A Comprehensive Guide To Managing Sciatica Symptoms

If you've ever experienced sciatica, that burning, aching feeling that radiates down one leg, you know how much it can impact your day.

Hip and leg pain from sciatica can affect everything from a good night's sleep to getting where you need to go.

The sciatic nerve is the thickest nerve in your body, at its largest, about 2 cm. It originates in the lower back as a spinal nerve and routes through the hip and down the legs, calves, and feet. It connects the central nervous system to the lower body and has sensory and motor functions, meaning it helps control the legs, feet, and toes.

The sciatic nerve has branches on both sides of the body, but with sciatica, typically, just one side is affected.

Contrary to popular belief, there's not enough evidence linking sciatica to BMI 1and weight in people under 50.1 There is good evidence linking sciatica to pregnancy, herniated discs, and spinal stenosis.

For decades, the dominant clinical opinion regarding the cause of sciatica was that it was nerve pain caused by compression of the spinal nerves from herniated intervertebral discs. These discs are like pillows that act as gel cushions between each level of the spine, and when they herniate (or "slip"), they can press upon nerves leaving the spine, like the sciatic nerve.

More recently, piriformis syndrome2 has been thought to be an alternate explanation of sciatica symptoms. The piriformis is a muscle that lies superficial to the sciatic nerve in the hip and assists in hip extension and leg rotation.

Although living with chronic sciatica presents challenges, especially with everyday tasks like sitting at the computer and vigorous exercise, implementing a few strategies can make long-term or chronic sciatica more bearable:

Yoga can offer a therapeutic approach for managing sciatica, though it requires careful application. A 2012 study involving 80 participants revealed that yoga, including specific postures and breathing exercises, significantly reduced pain, anxiety, and depression5 while improving spinal mobility. This was compared to a control group that participated in physical therapy exercises, counseling, and educational sessions, with the yoga group showing more substantial improvements.

However, yoga's therapeutic potential comes with a cautionary note. A case report of a 67-year-old woman developing bilateral sciatica6 after performing an advanced yoga pose illustrates the importance of being mindful of one's body's limits.

With sciatica symptoms, it's essential to see a health care provider to diagnose the underlying cause—which could be as simple as a tight piriformis or a sign of a more significant issue like a herniated disc. 

It's important to remember that sciatica is a syndrome8, not a disease, and a herniated disc causes most cases.

See a provider immediately if there is a danger of falling because of pain or numbness, problems controlling your bowel or bladder, sudden pain or weakness, trauma, or trouble picking up your foot from the floor—as these are all signs of a severe medical issue.

A health care provider might use ultrasound, a CT scan, an MRI, or EMG to image the tissue and surrounding areas. A physical therapist, occupational therapist, or massage therapist can also be a health care team member who prescribes exercises and activities to reduce pain and improve function. In some cases, providers might recommend surgery.