The sciatic nerve is the longest nerve in the human body and is responsible for innovating motor and sensory functions of the lower extremities. The term sciatica refers to symptoms felt anywhere along the pathway of this nerve. The sciatic nerve starts in the lumbar spine and follows a path down through the buttock into the back of the thigh to the back of the knee. At this point behind the knee in what is known as the popliteal fossa, the nerve branches into two main parts, the tibial nerve and the peroneal nerve.
- The tibial nerve – continues down the back of the leg to the heel and sole of the foot.
- The common peroneal – travels sideways along the outer part of the knee to the outer border of the leg and foot.
The most common symptoms of sciatic nerve pain are a mild ache sometimes associated with a sharp/burning sensation or excruciating pain. Typically, sciatic nerve pain only affects one side of your body. The pathway of pain is related to the path of the nerve. Therefore, a large number or patients who have sciatic nerve pain complain of pain radiating from the lower back through the buttocks into the back of the thigh.
Other common symptoms that range in severity include:
- Radiating numbness in the leg
- Tingling sensation (pins and needles) in the feet and/or the toes
- Symptoms can be aggravated by prolonged sitting
Sciatic pain often occurs when the sciatic nerve becomes impinged. This can be for a number of different reasons. These are are herniated disc or spinal stenosis (narrowing of the spaces in the spine). In some cases the nerve can be compressed by a tumour or damaged by an underling disease e.g. diabetes.
- Prolonged sitting
Management of Sciatic nerve pain
Most of the time sciatic nerve pain symptoms can be relieved by self-care. With rest the condition normally subsides. Initially using NSAIDS (non -steroidal anti-inflammatory drugs) should help to reduce pain. This will allow you to try and manage the symptoms further by continuing home management treatments:
- Light stretching + alternate hot or cold compression packs to reduce pain
- Light exercises and walking – pay attention to core muscles (lower back and abdomen muscles are essential to ensure correct alignment and posture.
- Correct lifting form – using the lower limb to protect the back by bending through the knees with straight back and holding any load close to the body. Avoid lifting heavy objects and twisting at the same time.
- Physiotherapy – using a combination of stretching and strengthening to help reduce the symptoms and ensure they do not return. This would involve strengthening the buttocks, lower back, abdominals and hip muscles while maintaining core strength.
The vast majority of people fully recover from sciatic nerve pain, often without treatment, although it can rarely cause permanent changes if not treated when necessary. If you have any of the below you should seek medical attention immediately.
- Loss of feeling in the affected leg
- Weakness in affected leg
- Loss/ changes to balder and bowel function