Understanding Sciatica: Symptoms, Causes, and What You Can Do to Find Relief

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Imagine a sharp, shock-like pain that begins in your lower back and shoots down your leg.Sitting, standing, walking, or even sleeping is difficult without pain. If this sounds familiar, you might have sciatica—an issue that affects up to 40% of people in the U.S. at some point during their lifetime.

In this post, based on data from Kevin Taliaferro, MD, an orthopaedic surgeon at Henry Ford Health, we'll break down everything you need to know about sciatica: its symptoms, causes, and risk factors, and most importantly—how to properly treat and manage it.

What Is Sciatica?

Sciatica is not a diagnosis itself, but a catch-all term for pain that begins in the lower back or buttocks and can run down the leg. The pain is generally the result of irritation or compression of the sciatic nerve, which runs from the spine down into the legs.

"Not all back or leg pain is true sciatica," Dr. Taliaferro says. "It's often misattributed."

Common Sciatica Symptoms

Sciatica pain can be mild discomfort or debilitating pain. Typical symptoms are:

• Lower back pain
• Pain down one leg
• Numbness or tingling in the leg or foot
• Muscle weakness
• Pain that increases when sitting, standing, or walking

Red Flag Symptoms (Seek Medical Attention Immediately):

• Numbness or weakness in the legs
• Loss of bowel or bladder control

These can be signs of severe nerve compression or a medical emergency.

What Causes Sciatica?

1. Herniated Disc

When a disc in your spine bulges or ruptures, it can put pressure on nearby nerves—including the sciatic nerve.

2. Spinal Stenosis

This is a narrowing of the spinal canal, which can put pressure on nerves and cause leg pain.

3. Degenerative Disc Disease / Arthritis

As we age, spinal joints and discs wear down naturally, making nerve compression more likely.

4. Poor Lifting Techniques

Twisting while lifting heavy is a common precipitating cause of sciatica flare-ups.

5. Pregnancy

The increased weight and postural changes of pregnancy can stress the lower back and irritate the sciatic nerve.

Who's at Risk?

• Adults over 40 (due to wear and tear)
• Manual workers or sports persons
• People with inactive lifestyles
• Pregnant women
• Persons with a history of past back issues

Even children can get sciatica—especially from trauma or poor posture.

Do You Need an MRI for Sciatica?

Not necessarily. While MRIs diagnose soft tissue issues like herniated disks, many get better without imaging.

"Most sciatica symptoms improve over 2 to 6 weeks," says Dr. Taliaferro. "An MRI is helpful only if the symptoms are severe, ongoing, or include red flags.".

In most cases, a simple X-ray or physical exam will be more appropriate (and cost-effective).

How Is Sciatica Treated? (Non-Surgical Options First)

Most sciatica gets better without surgery. Dr. Taliaferro favors a multimodal, nonoperative approach:

1. Anti-inflammatory Medications

Over-the-counter drugs like ibuprofen (Advil) or naproxen (Aleve) can reduce inflammation and pain.

2. Muscle Relaxants

Help relax tense back muscles and restore mobility.

3. Nerve Pain Medications

Gabapentin or neurontin may reduce pain associated with nerves.

4. Topical Analgesics

Lidocaine creams or patches can numb painful areas.

5. Physical Therapy

Core and back muscles are strengthened, posture is improved, and healing is promoted.

Planks and hamstring stretches can be especially helpful.

6. Epidural Injections

Inflammation can be reduced by corticosteroid injections in severe cases.

"Surgery is rarely needed," Dr. Taliaferro notes, "and only after nonoperative treatments have failed."

Exercise, Not Bed Rest: Movement Is Key

Though rest is important in the first day or two of a flare-up, protracted inactivity makes things worse.

"Get up and move," advises Dr. Taliaferro. "Light aerobic exercise like walking, swimming, or yoga shortens symptom duration."

Preventing Sciatica: Tips That Work

✔️ Practice Proper Lifting:

Lift with your legs, not your back.

Avoid twisting while lifting.

✔️ Stretch and Strengthen:

Stretch hamstrings and hip flexors daily.

Build core strength through planks and isometric exercises.

✔️ Stay Active:

Maintain a healthy weight

Incorporate low-impact exercise into your routine

When to See a Doctor for Sciatica

Most get better within a few weeks, but consult a doctor if:

• Pain lasts more than two weeks
• Over-the-counter medications don't always alleviate the pain
• You experience numbness, weakness, or loss of bowel/bladder control

Final Thoughts: Sciatica Is Common—But Treatable

Sciatica doesn't have to control your life.With proper care, exercise, and nonoperative treatment plan, most people make a complete recovery and avoid future flare-ups.

"Sciatica is one of the most prevalent back issues we treat," Dr. Taliaferro says. "But with the right steps, you can get back to living pain-free."