Pain radiating from the buttock down the back of the thigh into the calf and/or foot. Oftentimes, sciatica is associated with numbness and tingling as well as pain into the same region of the back of the leg. Sciatica is a form of radiculopathy.  


Sciatica is caused by irritation or compression (pinching) of the sciatic nerve or the lumbar spine nerves that feed in to merge together to form the sciatic nerve. Most commonly, this is due to ruptured/herniated disk in the lumbar spine (lower back). Other causes of pinching of the nerves causing sciatica include bone spurs in the spine, tumors of the nerves in the spine or the sciatic nerve itself. Occasionally thickened ligaments or bone overgrowth in the spine can irritate the nerves and cause sciatica.  Rarely, sciatica can be caused by a direct trauma to the sciatic nerve in the leg or buttock.  


Most commonly, sciatica cause is found during MRI or CAT scan myelogram of the lumbar spine identifying a source of the pinched nerve. Other testing might include electromyelogram (EMG) to identify damage to the sciatic nerve or one of its originating lumbar spine nerves. Physical finding and history by the physician alone can usually make the diagnosis of sciatica, but the cause usually requires further investigation or testing.  


Oftentimes sciatica responds favorably to a combination of rest, oral medication such as analgesics, anti-inflammatory medications, muscle relaxants, physical therapy, chiropractic, or acupuncture treatment.  Sometimes injections in the spine are required. If none of the above relieves the sciatica pain, surgery to relieve pinched nerves typically in the spine enjoys a good success rate with a good likelihood of return to previous normal activities.  


Most often, sciatica resolves with non-surgical treatment, but when surgery is required success for relief of the sciatic pain and numbness is usually highly successful. Complication risks are rare but include persistent pain, infection, nerve damage and cerebrospinal fluid leakage.  

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