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7 Common Causes of Sciatica

October 25, 2023

Sciatica can literally be a pain in the you-know-what – especially when the pain extends into your lower back or down your leg. But what's to blame? We asked a neurosurgeon to explain the common causes of sciatica, and when it's time to see a doctor. [insert-cta-small id=27138]

The "root" cause.

Sciatica is caused by irritation of your sciatic nerve root – the largest nerve in your body. The result can be not only pain, but weakness, numbness or even tingling in one of your legs. > Related: How to Know When Back Pain Requires Surgery

7 common causes of sciatica.

There's a number of different injuries and conditions that can cause sciatica. “Not always, but sciatica is often the result of a lumbar spinal nerve impingement or pinched nerve,” says Pedro Coutinho, MD, a neurosurgeon at St. Vincent’s Medical Center. A few possible causes include:
  • Herniated disc
  • Spinal stenosis, or narrowing of the spinal canal, where the nerve roots travel through
  • Fractures
  • Tumors
  • Infection
  • Pregnancy
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Your age may help determine the cause.

Sciatica can affect people of all ages, but the cause may be different. “Among younger patients, it is more commonly caused by lumbar disc herniation,” says Dr. Coutinho. For elderly patients, narrowing of the lumbar spinal canal, or spinal stenosis, is the main cause mostly due to “wear and tear.”

Most cases don’t require surgery.

Some good news for sciatica sufferers – surgery usually isn't the answer. “Statistically, 85 to 90% of the patients presenting with nerve root compression and sciatica will never need surgical treatment,” says Dr. Coutinho. Most people will improve with physical therapy, oral medications and sometimes lumbar spine injections.