Sciatica is a condition that causes pain, numbness, or tingling in the lower back, buttocks, and legs. It is caused by compression or irritation of the sciatic nerve, which is the longest nerve in the body that runs from the lower back down through the buttocks and legs.

Common causes of sciatica include a herniated disc, spinal stenosis, degenerative disc disease, or a bone spur that presses on the nerve. Pregnancy, obesity, and prolonged sitting or standing can also increase the risk of developing sciatica.

Symptoms of sciatica can vary, but typically include:

• Pain in the lower back, buttocks, or legs
• Numbness or tingling in the legs or feet
• Weakness in the legs or feet
• Shooting pain down the leg, especially when sitting or standing for long periods
• Difficulty moving the affected leg or foot

Diagnosis of sciatica is typically based on a physical exam and medical history. Imaging studies such as an X-ray, MRI, or CT scan may be ordered to confirm the diagnosis and determine the underlying cause.

Treatment for sciatica may include a combination of medications, physical therapy, and self-care measures. Medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) or muscle relaxants may help to reduce pain and inflammation. Physical therapy may include exercises to improve flexibility, strength, and range of motion, as well as techniques to improve posture and reduce pressure on the affected nerve. Self-care measures such as ice or heat therapy, rest, and gentle stretching may also help to alleviate symptoms.

In severe cases, surgery may be required to remove the underlying cause of the compression or irritation of the sciatic nerve. However, most cases of sciatica can be effectively managed with conservative treatment methods.

Sciatica occurs when the sciatic nerve becomes pinched, usually by a herniated disk in your spine or by an overgrowth of bone (bone spur) on your vertebrae. More rarely, the nerve can be compressed by a tumor or damaged by a disease such as diabetes.

It's not always possible to prevent sciatica, and the condition may recur. The following can play a key role in protecting your back:

• Exercise regularly. To keep your back strong, pay special attention to your core muscles — the muscles in your abdomen and lower back that are essential for proper posture and alignment. Ask your doctor to recommend specific activities.
• Maintain proper posture when you sit. Choose a seat with good lower back support, armrests and a swivel base. Consider placing a pillow or rolled towel in the small of your back to maintain its normal curve. Keep your knees and hips level.
• Use good body mechanics. If you stand for long periods, rest one foot on a stool or small box from time to time. When you lift something heavy, let your lower extremities do the work. Move straight up and down. Keep your back straight and bend only at the knees. Hold the load close to your body. Avoid lifting and twisting simultaneously. Find a lifting partner if the object is heavy or awkward.

If your pain doesn't improve with self-care measures, your doctor might suggest some of the following treatments.

Medications

The types of drugs that might be prescribed for sciatica pain include:

• Anti-inflammatories
• Muscle relaxants
• Narcotics
• Tricyclic antidepressants
• Anti-seizure medications

Physical therapy

Once your acute pain improves, your doctor or a physical therapist can design a rehabilitation program to help you prevent future injuries. This typically includes exercises to correct your posture, strengthen the muscles supporting your back and improve your flexibility.

Steroid injections

In some cases, your doctor might recommend injection of a corticosteroid medication into the area around the involved nerve root. Corticosteroids help reduce pain by suppressing inflammation around the irritated nerve. The effects usually wear off in a few months. The number of steroid injections you can receive is limited because the risk of serious side effects increases when the injections occur too frequently.

Surgery

This option is usually reserved for when the compressed nerve causes significant weakness, loss of bowel or bladder control, or when you have pain that progressively worsens or doesn't improve with other therapies. Surgeons can remove the bone spur or the portion of the herniated disk that's pressing on the pinched nerve.