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Sciatica & Sciatic Nerve Pain

Backache

Older woman experiences sciatic nerve pain while sitting in bed

Sciatica, also called lumbar radiculopathy, is pain that runs along your sciatic nerve.1 This nerve extends from the back of your pelvis down the back of your thigh to the heel in your foot and when the nerve is compressed or irritated, the pain may radiate from the back to the leg.2

Key Takeaways

  • The sciatic nerve is a large bundle of nerves that runs down either side of the lower back, down the leg and into the foot. A herniated disk or may put pressure on some part of this nerve, causing pain.
  • Symptoms may include radiating pain, tingling, numbness, or weakness in the leg or foot.
  • Treatment ranges from home care and physical therapy to medications or surgery for severe cases.

What is the Sciatic Nerve?

The sciatic nerve is not only the largest nerve in your body but also the primary nerve in your leg.1

Where is the Sciatic Nerve?

The sciatic nerves start in the lower back, where several spinal nerves (from the L4 to S3 levels) come together to form one large nerve on either side of your body.2,3 It leaves the pelvic region and travels down the back of the thigh. From there, it runs underneath some muscles and on top of others, as it continues toward the knee.2

Just before it reaches the back of the knee (the popliteal area), the sciatic nerve splits into two main branches:2

  • Tibial nerve: continues down the back of the leg and into the foot
  • Fibular nerve: moves down the outer and front parts of the leg and into the foot

What Does the Sciatic Nerve Do?

The sciatic nerve controls many of the muscles in the back of your thigh, which help you bend your knee and bring your leg inward at the hip.2 But the two branches of the sciatic nerve have different jobs:2

Part of Sciatic Nerve Job in the Body
Tibial Nerve
  • Controls muscles in the back of the lower leg (calf) and foot so you can point your toes down and curl your toes
  • Provides sensation on the bottom of your foot
Fibial Nerve
  • Controls muscles in the front and side of your lower leg so you can lift your foot up, straighten your toes or roll your foot outward
  • Provides sensation in the outer part of your lower leg and the top of your foot, as well as sensation between your big toe and second toe

What Causes Sciatica?

Sciatica, or sciatic nerve pain occurs when inflammation, pinching or compression affects one of more parts of the sciatic nerve, which runs from your lower back into your legs and feet.3 Most commonly, sciatica is caused by a herniated disk in your spine that puts pressure on the nerve.1 This is often due to degenerative changes – natural wear and tear – that occur as we age.4

Some other potential causes of sciatic nerve pain include:1,3,4

  • Degenerative disk disease – a condition where the cushioning in the spine begins to wear away allowing the vertebrae touch
  • Spinal and Foraminal stenosis – when the space around the spine narrows and puts pressure on nerves
  • Spondylolisthesis – when a bone in your spine slips out of alignment and puts pressure on the vertebra below it
  • Pregnancy – the curve of the spine becomes more pronounced as the body tries to redistribute weight
  • Blood clots – deep vein thrombosis can put pressure on the sciatic nerve in the leg

What Puts You at Risk for Sciatic Nerve Pain?

Because there are so many potential causes for sciatica, it’s important to be aware of risk factors:3,4

  • A current or previous back injury
  • A job that requires heavy lifting, bending, awkward positioning or prolonged sitting
  • Having type 2 diabetes
  • Tobacco use, which can affect circulation
  • Lifting with your back, not your legs
  • Insufficient core strength
  • Obesity
  • Osteoarthritis

What Are the Symptoms of Sciatica?

The most common symptom of an issue with the sciatic nerve is pain.1,2,3,4,5 It may start in the lower back and radiate down the back of one thigh or may start from a buttock and extend to your foot.1 Sciatic nerve pain is often described as feeling like burning or and electric shock.3 Because of where the nerve is located and its central role in controlling your lower body, this pain may get worse:5

  • After standing or sitting
  • When sneezing, coughing or laughing, or any other involuntary movement that may cause your back to move quickly and suddenly, especially if caused by a herniated disk
  • When bending backwards or walking, if caused by spinal stenosis
  • When straining or holding your breath

Other symptoms of sciatica may include:1,2,3,4,5

  • Paresthesia, the tingling sensation you experience when your leg “falls asleep”
  • Numbness, due to signals from your body being unable to reach your brain
  • Muscle weakness is a more severe symptoms because it indicates that command signals from your brain aren’t reaching their destinations

In rare cases, large disc herniation can press on the nerve roots that run through the low back.4 These nerves control the bowel and bladder, and if they are not functioning properly, you may experience incontinence.3,4

How is Sciatica Diagnosed?

If you think you may be experiencing sciatic nerve pain, talk to your doctor or healthcare provider. They may diagnose you via a physical exam where they look for:3,5

  • Visible changes in how you walk
  • Ability to raise your legs straight into the when laying on your back
  • Weak reflexes
  • Weakness when bending the knee
  • Difficulty bending your foot, walking on your toes, or bending your back forward or backward

Other Ways Sciatica is Diagnosed

There are a few tests that can help to diagnose sciatica while ruling out similar conditions. They include:1,3,4,5

  • Spine X-rays
  • Computed tomography (CT) scans
  • Magnetic resonance imaging (MRI)
  • Nerve conduction studies (NCS)
  • Electromyography (EMG)
  • Myelogram
  • Blood tests

Is an MRI Necessary to Diagnose Sciatica?

According to the American Medical Association, no, you don’t always need an MRI.5 While magnetic resonance imaging is great for looking at soft tissues, it doesn’t show bones as well as a standard X-ray does.5 The MRI has its place in making a diagnosis, but it should come at the request of a spinal or orthopedic surgeon.5

Treatment: What Helps Sciatic Nerve Pain?

Treating sciatic nerve pain often involves increasing mobility while decreasing pain.3 For the most part, treatment can be done at home, though there are instances where a healthcare provider must get involved.3

Treating Sciatic Nerve Pain at Home

In mild cases, sciatica may improve with self-treatment:1,2,3,4,5

  • Ice and cold packs can help reduce pain and swelling
  • Heat can help keep blood moving, use a heating pad or warm compress and alternate with cold
  • Stretching and physical activity can strengthen your muscles and keep you from exacerbating the problem

NSAIDs and Sciatica

Over-the-counter NSAIDs like ibuprofen are often recommended as a first choice for managing sciatic nerve pain because they can help reduce pain, swelling and inflammation.1,3 Advil is the #1 pharmacist recommended ibuprofen brand, and Advil Gel Caplets work at the site of pain to help temporarily relieve pain caused by inflammation. Talk to your doctor for specific treatment for your sciatic pain.

Conservative Treatment for Sciatica

These are a step up from self-treatment and may be prescribed by a doctor as options if self-care wasn’t successful:3

  • Prescription medications like painkillers and muscle relaxers may be prescribed. Anti-seizure drugs may help if the pain is chronic or nerve-based.
  • Physical therapy can help you find ways to move your body that decrease pressure on the sciatic nerve. These activities are often stretch-based or low-impact like walking and swimming.
  • Spinal injections like corticosteroids may provide relief for up to three months.
  • Alternative therapy like yoga, acupuncture and massage therapy are gaining popularity.

Surgical Options for Sciatica

When sciatic nerve pain is truly severe, and symptoms indicate that nerve damage is happening, surgery may be the best option.3 They may also recommend surgery if your quality of life is reduced and you’re unable to go about your life. These options include:3

  • Diskectomy removed fragments of a herniated disk to relieve pressure on the nerve
  • Laminectomy removes a section of the lamina (part of your vertebra) that’s putting pressure on the sciatic nerve

Prevention: How to Reduce Your Risk of Sciatica

Sciatic nerve pain is common – about 40% of people in the United States will experience some form of it during their lifetime.4 Yet due to the fact that it’s often related to age-based deterioration, it rarely occurs in people under 20 years old.4 These tips may help you prevent sciatic nerve pain:3,5

  • Regular exercise, especially strengthening your back and core
  • Maintain good posture while sitting, standing and lifting
  • Healthy weight management
  • Protecting yourself from falls to reduce the chance of back injury
  • Allow yourself to rest and recover, especially if you’re already experiencing back pain

Sciatica can limit your comfort and mobility, but it can be treatable. By understanding its causes, symptoms, and treatment options, you can take steps to ease pain with OTC medications like Advil and prevent future flare-ups. If symptoms persist or worsen, consult a healthcare provider for proper diagnosis and care.

Discover more ways to manage and avoid back pain, and visit the Advil Symptoms & Tips Hub for more helpful tips on finding pain relief.

SOURCES

  1. Sciatica. Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/sciatica. Accessed 9/2/25.
  2. Anatomy, Sciatic Nerve. National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK482431/. Accessed 9/2/25. 
  3. Sciatica. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/12792-sciatica. Accessed 9/2/25.
  4. What doctors wish patients knew about sciatica. American Medical Association. https://www.ama-assn.org/delivering-care/prevention-wellness/what-doctors-wish-patients-knew-about-sciatica. Accessed 9/2/25.
  5. Sciatica. Penn Medicine. https://www.pennmedicine.org/conditions/sciatica. Accessed 9/2/25.

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