Sciatica is lower back pain that can also be felt as a shooting pain down the back of your leg. Knowing how the sciatic nerve works will help you recognize this cause of intense leg and back pain.

Sciatica is a particular type of lower back pain, or leg and back pain that comes from injury or pressure on your sciatic nerve. Your sciatic nerve is a large nerve formed by roots coming out of your spinal cord in the lower part of your back. These roots come together to form two large nerves that run down the back of each of your legs.

The reason sciatica can cause lower back pain as well as leg pain and weakness is that your sciatic nerves control the muscles in the backs of your knees and lower legs. These two nerves also supply feeling to the backs of your thighs, parts of your lower legs, and the soles of your feet.

"Because sciatica is caused by pressure on the nerve roots that make up the sciatic nerve, and there are multiple nerve roots, different people feel sciatic pain in different places," says S. Christine Kovacs, MD, a rheumatologist at the Lahey Clinic in Burlington, Mass.

Sciatica Symptoms and Causes

Lower back pain and other symptoms of sciatica often strike people between the ages of 30 and 50, and about 1 in 50 people will have a herniated disk at some time. Sciatica may come from the general wear and tear that takes place in your lower back over time, or it may occur more suddenly from a herniated disk.

Your disks act as cushions and shock absorbers between the bones of your spine. If they become damaged and start to bulge out between the bones of your lower back, they can press on your sciatic nerve roots and cause sciatica.

Symptoms of sciatica may include:

• Lower back pain
• Shooting pain down the back of the leg
• Burning leg and back pain
• Tingling and numbness of the back or leg
• Weakness of the back or leg

Not everyone has lower back pain, notes Dr. Kovacs. You may only have tingling and numbness. It all depends on which roots of the nerve are affected. “Although sciatica can occur on both sides, it is usually one-sided," she adds. Sciatic pain may get worse with sitting, walking, bending, sneezing, or coughing.

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Alternative Therapies for Back Pain

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Diagnosing and Treating Sciatica

A diagnosis of sciatica is usually made during a history and physical examination. Your doctor will ask you about your pain. During the physical exam you may be asked to lift your leg while lying on your back — shooting pain down the back of your leg is a common sign of sciatica. Your doctor will also check the strength and reflexes in your leg.

An X-ray of your back and an MRI are common tests sometimes used to help diagnose sciatica. Not all cases will require these tests. "Sciatica symptoms such as numbness and weakness may need to be evaluated with an MRI," says Kovacs.

Treatment of sciatica usually starts with rest and pain control. "During the first 72 hours [after the pain starts] an ice pack may be applied to the lower back to reduce swelling. After that, heat works best to relax muscle spasms and reduce pain," explains Kovacs.

Typical treatment may include:

• A few days of bed rest
• Over-the-counter pain relievers
• Cold and hot compresses
• Resuming activity after a few days with mild stretching exercises or other physical therapy
• Muscle relaxants (may be needed for muscle spasms)

Some people may need steroid injections into the spine. In rare cases, surgery may also be considered.

Though it can be a very painful condition, sciatica usually responds to a short period of rest and non-surgical treatment. Up to 90 percent of people with sciatica get better over time without surgery.