Sciatic Neuropathy Guide: Common Symptoms, Causes, & Treatment Options

Sciatic neuropathy or a type of lumbar radiculopathy refers to the pain that occurs along the path of the sciatic nerve.

The pain goes from your lower back through the hips and buttocks and then down the legs.  Sciatic typically affects just one side of the body.

Most often, it occurs when a herniated disc, narrowing of the spine, or bone spur compresses a part of the nerve.

This results in inflammation, numbness, and pain in the affected limb. The pain related to sciatica  is severe, but non-operative treatments can resolve the issue within a few weeks.

People who experience several cases of sciatic pain normally experience weakness in the leg or changes in the bowel movements and bladder. In that case, they will require surgery.

Common Symptoms

sciatic neuropathy diagram

If you experience one or more of the following symptoms of sciatic neuropathy, you need to consult with a doctor:

  • Lower back pain
  • Pain in the leg or rear, which becomes worse when you are sitting down
  • Hip pain
  • Burning or tingling feeling down your leg
  • Numbness or weakness that makes it difficult to move your leg or foot
  • Continuous pain on one side of your rear
  • Shooting pain that makes it difficult for you to stand up

Sciatic affects only one part of your lower body and it extends from your lower back and down the back of your thigh and down through your leg. The type of pain you experience depends on the location of the affected sciatic nerve.

There is a possibility that you can experience pain in your toes or foot. You may feel intense pain from sciatic neuropathy, which can incapacitate you. Others might feel an irritating and infrequent pain with the possibility of it becoming worse with time.

Causes

Sciatic neuropathy occurs when the root or roots of the lower lumbar and lumbar-sacral spine become irritated. Some of the common reasons that can cause a person to develop sciatic neuropathy include:

  • Lumbar spinal stenosis narrows the spinal canal in the lower back
  • Degenerative disc disease breaks the discs down, which then serves as the cushions between the vertebrae
  • Spondylolisthesis occurs when one of your vertebrae slips forward into another one
  • Pregnancy
  • Muscles spasms in the buttocks or back
  • Compressed nerve due to a tumor
  • Damaged nerve due to diabetes or some other medical condition

Are You at Risk?

You are at an increased risk of developing sciatic neuropathy if the one or more of the following signs are true for you:

  • As you age, there is a chance your spine may undergo changes, resulting in bone spurs and herniated discs, which are both common causes of sciatic neuropathy.
  • Obesity can increase stress on your spine, placing unnecessary pressure on it. The excess body weight can cause changes to your spine, which then can cause you to develop sciatic neuropathy.
  • If your work requires you to twist your back, drive a motor vehicle for long durations, or carry heavy loads, you may develop sciatic neuropathy. However, research has yet to provide conclusive evidence to back up this claim.
  • If you sit in one place for long hours each day or live a non-active lifestyle, you are more at risk for developing sciatic neuropathy than people with an active lifestyle.
  • If you suffer from diabetes, a medical condition which changes the way your body utilizes blood sugar, your risk for developing sciatic neuropathy is more than people without diabetes.

Worst-Case Scenarios

Sciatic neuropathy usually disappears within 3 to 6 weeks with people not experiencing sciatica again or only once or two times in their lifetime. However, there are worst-case scenarios where sciatic debilitates a person for brief periods, but often, it causes frustrating pain that makes performing regular activities difficult. They will be able to perform tasks, but not without experiencing any pain.

According to statistics, 20% of people will experience chronic and/or recurrent sciatic neuropathy. An even smaller number of people will experience sciatic neuropathy for a lifetime. They with either experience sciatic pain every day of their life or episodic pain that will always return.

If the person has been experiencing the pain for quite some time, there is a significant risk that it can damage the function of the nervous system, changing the way it interprets pain. Known as central sensitization, the central nervous system becomes oversensitive to pain.

Treatment Options

If you are experiencing sciatic neuropathy pain, you need to visit your doctor.

Some signs that indicate it is time to visit your doctor to confirm if what you are experiencing is nerve pain due to sciatica include:

  • You experience unexpected and severe pain in your lower back or leg and numbness or muscle weakness in one of your legs.
  • You feel intense pain after you have suffered from a violent injury in a car accident.
  • You no longer have control over your bladder or bowel.
Doctor meeting with sciatic neuropathy patient

When you visit your doctor, he/she will perform a physical exam, checking for muscle strength and reflexes. For instance, your doctor may ask you to walk on the heels or toes of your feet, sit up from a squatting position, and tell you to lay on your back and lift one of your leg in the air followed by the other leg.

If you feel pain while performing these activities, your doctor will tell you to get certain tests done to confirm your diagnosis. Your doctor will ask you to get one or more of the following tests done:

  • X-rays are the most common tests doctors perform, as it reveals the cause of neuropathy sciatic, which in most cases is due to a herniated disc or bone spur.
  • Magnetic resonance imaging or MRI is a procedure that utilizes a powerful magnet and radio waves to generate cross-sectional images of the back. Doctors perform an MRI on people suspected of having sciatic neuropathy because it reveals detailed images of the soft tissues and bone, such as a herniated disc. You will have to lie on the table that moves you into the MRI machine.
  • Computed tomography or CT involves the doctor injecting a contrast dye into the spinal canal before they take the X-rays. This procedure is known as CT myelogram. Once the dye has been injected into the spine, it moves around the spinal nerves and spinal cord, which look white on the scan.
  • Electromyography or EMG measures the electrical impulses that the nerves produce as well as how your muscle responds. The test confirms if your sciatic neuropathy is due to a herniated disc compressing a nerve or narrowing of the spinal canal known as spinal stenosis.

Once your diagnosis has been revealed, the doctor will then proceed to reveal your treatment options for sciatic neuropathy.

Your doctor will ask you to take preventive measures, such as cold packs, hot packs, stretching, and over-the-counter medication, to reduce the nerve pain, but depending on the severity of your nerve pain, it may take the following approach to treat your sciatic neuropathy:

Medications

Your doctor may prescribe you the following medications for sciatic pain:

  • Anti-inflammatory
  • Narcotics
  • Tricyclic antidepressants
  • Muscle relaxants
  • Anti-seizure medications

If you are taking any other medication for any other medical condition, you need to let your doctor know beforehand.

Physical Therapy

Physical therapy can improve acute nerve pain. Either your doctor or a physical therapist will design a rehabilitation program to decrease your risk of experiencing future injuries. This involves helping you correct your posture, improving your flexibility, and strengthening the muscles that support your back. Yoga may also be recommended for neuropathy since it is low impact and greatly improves circulation and flexibility.

Steroid Injections

Doctors may suggest you can get a steroid injection containing corticosteroid medication. The doctor will inject it into the areas that involve the nerve root. Corticosteroid injections suppress inflammation around the affected nerve, which in return reduces pain.

However, the effects of the corticosteroid inject wear off after a few months. Your doctor will determine the number of steroid injections you need to receive, as getting them more frequently can increase your risk of suffering from serious side effects.

Surgery

Your doctor will only recommend surgery if your compressed nerve is causing extreme weakness, you feel that the pain is progressively getting worse, loss of bladder or bowel control, or therapies fail to improve your nerve pain. Your surgeon will remove a part of the herniated disc or the bone spur that is compressing your nerve.

If you are experiencing sciatic neuropathy, you need to consult with your doctor, as it can get worse as more time goes by. If nothing helps, surgery may be your last option to relieve sciatic pain. You will need to talk to your doctor to find out if surgery is the right option for you.

Summary

Sciatic nerve pain can be challenging to live with, but not impossible to deal with. By meeting with your doctor to understand the root cause, you can begin to implement the right treatment plan for your symptoms and reduce pain over time.

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