Sciatica

What is sciatica?

Sciatica refers to pain that follows the path of the sciatic nerve, which runs from your lower spine through your hips, buttocks, and down each leg. It is caused by irritation or compression of the sciatic nerve. Sciatica is a symptom of an underlying problem, most often a herniated disc or spinal stenosis compressing part of the nerve.

Common causes & risk factors

Sciatica is typically caused by:

• Herniated or bulging discs
• Degenerative disc disease
• Spinal stenosis (narrowing of the spinal canal)
• Spondylolisthesis (slipping of one vertebra over another)
• Piriformis syndrome (a tight muscle in the buttocks irritating the sciatic nerve)
• Trauma or injury to the lower back

Risk factors include:

• Age (typically 30–60 years old)
• Sedentary lifestyle or prolonged sitting
• Obesity, which adds stress to the spine
• Physically demanding jobs that involve lifting or twisting
• Diabetes, which can affect nerve health

Symptoms of sciatica

Sciatica symptoms vary but typically affect one side of the body. Common signs include:

• Sharp, shooting pain from the lower back or buttocks down the leg
• Burning, tingling, or numbness in the leg or foot
• Pain that worsens with sitting, coughing, or sneezing
• Weakness in the leg or foot (in severe cases)
• Difficulty standing or walking due to pain

Symptoms may come and go or remain constant, depending on the cause and severity.

Diagnosing sciatica

Our spine specialists at Iowa Ortho start with a thorough evaluation that includes:

• Medical history and symptom review
• Physical exam to test strength, flexibility, and nerve function
• Imaging tests, such as X-rays or MRI, are used to identify the source of nerve compression
• Nerve conduction studies or electromyography (EMG) in complex cases

Treatment options

Most cases of sciatica improve with conservative, non-surgical treatment.

Non-surgical treatment

• Physical therapy to strengthen core and back muscles
• Anti-inflammatory medications (NSAIDs) or muscle relaxants
• Heat and cold therapy
• Activity modification and posture training
• Steroid injections to reduce nerve inflammation
• Lifestyle changes, such as weight loss or ergonomic adjustments

Surgical treatment

If symptoms persist beyond several weeks or cause significant nerve issues, surgical options may be considered. These include:

• Microdiscectomy to remove part of a herniated disc
• Laminectomy to relieve pressure in the spinal canal
• Spinal fusion in cases of instability or spondylolisthesis

Recovery & outlook

Most people recover from sciatica with non-surgical care in a matter of weeks. Staying active, stretching, and strengthening your core are key to preventing future flare-ups. For those who undergo surgery, outcomes are generally positive, with many patients reporting significant pain relief.

Our multidisciplinary team of spine specialists provides personalized treatment plans backed by the latest techniques and technology.