Sports Medicine: Back Sciatica

The sciatic nerve is the longest nerve in the body. It runs from the lower back through the hips and down each leg. The sciatic nerve provides sensation and muscle innervation to the back of the thigh, lower leg, ankle and foot. Sciatica is caused by increased pressure placed on the sciatic nerve, most commonly from a herniated disk.

Signs and Symptoms

  • pain in the back of the thigh that usually travels below the knee
  • pain that is sharp, burning or tingling (like pins and needles)
  • often there can be pain in the back or buttock
  • pain that worsens with sitting, bending, sneezing, coughing or straining
  • numbness or weakness affecting the thigh, leg, foot or ankle

Increased Risk

  • having spondylolisthesis or previous back surgeries (spinal fusion)
  • any sports where movement causes downward or twisting pressure on the spine
  • obesity or inactive lifestyle
  • common between the ages of 30 to 50
  • poor mechanics with lifting

Treatment

  • Medicine
    • Anti-inflammatory medicines, such as ibuprofen (Motrin® or Advil®) or naproxen (Aleve®) may be recommended. Take these as directed by your health care provider.
    • Other minor pain relievers, such as acetaminophen (Tylenol®).
    • Oral steroids may be prescribed to reduce pain and swelling around the nerve.
  • Use of cold and heat
    • Cold should be applied for 10 to 15 minutes every 2 to 3 hours for swelling and after any activity that makes symptoms worse. Use ice packs or an ice massage.
    • Heat may be used before performing stretching and strengthening activities prescribed by your health care provider or athletic trainer. Use a heat pack or warm soak. Apply for 10 to 15 minutes.
  • Exercises to improve strength, flexibility and proper body mechanics are important. These can be done at home but often a referral to a physical therapist or athletic trainer may be recommended by your health care provider.
  • Bracing may be used to help reduce pain in the short-term.
  • If pain does not improve with bracing and exercises, steroid injections may be used to decrease pain.
  • For patients with on-going pain, surgery may be needed.

How to Prevent

  • Use proper lifting and posture techniques when lifting or sitting for long periods.
  • If previously injured, avoid physical activity that requires twisting of the body in awkward and uncontrolled positions.
  • Maintain proper conditioning, back and hamstring flexibility, muscle strength and endurance, cardiovascular fitness and ideal body weight.

When to Call the Health Care Provider

Call your health care provider or the Sports Medicine team at (614) 355-6000 if:

  • symptoms get worse after 2 weeks, even with treatment
  • you develop numbness, weakness or loss of bowel or bladder functions
  • new, unexplained symptoms develop

 

Sports Medicine: Back Sciatica (PDF)

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