Sciatica occurs when a herniated disk (see section on herniated disks) in the lower spine presses against the sciatic nerve. It most commonly occurs in people who are 30 to 50 years old. It is often felt as a sudden pain in the lower back that radiates down the back of your leg. Some people describe it as a bad leg cramp that lasts for weeks. The pain is often worse when you cough/sneeze or sit down. You may have other symptoms in the back of your leg, including numbness, weakness, or a burning sensation.
Most people with sciatica get better over time without surgery. A doctor may use MRI or X-rays to determine which nerve roots are affected—sciatica usually affects L5 or S1. The first line of treatment usually includes bed rest, aspirin or ibuprofen, and cold or heat packs. While bed rest is important, you should still be active as moving around can also help reduce the inflammation. Your doctor will recommend a physical therapy routine once you are on the road to recovery. If your pain lasts for three or more months, you may be a candidate for surgery (see section on lower back surgery). A laminotomy to remove part of the herniated disk may be necessary. This procedure has a high success rate for treating sciatica that does not go away on its own. However, if you lose control of bowel/bladder function due to a herniated disk, then the situation is more serious and surgery should be performed immediately.