What Causes Sciatic Nerve Pain?

Have you had lower back pain for more than a week? Has your lower back pain worsened over time? Does your pain radiate to your leg and cause numbness or muscle weakness? Have you experienced a loss of bladder and bowel control? 

If you said yes to any of these questions, you may have sciatic nerve pain. Let’s review what causes sciatic nerve pain, as well as risk factors and how to manage and alleviate your pain.

What Is the Sciatic Nerve?

The sciatic nerve is the longest nerve in the body. Nerve roots in the lower back combine to make the sciatic nerve, which extends from the lower back through your hips and buttocks and down each leg.

Sciatic Nerve Pain

Sciatic nerve pain often affects the inside of the body. The pain radiates from the lower spine through the buttocks, down to the leg, along the sciatic nerve path. You might feel lower back pain, buttock pain, hip pain, and/or leg pain. The pain can range from mild to sharp, and it can be a burning sensation. 

What Causes Sciatic Nerve Pain?

Sciatic nerve pain results from the inflammation or pinching of nerve roots along the sciatic nerve, or the narrowing of the spine. It can also be caused by pressure on these nerve roots.

Sciatic nerve pain can also result from the irritation of nerves due to abnormal intervertebral discs. Also, tumors, internal bleeding, infection around the lower spine, spondylolisthesis, injury, spinal stenosis, cauda equina syndrome, and osteophytes can all cause sciatic nerve pain. 

The sciatic nerve extends from the lower spine, and spinal integrity affects nerve function. The spine is composed of 33 bones called vertebrae. Attached to muscles and tendons are ligaments, which hold the vertebrae together. In between the vertebrae are the intervertebral disks, gel-like cushions containing protective semi-fluid material. 

Conditions such as a ruptured disc, herniated disc, or slipped disc in the spine cause compression to the nerve, resulting in sciatic nerve pain. 

Will Sciatic Nerve Pain Last Forever?

Most cases of sciatic nerve pain are resolved with effective treatment. According to this study, the level of compression does not determine the level of pain and nerve damage. 

For example, small compressive lesions can at times produce severe, irreversible nerve damage if they affect the arterial blood supply to the nerve. It’s all case by case, so you and your doctor should consider what’s causing your sciatic nerve pain and then you can figure out how to relieve it.

Risk Factors for Sciatic Nerve Pain

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The findings from this study revealed that age, mental stress, smoking, and work-related twisting of the trunk increased the risk of incidental sciatic pain. Let’s take a closer look at some of the causes of sciatic nerve pain.

Age

Unfortunately, the more we age, the more the spine degenerates. Age-related conditions such as herniated disks and bone spurs commonly cause sciatic nerve pain. Sciatic nerve pain is more common between 30 and 50 years of age.

Obesity and a Sedentary Lifestyle

Excessive body weight increases the stress on your spine and makes you more likely to develop sciatic nerve pain. Prolonged sitting, such as doing a desk job, compresses your spine and discs. Depending on the status of your spine, this may may irritate your sciatic nerve.

Twisting and Heavy Lifting

Frequently lifting heavy loads and repeatedly twisting your spine are both associated with disc herniation, which often results in sciatic nerve pain or irritation. 

Walking and Running

While walking and running are great ways to be active, they are both associated with an increased risk of sciatic problems. This is due to the use of the piriformis muscle, which is located above the sciatic nerve. As the piriformis muscle contracts to propel you forward, it becomes tight, which increases the risk of sciatic nerve irritation.

Proper and timely stretching, and considering the proper amount of walking and running are effective preventative measures. Furthermore, complementing your walking and running routine with core training exercises will improve your overall spine strength and help prevent injury.  

Diabetes

Diabetes increases the risk of sciatic nerve pain by increasing the risk of nerve damage. Diabetes-related nerve damage can affect nerves in the thighs, hips, buttocks, or legs. This is more common in Type 2 diabetes and in older adults. Common symptoms include pain in the hips, thighs, or buttocks, muscle weakness, and difficulty rising from a sitting position. 

Trauma and Injury 

Trauma to the lower back causes inflammation, which can suppress the sciatic nerve roots and cause sciatic nerve pain. A 2017 study found reduced nerve function in injured athletes.  

Causes of Sciatic Nerve Pain That You Can Avoid

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Wearing High Heels 

Wearing high heels pushes your weight forward, causing you to flex forward at the hips, mimicking a movement you would do if you were stretching your hamstrings. In reality, a hamstring stretch should be more controlled, and you wouldn’t do it while walking. 

This position also stretches and often irritates your sciatic nerve, which can lead to sciatic nerve pain.

Sitting Down With Things in Your Back Pocket

Some people have a habit of carrying their wallet in the back pocket of their pants. Sitting down for prolonged periods with things in your back pocket can irritate your piriformis muscle by putting pressure on it. The same pressure can affect the sciatic nerve, which runs underneath the piriformis muscle.

How to Prevent and Manage Sciatic Nerve Pain

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Exercise Regularly

If you’re in pain, exercising might feel counterintuitive. But a recent study found that exercise keeps your back strong and protects your spine. However, you’ll want to consider what types of exercises are appropriate for your fitness level and circumstances. Yoga and pilates can sometimes be a great place to start, but you should check with a doctor to make sure.  

Maintain Proper Posture and Body Mechanics

Ensure your sitting position supports and comforts your lower back. Using a pillow or support for your lower back curve can improve posture and comfort while sitting, such as at your desk or while driving. 

When you lift objects, maintain proper body mechanics. Keep your back straight and your legs spread, and only bend at the knees. Hold the load closer to your body and lift it with your leg muscles, not your back muscles. Avoid lifting something up and twisting your body simultaneously. 

Relax Before Bed

Light stretching, prescribed painkillers and warm baths can all help your body relax before bed, which can help alleviate the causes of sciatic nerve pain. 

Change Your Sleeping Position

Sleeping on your stomach causes excessive curvature of your spine, leading to sciatic nerve irritation, lower back pain, and discomfort. Even if you have been sleeping on your stomach for a long time, with practice, you’ll be able to change to a new sleeping position. It’s possible to retrain your muscles to like other, safer sleeping positions, and in the long run, you’ll sleep better.

Since sciatic nerve pain is triggered by the compression or irritation of the sciatic nerve roots in the lower back, one option is to sleep on your back with your knees elevated. Propping your knees up on a pillow may relieve some pressure and reduce your pain. 

When to See a Doctor for Sciatic Nerve Pain

Treating sciatic nerve pain involves addressing the underlying cause, so the first thing to figure out is what causes your sciatic nerve pain. 

If you’ve tried the above self-care measures and they’ve failed to alleviate your pain, it’s likely time to see a doctor. Other reasons to see a doctor for your sciatic nerve pain:

  • if your pain lasts longer than a week or gets severe or worse over time
  • if you have a sudden or unbearable pain in your lower back or leg
  • If you have numbness or muscle weakness in your leg
  • if the pain starts after an injury 
  • If you have poor bladder or bowel control

If some cases, sciatic nerve pain is caused by the narrowing of the spine, and surgery might be required to relieve the pressure on the nerve roots. However, surgery only happens in 10-15% of cases

It’s more likely that your doctor will prescribe painkillers, anti-inflammatory drugs or muscle relaxants. A recent study strongly suggest exploring non-pharmacological strategies first before offering pharmacological options, but it’s best to talk to your doctor to get the right treatment for the causes of your sciatic nerve pain.

Additional Resources on Sciatic Pain