What is Sciatica?
Sciatica, also called lumbar radiculopathy, nerve root pain, or radicular pain, refers to pain, tingling, or numbness in the leg caused by compression of the sciatic nerve at the lumbosacral nerve roots as they exit the spinal canal. The L5 nerve root is most commonly affected.
Symptoms often extend from the buttocks down the back of the thigh, outer calf, and into the foot and toes, sometimes accompanied by non-specific low back pain. Sciatica may also cause neurological deficits, such as weakness in the affected leg.
Causes of Sciatica
Sciatica occurs when one or more nerve roots are compressed. Common causes include:
- Disc herniation or bulge – often at L4/L5 or L5/S1, affecting the L4, L5, or S1 nerve root.
- Spinal stenosis – narrowing of the spinal canal caused by degeneration, ligament enlargement, or bone spurs.
- Spondylolisthesis – when a vertebra slips forward relative to the one below it.
Treatments for Sciatica
Treatment depends on the cause and severity. Always consult a professional before starting any management plan. Options include:
- Self-management: Stay active, perform simple exercises, use ice for inflammation or heat for muscle tightness.
- Manual therapy package: Spinal manipulation, mobilization, massage, soft tissue techniques, and tailored exercises.
- Pharmacological treatment: NSAIDs to reduce inflammation and pain.
- Psychological therapy: Cognitive Behavioral Therapy (CBT) for pain management.
- Invasive treatment: Non-surgical (epidural injections) or surgical (spinal decompression) interventions if needed.
Common Misunderstandings About Sciatica
- “I have leg pain, so it must be sciatica.” Not always. Other conditions, like piriformis syndrome or sacroiliac joint syndrome, can cause similar leg symptoms. Correct diagnosis requires a professional history and physical examination.
- “I should rest completely.” Staying active is recommended. Prolonged bed rest is not advised. Adjust your environment to allow movement safely.
- “Treatment isn’t working because the pain hasn’t gone away.” Symptoms usually improve within 4–6 weeks, but recovery can take longer depending on the cause. Function often improves before pain fully resolves.
- “The pain is worse because it’s in a different location.” Changes in pain location are normal. Your body adjusts to biomechanical changes and treatment, which may temporarily shift symptoms. Consult a professional to monitor recovery.