Sciatica describes the pain you feel when something compresses your sciatic nerve. This is the longest nerve in your body; it starts in your lower back, branches off, and travels through your buttocks and down each leg. You may feel:
- Radiating lower back pain
- Pain in one leg
- Pain that worsens when you sit, sneeze, or cough
- Tingling or numbness in your leg
- Leg weakness
Not all back pain involves the sciatic nerve, but if you experience any of sciatica’s signature symptoms — even tingling and numbness with no pain — chances are high you’ve pinched your sciatic nerve.
Here to explain how and why sciatica occurs is our double board-certified, award-winning orthopedic surgeon, Dr. Patrick S. McNulty. As one of the country’s top spine specialists, he has treated thousands of people with back pain and sciatica for over three decades at McNulty Spine in Las Vegas and Henderson, Nevada.
Sciatica — Why me?
If you have sciatica, you probably fall into one of the high-risk categories. Although anyone can get sciatica, it’s most common in people who:
- Are between the ages of 30 and 50
- Have spinal arthritis
- Lead a sedentary lifestyle
- Are obese
- Are tall
- Sit for long periods
- Lift heavy objects
Pregnant women are also at high risk for sciatica because the growing uterus puts pressure on the sciatic nerve.
Sciatica goes by various names, including pinched nerve, compressed nerve, and lumbar radiculopathy. Regardless of which term you use, it’s important to know that it describes a set of symptoms, not a medical condition. However, a medical condition is likely the underlying cause of your sciatica.
Four common causes of sciatica
Sciatica affects up to 40% of Americans at some point in their lifetime. Any spinal condition that applies pressure to your sciatic nerve can lead to sciatica. Here are the four most common.
1. Herniated disc
Discs are the cushions between the bony vertebrae in your spine. They absorb shock when you bend and move, thanks to a gel-like center encased in a firm outer shell. If injury or illness causes a disc to rupture, or herniate, the inner gel bulges outward and presses on nearby nerves.
A herniated disc in your lower back can cause sciatica.
2. Spinal stenosis
Over time, all your body parts show signs of wear and tear. When your joints wear down, you develop osteoarthritis, which breaks down the cartilage in the joints and triggers the development of bone spurs. This effectively narrows the space in your spine — which is spinal stenosis.
This narrowing can also stem from other problems like injuries, tumors, and bone disease. Whatever the cause, sciatica is typically one of the symptoms.
Spondylolisthesis occurs when one vertebra slips forward out of alignment with the rest of your spine. Although it can occur anywhere in your back, it’s most common in the lower (lumbar) region.
Disc degeneration and injury can cause spondylolisthesis, putting pressure on your sciatic nerve and resulting in the telltale symptoms of sciatica.
4. Piriformis syndrome
Not all cases of sciatica begin in the lower back; some originate in the buttocks. Your piriformis muscle connects your thigh bone to your lower spine and runs along your sciatic nerve. A piriformis muscle spasm compresses the sciatic nerve and results in pain, numbness, weakness, and tingling.
Carrying a large wallet in your back pocket can cause piriformis syndrome by applying constant pressure on the nerve.
Traumatic injury, infections, and spinal tumors can also cause sciatica. Dr. McNulty develops your treatment plan based on the underlying cause, which he determines after running various physical and imaging tests.
Your treatment plan may include any of the following:
- Physical therapy
- Epidural steroid injections
- Spinal cord stimulator
- Surgical lumbar laminectomy to widen your spinal canal
- Discectomy to remove or repair a herniated disc
As a pain management specialist, Dr. McNulty excels at helping people achieve lasting relief. If surgical intervention becomes necessary, he uses minimally invasive techniques that reduce the damage to healthy tissue and facilitate a faster recovery.
If you have sciatica, find out what’s causing it and how to treat it by contacting us online or by phone to schedule a visit with Dr. McNulty.