Sciatica is a commonly used term, but poorly understood. Sciatica refers to back pain commonly shooting down the buttocks and sometimes down the leg. The sciatic nerve gets pinched which causes the electric, shooting type of pain that is familiar with this type of diagnosis. So how can you treat it? This post will clear up what causes the sciatic nerve to get pinched in the first place and the types of sciatica treatment to help reduce your pain.
**This is not medical advice. Please consult your medical provider for more information.
Sciatica is an Umbrella Term
An umbrella term is very broad and does not specify where the pain is coming from. It is known that the shooting pain in the buttock and down the leg is coming from the sciatic nerve, but what is the cause of it?
Nerves like movement. When they don’t move well, they get angry and let you know – aka… it causes pain. Nerve pain can be described as electric, shooting, and sharp in nature. While sciatica tends to only occur on one side of the body, it is possible to have sciatic-like symptoms in both legs.
In order to effectively treat sciatica, you have to address what is causing the compression of the sciatic nerve. If you have been dealing with sciatica for quite some time and treatments in the past have been unsuccessful, it may be because the source of the sciatic nerve compression was not addressed.
Where Can the Sciatic Nerve Get Compressed?
Lets discuss common reasons/areas the sciatic nerve can get compressed, inflamed, and/or irritated. Depending on where the sciatic nerve is getting “pinched” will determine the course of sciatica treatment.
It is important to note that the items listed below may or may not cause sciatic-like symptoms. For example, there are plenty of people who may have a herniated disc that never experience sciatic-like symptoms. This list is for informational and educational purposes and is not intended to diagnosis or offer treatment without consult from your PCP.
Degenerative Disc Disease (DDD)
DDD happens over time. It is the natural wear and tear of the discs between the vertebrae over time. As the discs lose their height, this creates a narrowing of the space between the joints where the nerve roots exit the spine. With less space, the nerves can get compressed.
Spinal Stenosis
Spinal stenosis refers to the narrowing of the spaces in the spine, creating less room for the spinal cord and nerve roots to move.
Herniated Disc
A herniated disc happens when the nucleus pulposus, the gelatinous inner contents of the intervertebral disc, are compressed and bulge out of a weak area of the outer portion of the disc. This can place increased pressure on the nerve roots.
Bone Spurs
Bone spurs are small areas of bony overgrowth which can cause narrowing where the nerve roots exit the spinal column or within the spinal canal itself. This can lead to compression of either the spinal cord or the nerve roots, depending on where the bone spur is.
Spondylolisthesis
Spondylolisthesis occurs when one vertebrae slips over another causing a malalignment of the vertebrae and the neural formina where the spinal nerves exit. Because of the malalignment, the neural formina can compress the spinal roots exiting the spinal canal.
PIriformis Syndrome
The piriformis is a muscle deep in the gluteal region. It attaches onto the sacrum and greater trochanter of the femur. The piriformis muscle can cause compression of the sciatic nerve.
Sciatica Treatment
The list above is a non-exhaustive list of what may cause sciatic-like symptoms. Sciatica treatment will be determined by the cause of where the sciatic nerve compression is and the severity of symptoms. Consult with your doctor to determine the best course of action if you are experiencing sciatica symptoms.
Surgical Approach for Sciatica
Surgery may be an option if conservative approaches are unsuccessful and symptoms are severe. Emergency surgery may be indicated if cauda equina syndrome is evident.
If surgery is an option, treatment will address releasing the compression on the sciatic nerve.
Conservative Sciatica Treatment
Injections
Anti-inflammatory injections can help reduce inflammation and swelling around the area that is affected. Injections are typically short-lived and may not work for everyone. But when an injection is successful, it can provide significant pain relief and improve quality of life.
Physical Therapy
The goal of physical therapy with sciatica treatment is to find the area of the nerve that is being compressed and then to reduce the compression. It can combine manual techniques along with exercise to help distribute compressive forces to help offload the sciatic nerve.
Physical therapy helps to restore movement and strength naturally by providing a comprehensive plan to address an individual’s specific needs based on what is found in their evaluation. Since every person presents with different impairments, it is important to address everyone’s concern on an individual basis. One treatment may not work for every person.
Related Articles on Sciatica Treatment
- How to Get Rid of the Pain from Piriformis Syndrome
- Sciatica Symptoms? Try This and Feel Better
- Pain From Your Back Down Your Leg? Sciatica Treatment Explained!
TL;DR
This post reviews multiple causes of sciatic-like symptoms and different treatment options. Treating the cause of the nerve compression will help with reducing the symptoms.
Tera Sandona is a licensed Doctor of Physical Therapy (DPT) and the founder of PT Complete. She helps high-achieving women break out of cycles of chronic pain, stress, and burnout through her Regulate and Rebuild Method, a sequenced approach that addresses the nervous system first and builds strength second. Her work focuses on helping women finally understand their bodies, rebuild strength, and create lasting resilience that fits real life.
