Sciatic nerves are the longest and thickest nerve in the body, starting in the buttock area and stopping below the knee. There are two sciatica nerves comprising five nerve roots – two from the lumbar spine in our lower back and three from the end part of our spine. Sciatica is a nerve pain that happens when the sciatic nerves get inflamed due to injury or nerve pressure and usually affects one side of the body.

Causes
Certain health conditions can pinch or compress the sciatic nerve, leading to nerve pain. They include slipped or herniated disk, degenerative disk diseases, spinal stenosis, osteoarthritis, spondylolisthesis, piriformis syndrome, and cauda equina syndrome.

Risks factors
Multiple risk factors can trigger sciatica nerve pain. For example, a previous history of trauma or injury to the spine or lower back and aging that causes shifts in bone, disks, and ligaments can pose risks. Besides these, other factors include high BMI that strains the muscles and nerves, weak back and abdomen muscles, a history of poor posture while sitting, exercising, or undergoing sports and fitness training, unhealthy lifestyle habits that damage spinal tissues and disks, a sedentary lifestyle, and hormone changes during pregnancy.

Symptoms
The first and initial symptom of sciatica nerve pain is mild, moderate, or severe pain in the areas where the sciatic nerve passes. The pain may be sudden or can build up gradually. It can be mild for some, while it can be a burning sensation or an electric shock. The pain may also accompany calf, leg, or foot inflammation. Other symptoms include weakness and numbness in buttocks, feet, and lower back, pain whenever you move your feet or legs, paresthesia or pins-and-needles-like sensation in legs, feet, and toes, and loss of bladder control if sciatica nerve pain is caused by Cauda equina syndrome.

Diagnosis
You can apply hot or cold packs or approved painkillers if the pain is new and recent. However, if the pain does not reduce in a week or two, do not continue self-care and visit a doctor for a proper examination and diagnosis. Sciatica manifests differently for each person, and treatment will be decided based on the underlying cause of the pain. Doctors would do a thorough physical examination and ask you to walk and move your leg to different positions to ascertain the cause of the pain. If they suspect sciatica nerve pain, they would first recommend spinal X-Rays to check for any fracture in the spine or any other issues like tumors in the disks. They may also recommend an additional MRI to confirm sciatica nerve pain. MRI can accurately pinpoint where the sciatic nerve is being compressed or pinched. They may also prescribe a myelogram which analyses if a disk or any vertebrae cause the pain.

Treatment
Once a doctor confirms sciatica nerve pain, they prescribe pharmacological therapies with painkillers as the first treatment. They would combine it with physical therapy, where you would be taught to do stretches and exercises that relieve the pain. Stretching exercises are a crucial part of pain treatment, and you should carefully follow the routine recommended by a therapist to find relief from the pain. Depending on the intensity of your symptoms, doctors may also recommend other physical exercises like swimming, walking, or aerobics. They may also prescribe spinal injections if imaging tests show inflammation in the nerve roots. You may have to repeat the injections in three months if you do not see any improvement. If the pain persists, making it difficult for you to sit, stand or move, or lose bladder control, doctors will perform surgery to remove the pressure on the sciatic nerve. The standard surgical procedures associated with sciatica nerve pain are Microdiscectomy and Laminectomy. Doctors suggest surgery only in rare cases, as spinal surgeries carry many risks and result in side effects like bleeding, blood clotting, nerve damage, infection, and spinal fluid leak.