Lower back pain can sometimes occur together with leg numbness. When the sciatic nerve is irritated, pain starts in your lower back and extends to your thigh and leg. The irritation of the sciatic nerve causes a loss of sensation in the lower leg, which is why you experience numbness. These symptoms are jointly known as sciatica.
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Sciatica is the pain that arises from irritation of the sciatic nerve and typically affects only one side of your body. The sciatic nerve runs from your lower back, through your buttocks, down the back of your legs, and ends just below the knee. This nerve, which is the longest and has the largest diameter in the body, supplies sensations to the leg muscles and the skin of the foot.
Sciatica is not a condition on its own but rather a symptom of an underlying condition of the sciatic nerve. Experts say that about 40% of people will experience sciatica at some point in their lives.
Sciatica pain varies from a mild ache to sharp, burning, or excruciating discomfort. It often occurs when the sciatic nerve is irritated. Here are some of its potential causes.
Pinched by a herniated disk in the lumbar region
Disks in the lumbar region may slip out or bulge and put pressure on the sciatic nerve, resulting in pain.
Bone spur on your vertebrae
A bone spur is the overgrowth of bony projections in your spine. In sciatica, the bone spurs grow from spinal vertebrae and may extend far enough to reach the sciatic nerve and compress it.
This is the narrowing of the opening between the lumbar vertebrae, which is the passage point of the sciatic nerve. A narrowing of this point will cause compression of the nerve.
This instability may result from several conditions, such as spondylolysis, spondylolisthesis, or complete lumbar vertebral dislocation.
The instability of the vertebrae may cause it to slip over the vertebrae below it, pinching the sciatic nerve.
Piriformis is a muscle located in your buttocks near the top of your hip joint.
Piriformis syndrome occurs when your piriformis muscle compresses your sciatic nerve, resulting in pain in your lower back and numbness in your lower leg.
Compression by a lesion
Tumors within the spine may compress the sciatic nerve or its roots. Infections can also lead to abscesses in the spine that cause a similar effect.
Nerve damage from diseases like diabetes
Diabetes neuropathy is a condition that causes direct damage to nerves, including the sciatic nerve. It results in leg numbness and lower back pain.¹
Infections and vasculitis (an autoimmune inflammation of blood vessels) can also cause nerve damage.
Most people aged between 30 to 50 years old are at a higher risk of getting sciatica.
Diabetic people have increased risk since the disease causes sciatic nerve damage.
Studies show that genetics play a big part in the development of sciatica by causing intervertebral disc degeneration.
Some gene mutations may change the structure and function of collagen proteins that are part of the intervertebral discs. This results in weakened discs that degenerate, which leads to irritation of the sciatic nerve.
The main symptom of sciatica is a shooting pain along the path of the sciatic nerve, which goes from your lower back down to your buttocks and lower leg.
Here are other signs you may have sciatica:
Leg or foot weakness or difficulty mobility
Weakness in thigh muscles
Numbness in your lower leg
Tingling sensation in your feet and toes
Mild sciatica resolves on its own. However, you should see a doctor for your lower back pain and leg numbness if the pain persists for more than a week or becomes progressively worse.
You should seek immediate medical attention if:
Your pain occurs after a trauma like a traffic accident
Your pain is sudden and severe, radiating from your lower back or leg
You are experiencing numbness or muscle weakness in your lower leg
You have difficulty controlling your bowels and bladder
Your pain is accompanied by fever, nausea, and unintended weight loss
While sciatica may eventually resolve on its own, there are several treatments available to improve the symptoms, ranging from home remedies to, in extreme cases, surgery.
Mild sciatica can resolve after a few weeks without the need to consult a doctor. You can try some home remedies to help reduce the pain.
Instinctively, you may want to rest when your sciatica flares up. However, it is recommended to keep moving since motion reduces inflammation, while resting would cause continuous nerve irritation.
Alternatively, placing cold packs and hot packs on your low back regularly throughout the day should help reduce your pain.
You can also incorporate stretches and gentle exercises such as walking that are good for lower back pain as a part of your daily routine. This remedy reduces the need to take medications and helps you relieve your symptoms independently.
Here are some exercises you can do to ease the pain in your lower back:
Reclining pigeon pose
While on your back, lift your right leg to a right angle. Clamp your hands behind your thigh and lock your fingers.
Lift your left leg next and place your right ankle on top of your left knee.
Hold this position for a few minutes.
Gently get out of this position and do the same exercise on the other leg.
This position is best if you suffer from piriformis syndrome since it helps stretch the piriformis muscle.
Forward pigeon pose
While on the floor, get on all fours.
Move your right leg toward the front of your body with your lower leg flat on the ground horizontal to your body.
Stretch out your left leg behind you with your toes pointing backward.
Gently shift your body weight from your arms so that your legs support your weight. Sit up straight with your hands placed at either side of your legs.
Take a deep breath, then slowly exhale while leaning your upper body over your front legs.
Repeat the same on the left side.
This stretches your glutes and your lower back.
Standing hamstring stretch
Position your right foot on a chair, stairway, or any raised surface, and flex your foot. Ensure your toes and legs are straight.
Bend your body slowly and carefully toward your foot, feeling a deeper stretch the farther you go. Do not stretch too far that you feel pain.
Release your right hip. You may use a yoga strap or an exercise band for this.
Hold this position for at least 30 seconds before repeating on the other side.
This stretch helps reduce the muscle pain and tightness in the back thigh due to sciatica.
Sitting spinal stretch
While sitting on the ground, stretch out your legs with your foot flexed upward.
Bend and raise your right knee, placing your foot on the outside of your left leg.
Put your left elbow on the outside of your right knee to help you gently turn your upper body to the right.
Hold his position for at least 30 seconds. Repeat twice before switching sides.
This stretch helps open up space in the spine and relieve the pressure on the sciatic nerve.
As part of your treatment plan, your doctor may recommend physical therapy to ease your pain and reduce inflammation. Physical therapy will also help improve your posture for overall improved physical health.
Your physical therapist may request you to perform a variety of simple and compound movements to help evaluate your range of motion, movement ability, posture, and reflexes. These will help them customize a physical therapy program to help with your condition.
The physical therapist may also suggest getting a deep tissue massage that targets specific spinal muscles in the lumbar region to release tension in the soft tissues.
Over-the-counter pain relievers and anti-inflammatory drugs like ibuprofen and naproxen can help if the pain is severe.
Surgery is usually the last resort to treat sciatica. A surgeon has to consider the underlying cause of sciatica before suggesting a suitable surgical intervention.
The surgical options for this condition include:
Lumbar laminectomy—involves widening your spinal cord to reduce pressure on the compressed nerve.
Discectomy—entails partial or complete removal of a herniated disk.
Pain radiating from your lower back and numbness of your lower leg are symptoms of an underlying condition collectively known as sciatica.
Sciatica is caused by various conditions that irritate the sciatic nerve and is associated with different risk factors ranging from age to genetics. It is highly recommended to get medical advice if severe pain persists for more than one week.
Home remedies can easily manage mild sciatica. However, if your lower back pain progresses, your doctor may prescribe pain relievers, suggest physical therapy, or recommend surgery when other treatment options have failed.