Sciatica is lower back and leg pain caused by irritation of the sciatic nerve, most commonly from a herniated disc or spinal stenosis.
Understanding the common sciatica causes helps you choose safe self-care and when to seek professional help.
Conservative measures—activity modification, targeted exercise, heat/ice, and physical therapy—are first-line for sciatica relief.
What is sciatica?
Sciatica is a pattern of pain, numbness or tingling that follows the path of the sciatic nerve from the lower back through the buttock and down the back of the leg.
It describes symptoms rather than a single disease, so uncovering the underlying sciatica causes is key to effective treatment and sciatica relief.
Most common sciatica causes
Several spinal problems can irritate or compress the nerve roots that form the sciatic nerve. The main causes are:
- Herniated (slipped) disc: Disc material pressing on a nerve root is the most frequent cause of sciatica symptoms.
- Degenerative changes and spinal stenosis: Narrowing of the spinal canal or foramina from arthritis can compress nerve roots, especially in older adults.
- Spondylolisthesis: One vertebra slipping forward can pinch nerve roots.
- Muscle-related irritation: Tight or inflamed muscles (e.g., the piriformis) can irritate the sciatic nerve in some people.
- Trauma or tumour (less common): Fractures, infections, or growths can cause nerve compression—these are less common but serious causes.
Identifying which of these is present determines the best path to sciatica relief.
Who’s at higher risk?
Risk factors include heavy manual work or frequent bending and twisting, prolonged sitting, poor posture, obesity, and age-related spinal wear. Pregnancy can also increase risk due to changes in posture and pelvic mechanics.
Genetics and a history of back problems can make some people more likely to develop symptoms.
How sciatica is diagnosed
Clinicians diagnose sciatica through history and physical exam, looking for a characteristic nerve root pattern of pain, weakness or sensory changes.
Imaging (MRI or CT) is used when symptoms are severe, progressive, or persistent despite conservative care, or when red flags are present.
Evidence-based approaches for sciatica relief
Most people improve with non-surgical care over weeks to months. Guidelines recommend a stepwise approach that prioritizes conservative treatments first.
Self-care and at-home strategies
- Stay as active as tolerated: Gentle walking and avoiding long bed rest helps recovery and reduces stiffness.
- Targeted exercises: Core-strengthening and nerve-gliding exercises prescribed by a physical therapist can reduce pressure on the nerve and speed recovery.
- Heat and ice: Short-term use of ice (first 48–72 hours) then heat can ease muscle spasm and comfort.
- Ergonomics and posture: Adjust chair height, use lumbar support, and break up prolonged sitting with standing or walking every 30–60 minutes.
These measures are commonly effective for sciatica relief in the early phase.
Physical therapy and structured rehabilitation
Physical therapy combines exercise, manual therapy, education and graded activity to address the underlying sciatica causes and reduce recurrence. Many guidelines recommend physical therapy as a core treatment option.
Practical tips for fast, safe sciatica relief
- Keep moving—regular gentle activity beats prolonged rest.
- See a physical therapist for guided exercises and ergonomic advice.
- Use heat/ice and simple analgesics for symptom control while you rehabilitate.
When to see a specialist
Make an appointment with a specialist if pain doesn’t improve after a few weeks of conservative care, or if pain is severe or limiting daily life. A targeted assessment will look for the specific sciatica causes and match treatment to your situation.
Call (734) 525-3000 or click here to book a free discovery visit, if you’re ready to take the next step in combating sciatica.
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