If you have stabbing, shooting spine pain that runs down one side of your lower body, and a feeling of burning or tingling, you may have sciatica. Sciatica is a type of spine pain that typically gets worse when you remain in one position for a long time, and even when you cough or sneeze. It also can make your leg(s) feel numb or weak. In my experience as a spine neurosurgeon, about half of people will experience mild sciatica at some point in their life — usually after age 30. Most will get sciatica relief within six weeks with self-care treatments such as over-the-counter pain medicines, light exercise, and ice and heat.
Common Causes of Sciatica
Sciatica, which is caused by sciatic nerve irritation, is common. The sciatic nerve is the longest nerve in the body. It is made of nerves that originate from several segments of the lower back. These nerves come together as the sciatic nerve to run through the hips and buttocks, and down each leg, ending just below the knee, where it divides again into smaller nerves. Usually, sciatica only causes pain on one side of the body, but it can affect both.
Most of our spine surgery patients with sciatica are between age 30 and 70. We know that age-related changes in the spine are the most common cause of sciatica. These changes, which start around age 30, include:
- Herniated disc
- Bone spur on the spine
- Narrowing of the spine (spinal stenosis)
In nine out of 10 cases, a herniated disc causes sciatica. Discs are rubbery, cartilage-filled cushions between the bones in your spine that serve as shock absorbers as you bend and twist. As you age, wear and tear can cause a herniated (slipped or ruptured) disc, where some of the soft inner part of the disc pushes through a crack in the outer part. If the disc is near the nerves making up the sciatic nerve, it can push or rub the nerve and cause sciatica pain.
I tell patients that genetics also play a role in how their back ages. So even though everyone has age-related changes in the spine, some people will have spine pain and others won’t.
A few pregnant women get sciatica in the second and third trimesters, when the growing baby puts pressure on their sciatic nerve in the pelvis. But this is rare, and it usually relieves with birth.
Other risk factors for sciatica are as follows:
- Sitting too much
- A job that requires constant twisting, heavy lifting, or drivi
- Rare causes of sciatica are tumors and sciatic nerve damage from diseases like diabetes.
When to See a Doctor for Sciatica
Many people get sciatica relief with self-care treatments, but I recommend getting your doctor’s approval before trying them. After onset of sciatica, resting for the first day or so can provide relief. But being inactive for longer than that can make your spine and/or leg pain worse.
The main self-care treatments for sciatica relief we recommend are:
- Gentle exercise, such as a walk around the block
- Gentle stretches for your lower back
- Ice and heat to the back
- Over-the-counter pain relievers, such as ibuprofen (Advil, Motrin), aspirin (Ecotrin), or naproxen (Aleve)
- Varying your posture every 20 minutes and using proper posture
If you have weakness or numbness, I strongly recommend that you see your doctor right away to make sure you don’t have a serious medical problem. For pain, burning, or tingling down one leg, if you don’t feel better after three days, see your primary care doctor or one of our Denver spine surgeons. Most especially if you have numbness in your saddle area (region you sit on a horse’s saddle, and/or the genitals), you should seek emergent care to prevent permanent nerve damage.
At Neurosurgery One, formerly South Denver Neurosurgery, we offer accurate diagnosis of sciatica and expert treatment for sciatica relief. Using a personalized approach, we’ll discuss your treatment options, focusing on nonsurgical treatments such as pain medicines, physical therapy, and injections whenever possible. Surgery for sciatica relief, when it’s absolutely necessary, is very effective.