- Sciatic nerve pain develops from compression on the nerve. This compression may come from injury, herniated disc, tumors pressing on the nerve, spinal stenosis and degenerative disc disease.
- Sciatic nerve pain can range from a mild ache to sharp jolts of pain radiating from your lower back down the back of one leg. Symptoms include numbness, tingling and burning pain. Sciatica pain can start and progress slowly. Pain can be worse at night, after sitting or standing for prolonged periods, and after coughing, sneezing or laughing. The pain will normally run along the pathway of the sciatic nerve. You may feel pain in certain areas of the nerve or along the entire nerve.
- Muscle weakness may occur in one area of the nerve pathway and numbness in another part. You may experience pins-and-needles feeling in your toes. A rare symptom of sciatica are a loss of bladder or bowel control.
- Your doctor will perform a physical exam and may ask you to try basic tests such as standing from a squatting position or while lying on your back raising each leg separately into the air. These tests check muscle strength and reflexes. When pain is severe or lasts longer than four weeks, your doctor may want a CT or MRI scan performed. These scans provide images allowing your doctor to see what may be causing the pain.
- Self-care measures are the first line of treatment for sciatic nerve pain. Apply cold packs for the first few days to reduce swelling. Use a heating pad after treating with ice to reduce stiffness and pain. Use over-the-counter medications such as Aleve or Motrin to reduce nerve pain. Your doctor may recommend physical therapy if a herniated disc is causing sciatica. A physical therapist can develop an exercise routine specifically for you to help strengthen back muscles and provide more flexibility. Anti-inflammatory medications and muscle relaxants may be prescribed by your doctor for short-term treatment. Anticonvulsant drugs may provide chronic pain relief by blocking pain signals from the brain.
- When pain is not alleviated, more aggressive measures may be taken. Epidural steroid injections are corticosteroid medications injected into the affected area. These injections reduce inflammation around the nerve and lessen pain, but because of side effects, no more than three are given a year. Surgery is reserved for pain that becomes progressively worse and for loss of bladder or bowel control. The surgeon will remove the section of herniated disc pressing on the nerve which should relieve pain and allow you to gain back control of your bladder and bowels.
