What Is Sciatica? Causes, Treatments, and Complications
Causes of Sciatica
Sciatica can have a number of causes, many of which are associated with aging. Sciatica can also result from a traumatic injury that affects the lower portion of the spine.
Here are some of the most common causes of sciatica:
Herniated DiskSpinal disks normally act as cushions between the vertebrae. When the tough outer portion of the disk ruptures or tears, the soft material inside the disk oozes out, and when it presses against a nearby nerve, the result is a “pinched nerve.” If the herniated disk occurs in the lumbar spine (the lower back), it can press against the sciatic nerve, causing sciatica. The jelly-like material that leaks out of the disk can also inflame and irritate the nerve, causing additional pain.
Bulging DiskIn a bulging disk, the outer wall has weakened and is bulging outward. A bulging disk can press against a nerve root and may progress to a herniated disk.
Degenerative Disk DiseaseAs people age, their spinal disks lose water, become less flexible, and become more likely to rupture, leading to herniated disks and, possibly, sciatica.
Bone SpurOsteophytes, also known as bone spurs, are bony enlargements that can form on the vertebrae in response to other changes in the spine. They may cause no symptoms, but if they press against the sciatic nerve, the result is sciatica. Bone spurs are often associated with osteoarthritis of the spine or degenerative disk disease, and they are common in people over age 60.
Spinal Stenosis Spinal stenosis is a narrowing of the spinal canal, the bony channel that houses the spinal cord and spinal nerves. Spinal stenosis can be caused by bone spurs growing in the spinal canal as a consequence of osteoarthritis. It can also be a result of Paget’s disease, which causes abnormal bone growth, and it can have other causes, too. When spinal stenosis occurs in the lumbar spine, it can cause sciatica.
Piriformis SyndromeSciatica can be a complication of piriformis syndrome, in which the piriformis muscle, located deep in the buttocks, spasms and causes buttock pain. The sciatic nerve runs directly beneath the piriformis muscle (or, in some people, through the muscle), and spasms, tightening, or swelling in the muscle can irritate the sciatic nerve, causing sciatica. (1)
According to David A. Spinner, DO, director of pain medicine and endoscopic lumbar surgery for the department of rehabilitation medicine at Mount Sinai in New York City, and assistant professor at the Icahn School of Medicine at Mount Sinai, the most common cause of a pinched nerve in people around 20 to 40 years old is disk herniation that compresses the sciatic nerve. In older people, it usually comes from spinal joint arthritis or degenerative disk disease — or a combination of the two.
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