July 17, 2018

Get the scoop on sciatica, one of the most common lower-back pains.


The sciatic nerve is the widest and longest nerve in the human body, running from the lower back through the back of each leg and into the feet and toes. The word “sciatica” gets thrown around a lot when back pain pops up. Byron Stephens II., M.D., a Vanderbilt Spine Center specialist at Vanderbilt Bone & Joint, helps clear up some myths about the term.

First things first: Sciatica is not a diagnosis for what is causing pain. It is a set of symptoms.

Sciatica means that the sciatic nerve is being compressed. This usually results in pain in the lower back, in one side of the buttocks, and/or the back of one leg. The most common low-back problems that cause sciatica include lumbar disc herniation, lumbar degenerative disc disease, isthmic spondylolisthesis and lumbar spinal stenosis. So, sciatica isn’t causing the pain – it is the pain.

Other problems can mimic sciatica, Stephens said, “including hip arthritis, knee arthritis, piriformis syndrome (compression of the sciatic nerve near the hip joint), myositis and others.”

The good news: There are options for treating sciatica pain. For some, surgery has the highest success rates of relieving pain, while others can help decrease pain through exercise. Without proper exercise, low-back muscles become weak, leaving them less able to support the back and spine. Ultimately though, if you or a loved one have pain that you believe is related to sciatica, visit your doctor. Because sciatica can be caused by numerous conditions, it’s important not to self-treat before consulting a physician.

Ask your health insurance company if you need a referral to see a spine specialist. If so, you may need to see your primary care doctor first for a referral to the specialist. Many comprehensive spine centers, including Vanderbilt’s, offer next-day appointments, Stephens said, so patients in acute pain can be seen quickly.

Most sciatica pain goes away on its own eventually, Stephens said, and few people develop truly chronic sciatica. However, people should see a doctor if they have ongoing symptoms — “weakness, extreme pain, bowel or bladder symptoms, weight loss, fever, chills or night sweats. ” Also, those with a history of cancer should seek medical attention for sciatic pain sooner rather than later.

There are things that can help ease sciatica pain in the moment when it’s really bothering you.

“In general, with an acute injury, you should avoid heat, as this can increase the inflammatory response and worsen pain and swelling,” Stephens said. “For chronic conditions, experiment with ice and heat to see which helps more. Sciatica caused by a lumbar disc herniation is often worse sitting, so standing can help significantly. Long car rides re particularly problematic for patients suffering from acute sciatica. Small adjustments in the car seat angle can help relieve the shooting pain.”

Woman in silhouette, bending over to touch her palms to the floor.

Need help?

Do you have sciatic pain or other back pain? The specialists at Vanderbilt Bone & Joint can help. To get back to doing the things you love, pain-free, schedule an appointment today at 615-790-3290.