Sciatica is leg pain often due to pressure on a nerve in your low back that connects to the sciatic nerve, which then passes between layers of the buttock muscles into the deep muscles of the back of the thigh. This pressure may be caused by a damaged disk or by abnormal bone growth. You may feel pain, burning, tingling, or numbness that shoots down your leg.
Sciatic pain usually starts in the buttocks and extends down the rear of the thigh and lower leg to the sole of the foot and along the outer side of the lower leg to the top of the foot. Pain may also be present in the lower back.
Sciatica is primarily caused by a herniated or bulging lower lumbar intervertebral disc that compresses one of the nerve roots before it joins the sciatic nerve. Another cause of sciatica is Piriformis syndrome. The piriformis muscle extends from the side of the sacrum to the top of the thighbone at the hip joint, passing over the sciatic nerve in route. When a short or tight piriformis is stretched, it can compress and irritate the sciatic nerve.
The primary treatment of sciatica is rest to allow the inflammation of the nerve to subside. To help alleviate pain, various medications (such as analgesics and muscle relaxants) may be prescribed, or anesthetic agents may be injected into the area around the spinal cord. In cases that do not respond to such conservative measures, spinal surgery may be necessary.
Physical therapy under a doctor's supervision or prescription is often used to relieve the pain of sciatica. Many therapists advise their patients to overcome the effects of a ruptured disc by developing the core muscles (the four muscle groups that form at the waist) in order to provide a supportive column of muscle that will help keep the disc in place.
Recently, new surgical techniques, such as microsurgery and the percutaneous (through the skin without cutting, as with a needle) removal of disc fragments, have been used. So far, success at relieving pain and neurologic symptoms has been good. Not all individuals with disc problems, however, are suitable for this surgery.