Sciatica usually starts in the buttocks. The pain can extend 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. Sciatic pain also can extend up into the lower back.
What causes sciatica?
Sciatica usually is a symptom of a problem with one of the intervertebral discs in the lower back. An intervertebral disc is a rubbery pad between two spine bones, or vertebrae.
Other conditions can cause sciatica. One such condition is piriformis syndrome. Piriformis syndrome occurs when the piriformis muscle -- a flat muscle located in the buttocks -- compresses the sciatic nerve.
Sciatica treatment options
Our doctors typically recommend rest to allow the sciatic nerve’s inflammation to decrease. You may need prescription medication for pain relief or an injection of medication to relieve sciatic pain.
Your doctor also may recommend physical therapy to relieve sciatica. Increasing core strength can help improve the symptoms of a bulging or ruptured disc that may cause sciatica.
If these treatments don’t work, you may need spine surgery. In some cases, our spine specialists have had success with microsurgical procedures to correct sciatica. Percutaneous (through the skin without cutting, such as with a needle) removal of disc fragments also may be an option. Your doctor will discuss the options and help you decide on the best approach.