What Causes Sciatica to Flare Up?

Sciatica nerve pain is characterized by radiating pain in the back to the hip and glutes.

Sciatica is nerve pain caused by an injury or irritation of the sciatic nerve. Most people with sciatic nerve pain get better on their own with self-care and home treatments.

The underlying cause of sciatic nerve pain varies from person to person. Most sciatic flare-ups are due to the herniated or slipped disk or overgrowth of a bone called bone spurs that occur on the spine, resulting in pressure on the nerve and causing severe pain and inflammation. 

Although the pain starts in the lower back, you may feel pain down the buttocks and in the leg.

The major causes of sciatic pain include:

• Degenerative disk disease or herniated intervertebral disk
• Bone spurs
• Spinal stenosis
• Inflammation of the muscles and muscle spasms
• Spondylolysis

Depending on the cause, sciatic pain is described in different ways. Some people describe it as sharp, shooting jolts of pain, whereas some people may describe sciatic pain as burning, electric, or stabbing pain.

Most people with sciatica may recover entirely with conservative treatment. However, seek immediate medical care in the following conditions:

• Loss or decreased sensation in the affected leg
• Weakness in the affected leg
• Loss of bowel and bladder control

Risk factors of sciatica include:

• Injury: Any injury to the lower back or spine increases the risk of sciatica.
• Age: A lot of changes occur in the spine with age, such as herniated disks and bone spurs. It puts you at risk of damage to the nerve, which increases the risk of sciatic nerve pain.
• Obesity: The more weight you have, the more pressure it puts on your spine, increasing the risk of sciatica. 
• Sitting for a long time: People who sit for long periods and do not move around are more likely to develop sciatica than active people.
• Diabetes: People with diabetes have an increased risk of nerve damage due to the increased blood sugar level. The severe damage caused by diabetes may result in sciatic pain.
• Osteoarthritis: This may lead to spine damage, which increases the risk of sciatic pain.
• Smoking: The nicotine in tobacco damages spinal tissue, weakens bones, and increases the resorption of intervertebral disks which causes sciatica.
• Pregnancy: Pregnancy may risk the development of sciatic pain. This may occur due to the combined effects of weight gain and hormone that results in the loosening of ligaments of vertebrae. Ligaments are the connective tissue that helps hold the vertebrae of the spine together.

The sciatic nerve is the body's longest and largest nerve.

• It begins at the lumbar spine (lower back) and travels through the buttocks and back of the leg into the foot.
• It is made of five nerve roots—two from the lower back region called the lumbar region and three from the end of the spine called the sacrum.

Sciatica is a nerve pain characterized by radiating pain that causes tingling and numbness in the back to the hip and glutes, which travel down to the legs and feet.

In sciatica, you may experience severe pain along the nerve path. Sometimes, you may feel muscle weakness in the legs and feet, numbness in the legs, and tingling and pins and needles-like sensations in the thigh, leg, and foot.

Depending on the cause of sciatic pain, the pain's onset may vary. For example, disk herniation may cause sudden pain, whereas the onset of pain in arthritis of the spine may be gradual.

Sciatic pain is the most common pain seen in 40 percent of the U.S. population. In addition, back pain is the third most pain that makes people visit their healthcare provider.

Your healthcare provider will perform a physical examination and ask for the symptoms. They will then perform a straight leg raise test. This may help diagnose the pain.

The healthcare provider may recommend X-rays to find any spine fractures and bone spurs.

MRI or CT scans are recommended to see detailed images of the backbone and soft tissues around it.

A nerve conduction test or electromyography examines how well the electric signals travel through the sciatic nerve and the muscle response to them.

The treatment aims to relieve the pain. In most cases, the person with sciatica may recover on their own with rest and pain medications.

Simple home remedies will ease the symptoms, such as:

• Apply ice packs to relieve the pain.
• Gentle physical therapy and stretching will help you relieve the symptoms.
• Take nonsteroidal anti-inflammatory drugs to reduce pain, swelling, and inflammation.

Severe cases such as those caused by herniated disks may need surgery.