Sciatica is nerve pain resulting from inflammation of the sciatic nerve, a major nerve running from the low back through the buttocks, and down the leg to the foot. There is a sciatic nerve on each side of the body, which controls muscles in the back of the thigh and the back of the calf. Symptoms of sciatica range from mild to severe and disabling. Sciatica often makes sleeping uncomfortable.
Causes of Sciatica
A number of factors can lead to sciatic nerve inflammation and pain. Sciatica rarely happens to young people unless there has been a low back injury or trauma. However, women who are pregnant can develop sciatica as the baby grows and compresses the sciatic nerve. Frequent causes of sciatica include a herniated disc, spinal stenosis, and osteoarthritis in the spine with bone spurs. These are all things that can lead to sciatic nerve compression. Injuries to the low back increase the risk for developing sciatica. Occupations that involve heavy lifting or bending can be risk factors for sciatica.
Common Symptoms
Milder symptoms of sciatica include tingling or numbness in the buttocks or leg. It may feel like the leg has “fallen asleep”. A more severe symptom is muscle weakness in the affected leg, or a drop foot, which can make walking difficult.
Sciatica can cause significant pain in the buttocks, which often radiates down the leg. The pain may feel like severe cramping or burning. Some people describe it as feeling like an electric shock that is disabling. Very severe symptoms include urinary or bowel incontinence.
Treatments for Sciatica
Managing sciatica usually starts with self-treatments. Alternating between cold therapy and heating pads helps relieve pain and inflammation. Stretching and certain exercises often help with muscle cramping and pain. Over-the-counter nonsteroidal anti-inflammatory medications also help relieve pain and inflammation.
If these conservative treatments are not working, a doctor can prescribe muscle relaxers and stronger pain medication. Spinal injections can provide short term relief. Physical therapy may be recommended to give the patient additional exercises and low impact activities to relieve pressure on the nerve.
Better Ways to Sleep with Sciatica
Those who sleep on their back can place a pillow under the knees to maintain the natural curvature of the spine. This relieves pressure on the sciatic nerve. Side sleepers should sleep on the nonpainful side with pillows under the head and between the knees to keep the spine properly aligned. Pregnant women with sciatica often find the most comfortable sleep position to be on the unaffected side with support pillows under the knees, ankles, and belly. People with sciatica should avoid sleeping on the stomach, as this puts too much strain on the lower back.
Is back surgery necessary for sciatica?
Sciatica usually resolves without surgery. However, surgery might be needed if there is severe nerve damage or the patient’s lifestyle is greatly impacted. A spine surgeon may recommend surgery if the problem is caused by a herniated disc in the low back, spinal stenosis, or large bone spurs from osteoarthritis.
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