your chance of sciatica include:
Personal health factors, such as:
Occupational factors, such as:
Other health conditions, such as:
Symptoms 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 health history. A physical exam will be done. Your doctor will pay close 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 often recommended. It does not seem to help healing. In fact, it may make your recovery longer.
If you have severe pain, bed rest may be suggested but for no more than 1-2 days. Activities may be restricted for a short period of time. It should then be resumed as soon as possible. Recovery time may be shortened by staying active and exercising. Avoid activities that make the pain worse.
Medications used to treat sciatica include:
Physical Therapy TOP
Physical therapy may include:
Surgery may be needed. It can help to relieve pressure on the nerve. It is the last resort, if other treatment has not worked. It may also be needed if there are urgent symptoms. Common surgical procedures include:
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 2018 by EBSCO Medical Review Board Teresa Briedwell, PT, DPT, OCS, CSCS
Last Updated: 7/17/2018
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