What Triggers Sciatica?

Sitting too much, being overweight, wearing ill-fitting clothing or shoes and other factors may trigger sciatica, that is, nerve pain that radiates from the lower back into the legs resulting from sciatic nerve compression.

Sciatica refers to a variety of symptoms that occur with pain that radiates from the lower back or hip to the back of the thigh and into the leg, usually to the foot or ankle.

Symptoms of sciatica usually originate from the sciatic nerve in the lower back, and run from the hip, down the back or side of the leg, to the foot or ankle, and include: 

• Pain that feels like a bad leg cramp
  • Sharp, “knife-like,” or electrical-feeling pain
  • Cramps that may last for weeks 
  • Pain can occur particularly when moving, sneezing, or coughing
• Weakness
• Numbness
• “Pins and needles” sensation
• Tingling sensation
• Burning sensation

Sciatic nerve pain is usually caused by impairments related to a spinal nerve root (radiculopathy) at the L4, L5, or S1 level from a disc disorder, along with any sudden pressure on the disks that cushion the bones (vertebrae) of the lower spine. 

Common causes of sciatica include:

• Normal wear and tear from aging
• Muscle spasm in the back or buttocks
• Degenerative disc disease 
• Spondylolisthesis 
• Lumbar spinal stenosis 
• Pregnancy

Risk factors for developing sciatica include:

• Age: most often occurs in people between the ages of 30 to 50 years
• Nerve damage from diabetes 
• Frequent heavy lifting 

Triggers for sciatic nerve pain include: 

• Sitting too much
• Being overweight/obese
• Wearing high heels or uncomfortable/uncushioned shoes
• Wearing overly tight, form-fitting pants, shorts, or skirts
• Carrying bulky items in a back pocket, such as wallets and phones

Sciatica usually heals on its own over time. About up to 90% of patients recover within several weeks with rest and nonsurgical treatments. 

Nonsurgical treatment to relieve sciatica includes: 

• Nonsteroidal anti-inflammatory drugs (NSAIDs) 
  • Ibuprofen (Advil, Motrin)
  • Naproxen (Aleve)
  • Aspirin
• Muscle relaxants 
• Gentle heat or cold applied to painful muscles
• Staying active, which can help reduce inflammation
• Taking short walks 
• Light stretching
• Strengthening core muscles of the abdomen and lower back
• Physical therapy
• Steroid injections into the spinal area 

Surgery may be recommended in cases where sciatic nerve pain is disabling for 3 months or more despite nonsurgical treatment. The two main types of surgery used to treat sciatica pain include: 

• Lumbar laminectomy: widening of the spinal cord in the lower back to reduce pressure on the nerves
• Discectomy: partial or total removal of a herniated disk