Sciatica is pain along the nerve that runs from your lower back down each leg, and it usually affects one side. A disc or bone spur is the usual cause. Sciatica in both legs, numbness around the genitals or trouble controlling your bladder needs the ER. Pain lasting over a week should be checked.
Pain That Travels
Sciatica has a recognizable route. It often starts low in the back, crosses the buttock and continues down the thigh and calf, sometimes reaching the foot and toes. Some people feel a burn, others a jolt like an electric shock. A cough, a sneeze or a long stretch in a chair can set it off.
The leg is the clue. Pain in the back alone is probably something else, and with sciatica the leg usually hurts more than the back does.
Understanding Sciatica
Sciatica is pain from irritation of or pressure on the sciatic nerve, your body's largest nerve, or on the nerve roots that form it. The nerve runs from the lower back through the buttock and down each leg, so symptoms can appear anywhere along its path, usually on one side.
This nerve carries signals both ways. It moves the muscles of your legs and feet, and it brings back feeling from them. That is why trouble here can show up as pain, numbness or weakness.
Doctors use the word for two things: true sciatica, where the nerve itself is affected, and sciatica-like conditions that involve nearby nerves. The two often feel the same.
What raises your risk
- Extra body weight, which adds stress to the spine
- Hours of sitting or driving
- Jobs with heavy loads or twisting
- Diabetes, which can damage nerves
- Smoking
- Age: herniated discs are most likely between 20 and 50, and bone spurs come later
Cleveland Clinic ranks sciatica high among the causes of leg pain that doctors see.
What Sciatica Feels Like
- A mild ache that can sharpen into burning pain
- Pain that feels like an electric shock
- Pain that flares when you cough, sneeze or sit for a long time
- Numbness in the leg or foot, which you should get checked
- Tingling, like pins and needles
- Weak muscles in the leg or foot, which need prompt medical care
- Pain in one part of the leg and numbness in another
What Presses on the Nerve
A herniated disc is the most common cause. In some cases, providers cannot find a clear cause at all.
Herniated disc
A disc's soft center can push out and press on a nerve root in the lower back. Age makes this more likely, because a herniated disc often develops as discs stiffen.
Spinal stenosis
The part of the spine that nerves pass through can narrow and crowd them.
Bone spurs
Extra bone on the spine can press against a nerve root.
A slipped spinal bone
One bone in the spine can move out of position. Doctors call this spondylolisthesis.
Pregnancy
Hormones loosen the ligaments of the spine, and the growing baby can press on the nerve.
A tumor or other growth
Growths can press on the nerve too, though this is rare.
Mayo Clinic traces most sciatica to a herniated disc or extra bone growth pressing on nerve roots in the lower spine.
When It's Something Else
A problem in the hip joint can pass for sciatica, and the difference often shows in where the pain starts. An exam, and sometimes imaging, is how a provider sorts them out.
Points toward the hip
- Pain in the groin
- Pain when you put weight on the leg
- Pain when you move the hip
Points toward sciatica
- Pain that begins in the lower back
- Pain that travels into the hip or on down the leg
- Numbness, tingling or weakness
How We Treat Sciatica in Towson
The plan depends on what is irritating the nerve. Depending on your condition, our comprehensive evaluation may lead to a recommendation for one of these services.
Chiropractic
A complete evaluation may come first, to look for the source of the sciatica. Spinal adjustments can follow if they suit your condition.
Spinal Decompression
Decompression stretches the spine, with the goal of taking pressure off nerves. A sciatica plan may pair it with stretching.
Traction Therapy
Back on Trac is a machine that works as a form of spinal decompression, and it may be an add-on for sciatica. Lumbar traction is also available at this clinic.
Chiropractic Rehab
Stretching may be part of a sciatica plan. Chiropractic assistants do this work.
Before any gentle chiropractic treatment, the chiropractor carefully evaluates your condition to see if you are a candidate. Orthopedic and neurologic testing is part of how numbness, tingling or weakness is carefully screened, to isolate the cause and the way your symptoms present.
How Sciatica Options Compare
This is not a full list. A doctor or spine specialist can tell you about other options.
| Option | What it involves | Who provides it |
|---|---|---|
| Self-care at home | Ice for the first few days and then heat, with light movement and stretching. Mayo Clinic says mild cases usually clear up over time. | You, with advice from your doctor |
| Medicine | Anti-inflammatory drugs, or prescription medicine for pain or muscle spasms. | Your doctor or pharmacist |
| Exercise and stretching | Guided work on strength and flexibility. | Chiropractic assistants do rehab here. Elsewhere, ask your doctor |
| Chiropractic adjustments | A controlled push on a joint in the spine. | A chiropractor, if your evaluation points that way |
| Spinal decompression and traction | A stretch of the spine. | This clinic, if recommended |
| Surgery | Cleveland Clinic calls it usually a last option, for severe pain, nerve damage or when other treatments do not help. | A spine surgeon |
Sciatica Warning Signs That Need the ER
Go to the emergency room now if you have sciatica in both legs, numbness around your genitals or bottom, or weakness in both legs that is severe or getting worse. Do the same if you cannot pee, cannot control when you pee or poo, or do not notice you need to go.
These can point to a serious back problem needing hospital treatment as soon as possible. Do not drive yourself. Have someone take you, or call 911.
Get immediate medical care as well for
- A leg that suddenly goes numb or weak
- Loss of feeling or weakness in the affected leg
- Pain after a violent injury like a car crash
Call your doctor for sciatica that
- Lasts longer than a week
- Is severe or getting worse
- Does not ease with self-care
- Stops you doing your normal activities
- Comes with tingling or some numbness
The NHS, the health service in the UK, treats sciatica on both sides as a reason to go straight to the emergency department.
Starting Sciatica Care on E Joppa Rd
Spinal decompression, Back on Trac and lumbar traction are all available at this clinic. A care plan may be built around your own needs, and it can sit alongside treatment from your own doctor.
Landmarks North of the Clinic
Two landmarks sit north of the clinic: Hampton National Historic Site, at 535 Hampton Lane, about 1.4 miles away, and Loch Raven Reservoir, farther out in the same direction.
Book a Sciatica Evaluation
Sciatica exams commonly include a look at how you walk and a straight leg raise, where a provider lifts one leg while you lie down. Insurance or cost question? Call the clinic.