What Is Sciatica?
Sciatic Nerve Pain Location
The sciatic nerve begins at the lower part of your spine. It extends across your tailbone and down the buttocks into the back of your leg and ends in your foot. Sciatica is a term that many people use to describe pain in this area. You can experience sciatic nerve pain along the entire nerve, or just along some parts of the nerve.
Doctors often distinguish two types of sciatic pain: above the knee and below the knee.
Understanding the location of the problem that causes the pain can help providers correctly diagnose the issue.
Some people incorrectly assume that all nerve pain in the lower back or leg is sciatica. However, other issues in the hips and hamstrings—including muscle or joint problems—can cause pain that feels similar. Your provider will ask you several questions about your symptoms and the location of the pain to determine if it is sciatica.
Sciatica Symptoms
The most common symptom of sciatica is a sharp pain in the areas affected by your sciatic nerve (lower back, buttock, leg, and foot). The pain might be episodic, meaning you feel it sometimes and it goes away other times or may be triggered by certain activities or injuries.
Like most nerve pain, sciatica causes a severe and uncomfortable sensation. The pain will stop you from doing normal daily activities. People often describe the pain as:
- stabbing,
- shooting,
- electrical, or
- “zinging.”
It’s important to see a specialist early when you have nerve pain. Waiting to go to a doctor and hoping the pain goes away on its own could lead to additional damage or deterioration, and worsening pain. Seeing a spine specialist sooner may also provide you with more treatment options. If you have symptoms of pain that do not get better, worsen, or last more than a month, schedule an appointment to see a spine specialist.
Why Choose University of Utah Health?
Spine specialists at U of U Health provide the latest treatments and surgical approaches to help with back pain. Our spine specialists work with patients to identify what is causing their back pain, then offer a range of options from nonsurgical to surgical treatment to relieve back pain. Our multidisciplinary team of specialists from Clinical Neurosciences Center and University Orthopaedic Center work together to treat sciatica and improve patients’ quality of life.
There are many treatment options for sciatic nerve pain. With a multidisciplinary team, patients can get evaluations for both surgical and nonsurgical treatments that are tailored to their specific diagnosis and needs. Patients will first meet with a rehabilitation specialist or other provider to start with nonsurgical treatments. If nonsurgical treatments do not work, a patient can meet with a spine surgeon to discuss other options.
Find a Sciatica Specialist
What Causes Sciatica?
The specific cause of sciatica is damage or injury to the spinal nerves that form the sciatic nerve, which come from inside your spinal column. Damage to the bones in your spine can also cause sciatic nerve pain.
Spinal bones can get injured or damaged from:
- accidents,
- arthritis,
- herniated disks,
- sports or other injuries,
- sitting for long periods of time, or
- tumors.
Sometimes nerve-related injuries resolve without needing extensive treatment. For example, a herniated disk in your spine might push on a nerve and cause pain for a short time. As your body heals, the disc herniation is reabsorbed by your body and the herniation no longer pushes on the nerve. However, not all causes of sciatica will resolve on their own. It’s best to see a spine specialist early to get a diagnosis and understand your treatment options.
What Causes Sciatica Flare-Ups?
Sciatica can last anywhere from several weeks to several years. Sometimes you will experience sciatic nerve pain that goes away and flares up again later.
Sciatica flare-ups can come from specific activities, such as:
- standing for a long time,
- reinjuring your back, or even
- moving the wrong way and causing part of your spine to push against the nerve.
What to Expect at Your First Appointment
When you experience sciatic nerve pain, the first step is to talk to your primary care provider. They will order X-rays or an MRI to figure out what is causing the pain. They can also refer you to see a spine specialist. For your first visit with a spine specialist, make sure you bring the results from any diagnostic tests you've had. Our spine specialists may order additional imaging if necessary.
At your appointment, our specialists will discuss your medical history and look at all the imaging. They will try to figure out exactly what is causing your pain. In some situations you may have pain that feels like sciatica, but is actually caused by something else. Our spine specialists will do a physical examination to find out what makes the pain feel better or worse, and look for any obvious damage or injury.
Your spine specialist may also order:
- CT scans;
- dynamic X-rays (conducted in different positions to see how your spinal bones move and shift); or
- electrodiagnostic studies, such as EMG.
We may do a nerve root block injection to help us pinpoint the specific spot on your sciatic nerve where the pain starts. These injections will also provider short-term pain relief while you are healing from an injury.
After the appointment, our spine specialists will work with you to create a treatment plan for your sciatica. We may refer you to a physical therapist or other specialists. We may also refer you to a spine surgeon if other treatments do not work to relieve your pain, or if we can see a clear issue that spine surgery could fix.
Sciatica Treatment
The right sciatic nerve pain treatment depends on several factors, including the:
- location of the pain,
- severity of pain, and
- how difficult it is to perform everyday activities.
At U of U Health, our spine specialists will help you determine what type(s) of treatment you need for sciatica, including:
- pain management with over-the-counter medications and at-home stretches;
- physical therapy (PT);
- physical medicine & rehabilitation (PM&R), a holistic approach to managing chronic pain that includes a combination of PT, injections, and at-home pain management;
- nerve injections, which are a combination of anesthetics (numbing medications) and corticosteroids that can relieve pain for several months or years; and
- spine surgery, for people that have an issue with the shape or structure of their spine that causes sciatic nerve pain, shape or structure of their spine.
Spine Surgery
Spine surgery can repair a problem that is causing sciatic nerve pain. Our spine surgeons use different methods based on each patient’s spinal anatomy, as well as other underlying conditions. Your surgeon may do one or more of the following during surgery:
- repair disk herniation,
- remove or repair bones damaged from arthritis,
- fix a slipped disk, or
- fuse bones together to prevent harmful movement.
There are multiple techniques surgeons can use to address sciatic nerve pain, including:
- arthroplasty (artificial disk replacement),
- minimally invasive endoscopic spine surgery,
- spinal decompression, or
- spinal fusion.
Our surgeons only recommend these procedures when other therapies are not beneficial, or the benefits from surgery are likely to outweigh the risks and recovery.
Spine surgery could be done as one procedure or as a series of shorter procedures. You may need to stay in the hospital for one or more nights to recover after the surgery. Some shorter spine procedures are done as outpatient surgery and you can go home the same day.
Most people need several weeks to recover from spine surgery. Some recovery could take several months. Your surgeon will discuss how they plan to approach your surgery and what to expect during your recovery.
Sciatica Exercises
For people with milder symptoms, home remedies for sciatic nerve pain relief can help. Your provider may refer you to a physical therapist or a physical medicine and rehabilitation (PM&R) pain specialist for treatment. These providers will give you several sciatica exercises and sciatic nerve stretches to do when you feel pain.
You can also try these sciatic nerve stretches at home:
Is Walking Good for Sciatic Nerve Pain?
Sciatic nerve pain can result from sitting for long periods of time. Make sure to walk for about five minutes once an hour when traveling, working, or sitting on the couch at home.
Schedule an Appointment with Our Sciatica Specialists
To meet with one of our spine specialists, contact our clinic for an evaluation. Our providers will look at your medical history and unique situation to determine the best option(s) for treating your nerve pain. You can schedule an appointment by calling 801-587-2225 or requesting an evaluation.
You can also get a referral from your primary care provider or other provider. Some insurance plans require a referral from your primary care provider to see a specialist. Contact your insurance provider directly with questions about your coverage.
