Sciatica and lower back pain are common companions and it is helpful to understand how they are related. Sciatica is a neither a disorder, nor a spinal condition. The term instead refers to a set of symptoms, including back pain, that can arise when the sciatic nerve becomes irritated or compressed by an anatomical abnormality in the spine.

The Sciatic Nerve

As the longest nerve in the body, the sciatic nerve runs down the right and left lower extremities, from the base of the spine, through the hips and buttocks, and down into the legs and feet. It is made up of several nerve roots that originate at the base of the spinal cord, including the fourth and fifth lumbar nerves (L4 and L5) and the first, second, and third sacral nerves (S1, S2, and S3).

Most people typically group the symptoms that characterize sciatica into a general "leg pain" category. More specifically, sciatic nerve compression symptoms can include radiating pain, numbness, muscle weakness, and tingling which can travel down the length of the nerve. Additionally, sciatica may present with back pain in the lumbar (lower back) region of the spine.

Causes

There are a number of conditions that might cause sciatica and lower back pain. Some of these conditions include:

• A herniated disc - A herniated disc is also known as a ruptured disc. When this condition develops in the lumbar spine, the sciatic nerve roots are vulnerable to compression by the expelled disc material that can leak into the spinal canal.

• Traumatic injuries - Car accidents, falls, and other injuries inflicted upon the lower back, hips, or buttocks can damage the sciatic nerve roots or the nerve itself.

• Spondylolisthesis - This condition arises when one vertebra slips anteriorly (forward) over the vertebra below it. The slipped vertebra in the lower back can cause sciatica if it comes in contact with a portion of the sciatic nerve.

• Piriformis syndrome - The piriformis muscle, situated between the pelvis and the hip joint, is part of the group of hip flexor muscles. When this narrow, triangular band of tissue tightens or spasms, it can put pressure on the sciatic nerve.

• Spinal stenosis - Lumbar spinal stenosis, or the narrowing of the spinal canal in the lower back, can lead to pinched lumbar or sacral nerve roots.

Treatments

A doctor or spine specialist may initially suggest treating sciatica and lower back pain conservatively. Conservative, or non-surgical, treatments typically include physical therapy, behavior modification, non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroid injections, stretching, low-impact exercises, and cold/hot therapies. Some patients dealing with sciatica and lower back pain have found relief from alternative methods that take a more holistic approach to treatment, such as massage therapy, acupuncture, chiropractic adjustments, and acupressure.

All of these methods are generally successful at alleviating sciatica symptoms after several weeks or months of application. However, a surgical procedure to treat sciatica - such as a discectomy or foraminotomy - may be required in the most severe cases of unrelenting and debilitating symptoms.