Article Reviewed & Updated on 9/8/2022
Medical Reviewer: Kari Haberman - DPT
Sciatica affects 40% of people in the course of their lifetime. In fact, it is one of the most common reasons why people seek medical attention in the United States and around the world.
In this article, we will provide & discuss a comprehensive look at what causes sciatica to flare-up, along with other related topics to sciatica nerve pain:
- What is Sciatica
- Four Types of Sciatica
- Causes of Sciatica Nerve Pain & Risk Factors
- Common Sciatica Signs & Symptoms
- Top 10 Sciatica Triggers
- How Long Does Sciatica Last
- What Does Sciatica Pain Feel Like
- How to Stop Sciatica Flare Ups
- How to Treat Sciatica at Home
- How to Sleep with Sciatica Nerve Pain
- Top 10 Common Sciatica Questions Answered
But first, let's answer your question - What Causes Sciatica to Flare Up?
What Causes Sciatica to Flare Up - Top 10 Triggers to Look For
What triggers sciatica? Sciatica triggers can be different for each person. Some people also find that they have multiple causes of flare-ups.
Knowing what triggers sciatic nerve pain is crucial because it will help a lot in preventing and managing them. For that reason, you should be aware of any triggers that you may have.
If you can identify what causes sciatica to flare up, you’ll know what you can do to avoid them.
Here are the ten triggers that may be causing your sciatica to flare up that you need to watch out for:
Trigger #1 - Putting Stress on Yourself
According to the Institute for Chronic Pain, Sciatica can be exacerbated by stress or emotional anxiety. The explanation is that during stressful times, the brain deprives the nerves, including the sciatic, of oxygen, resulting in symptoms of sciatic nerve pain.
Trigger #2 - Poor Posture
Poor posture and improper body alignment can put extra stress on the lower back and sciatic nerve. When the nerve gets irritated, signs and symptoms of sciatica become apparent.
📝 Expert Tip: As physical therapists, this is why we recommend sitting with good posture by resting your back on a lumbar back support for your chair or car seat.
Trigger #3 - Wearing tight-fit clothing
Several patients with sciatica claim that tight clothes such as blue jeans and undergarments with ill-fitting elastic bands can trigger flare-ups. This kind of clothing puts additional pressure on the sciatic nerve, enough to trigger a flare-up.
Trigger #4 - Sitting for long periods with hard objects in the back pocket
Sitting for extended periods with hard objects at the back pocket like keys, wallet, cell phone, or any hard object can aggravate the piriformis muscle under which the sciatic nerve is situated.
This pressure on the nerve can cause impingement and ensuing pain.
Trigger #5 - Using shoes with high heels and aren’t adequately cushioned
Wearing high-heeled shoes shifts your body weight and the center of gravity, forcing you to hunch forward at the hips.
On the other hand, footwear without cushioned insoles contributes to transferring the impact of steps to the hips or back.
These events can lead to stretching of the hip and the knee muscles (called the hamstring muscles) alongside the sciatic nerve, resulting in irritation and compression.
Trigger #6 - Excessive Weight
Studies say that there is a connection between being overweight and back pain. It states that if you weigh more, there is a greater chance that you will exert additional pressure on the sciatic nerve.
That is why keeping weight under control can go a long way in decreasing the risk of sciatic nerve pain.
Trigger #7 - Bending Over When Lifting Heavy Objects
Whether you are carrying groceries to your kitchen from your car, picking up your child from the bed, or moving flowerpots in your garden, you are placing large amounts of workload on your lumbar discs.
When your lumbar discs are overworked, there is an increased risk for developing herniated discs. This, in turn, can compress or irritate the sciatic nerve.
Trigger #8 - Sedentary Lifestyle
According to Mayoclinic.org, those who have a sedentary lifestyle or those who sit uninterrupted for extended periods are more likely to experience sciatica than those who regularly exercise.
Prolonged sitting can cause intervertebral disc damage, which contributes to possible nerve compression and irritation.
📝 Expert Tip: This is why we recommend sitting on a pressure relief wedge car cushion while driving or sitting in a car for long periods of time.
Trigger #9 - Pregnancy
In women, sciatica can occur secondary to a condition called piriformis syndrome. Piriformis syndrome is a condition that develops when the piriformis muscle, located at the buttocks area, spasms and compresses the sciatic nerve.
It often develops during pregnancy as a result of irritation and pressure on the nerve body and changes experienced during pregnancy.
How? The added weight of the growing baby causes the pelvis to begin to shift forward, thereby causing the piriformis muscle to lengthen and compress the sciatic nerve.
Trigger #10 - Depression and Negative Emotions
Stress can be a trigger for any kind of pain, including sciatica. According to Dr. John Sarno, a Physician at the New York University Medical Center and Clinical Rehabilitation Medicine Professor at New York University School of Medicine, bodily pain can be a result of repressed emotions and stress.
Sciatica and Dr. Sarno’s study on mind-body pain became topics of interest for people who suffer pain in their lumbar area, buttocks, legs, and feet.
For years, he has been advocating a different approach to determining the cause and managing back pain that is associated with emotions rather than those that are picked up through MRI scans or verified using a diagnostic injection.
Needless to say, not all medical professionals have been supportive of his straightforward yet patient-centric way of diagnosing and treating back pains.
Now Let's Define What is Sciatica?
Sciatica, also termed as Sciatic Nerve Pain, is a condition that involves the compression or irritation of the sciatic nerve. The sciatic nerve is the longest nerve that extends from the back of your pelvis, all the way through your buttocks, and down to your leg.
If you have a mild ache or sharp pain that radiates from your spine through your buttocks which runs down to the back of your leg, you may be experiencing sciatica. Although pain can vary widely, sciatica can be the main culprit.
Where is My Sciatic Nerve Located? Right or Left Leg
The sciatic nerve originates from your lower back and crosses your hips down to each leg and then it branches off into smaller nerves just before your knee. It is the longest and the thickest nerve in the human body.
It takes five nerve roots to comprise the sciatic nerve. Three of the nerve roots start at the last section of your spine called the sacrum, whereas the first two belong to the lower back region called the lumbar spine.
It is a common misconception that the sciatic nerve only exists in one leg, which is either the left or the right leg. However, this nerve exists in both and can be painful either way.
What Are the Four Types of Sciatica?
Sciatica can be of multiple types, and they are:
Acute Sciatica
This type of Sciatica is usually limited to the early days. It stays for a total of 4-8 weeks, and the pain is not extreme. Patients in this stage may not need medical treatment as the pain can be managed on their own.
Chronic Sciatica
If your sciatic pain is consistent and has been bothering you for more than eight weeks, and is unmanageable, then you must seek medical assistance. Doctors might suggest surgical or non-surgical treatment depending on the root of the problem.
Alternating Sciatica
This type of Sciatica is not just limited to one leg, but it affects both of your legs. This is not a very common type of sciatica and is usually caused by sacroiliac joint degeneration.
Bilateral Sciatica
The bilateral Sciatica affects both legs simultaneously. It is also a very rare type of sciatica and may result from degeneration in your vertebrae or possibly syndromes like Cauda Equina.
What Causes Sciatic Nerve Pain and What are the Risk Factors?
Now that you have answers to the question “what is sciatica,” the next thing that we will discuss is what causes sciatic nerve pain. And for us to easily determine the causes and risk factors, let us review the basic human anatomy.
The Spine or Vertebra
The human spine consists of thirty-three bones that are stacked on top of the other, which form the vertebra. Nerve fibers run along the spine, bridging the gap between the brain to each part of the body. These nerve fibers serve as conduct signals and transmit messages between bodily systems.
The Intervertebral Discs
The 33 bones of the spine are held and connected by the spinal discs, also known as intervertebral discs. Their function is to allow the spinal column to be flexible. Inside these discs are substances that have a gel-like texture. An injury to the intervertebral disc can damage the discs’ outer shell, causing the soft gel-like material to bulge out. This bulging condition is known as a slipped disc or herniated disc.
Herniated Disc and Sciatica
A herniated disc may then impinge or compress a nerve, which can cause pain around the area of the affected disc and down the nerve it is impinging. Research suggests that nerve impingement due to slipped disc is the most common reason for sciatica.
So, what are the most common signs and symptoms of sciatica? And what are the most common sciatica risk factors?
Most common signs and symptoms of sciatica:
Here are the most common signs and symptoms of sciatic nerve pain:
Pain
Sciatic nerve pain can range from being mild to very painful. Some people also experience mild ache at the lower back while others experience a burning sensation or sharp pain on one side of the lower extremity.
In some cases, patients may experience excruciating pain, depending on the severity of nerve impingement or irritation.
Tingling, weakness, and numbness
These symptoms occur as a result of the exerted pressure on the sciatic nerves secondary to nerve compression. When the nerve gets pinched or compressed, it disrupts the nerve function, thereby causing a tingling sensation, weakness, or numbness on the affected part.
Discomfort
Some patients report a sensation of jolt or electric shock in the lower back or legs. It is often aggravated and becomes worse when sneezing, coughing, or sitting for long periods.
Difficulty or impaired leg mobility
Individuals with sciatica may find it difficult to walk, stand or sit in due to the pain and other neurological manifestations of sciatica such as weakness or numbness of the lower extremities.
The signs and symptoms listed above may manifest for a couple of weeks or may last for many years.
However, it is essential to note that not everyone will experience the same sciatica symptoms because causes of sciatica may differ from one person to another.
Sciatica risk factors include:
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Aging
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Poor body mechanics - If you do not make the right movements when you do things, you are very likely to put a lot of pressure on your nerves, and that can cause sciatic pain.
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Poor posture - It is essential that you pay attention to your posture as it can cause injuries. If you are consistently in an awkward position, you may hurt your spine, and the damages will be long lasting.
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Being overweight - The more weight you have on your body, the more you strain your lower back. Being obese can cause lower back trauma and worsen your sciatica pain.
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Trauma or injury on the lower back
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Wear and tear related to sports or hobbies - Sports or activities that demand high physical activities can directly worsen your sciatica pain. It would be best to limit high and moderate impact physical activity if you are facing sciatica pain.
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Smoking during Pregnancy or childbirth - If a mother smokes during her pregnancy, she is most likely to give her child spine abnormalities when they are born.
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Inherited Spine Abnormalities
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Other conditions such as a tumor in the spine, spinal injury (herniated or slipped disc), infection, as well as disorders affecting the spine.
How Long Do Sciatica Flare-Ups Last
Typically, sciatica pain should only last for a couple of weeks. The acute stage is said to last for 4-8 weeks. If it takes any longer than that, then you must get medical assistance.
Read Related Article: How Long Does Sciatica Last? Acute vs. Chronic Sciatica Pain
What Does Sciatica Pain Feel Like
In most cases, sciatica pain feels like a shooting pain that starts from the lower back or the buttock. It radiates through the back or the front of the leg.
People have also reported it to be a burning sensation that can be felt throughout the leg. In other cases, patients have also reported a feeling of numbness.
Can Sciatica Be Cured
People with Sciatica always ask, “Can sciatica be cured?” The answer is, typically, with the appropriate treatment method, you may be able to consider sciatica pain an afterthought.
Sciatica pain is a treatable condition, no matter how challenging it may seem.
Physicians can help you determine the cause of sciatica, and from there, you may be able to look into various forms of treatment programs. If you have chronic sciatica, ask your physician about a referral to physical therapy to ease current pain and prevent future pain.
Most people respond well to natural treatment methods, depending on the probable cause of sciatic nerve compression and are symptom-free after a few treatment sessions. So, instead of living with sciatica pain, give some treatments a try.
How to Stop Sciatica Flare-Ups
There is a lot you can do to prevent a sciatica flare-up, here are some examples:
Take Medicines - If you are excessively affected by sciatica and want to take medicines to manage the pain then you must look into muscle relaxers, steroids and or NSAIDs.
These medicines can remove the inflammation and that can help ease the pain. Always talk to your doctor before starting over the counter medications.
Keep Moving - Most people with Sciatica avoid moving around much because it may hurt but sitting excessively is not beneficial. It will only put excessive pressure on your nerves and that can cause more pain. If you wish to avoid the flares, you must stay active.
Fix Your Posture - Your posture affects your sciatica pain greatly, poor posture means excessive pressure on the already pinched nerve.
To remove the pressure from your pinched nerve it is best that you fix your posture and keep your back straight when you sit or stand.
Focus On Healthy Eating - Being obese can contribute to your sciatica flares. The excessive weight adds more pressure to your sciatica nerve. To lessen the pressure you must try maintaining a balanced diet so that you lose weight.
Stretch - Tight muscles add more to sciatic pain and it is important to loosen these muscles to manage pain levels. You can stretch your muscles every now and then so that you keep them as mobile as possible.
Avoid Stress - Stress can be a big contributor to your pain. While you're stressed your brain does not supply enough oxygen to your nerves and that can elevate pain levels.
Best Natural Treatment for Sciatica: How to Treat Sciatica at Home
How to Get Your Sciatic Nerve to Stop Hurting?
Treatment for Sciatica begins with self-care and non-invasive therapies. The goal for treatment is to improve the function, avoid provoking factors, correct the problem, and prevent re-injury.
Physical Exercise for Sciatica
Over the last few years, experts say that exercise improves health at the cellular level. Many people say that it is effective, as it aids in pain modulation either by itself or in conjunction with other treatment therapies.
Exercise loosens tight muscles and bones that might be impeding the sciatic nerve, thereby causing pain and other symptoms of sciatica.
If you are too busy to do extended periods of exercise, here is a video about One Minute Sciatica Exercises for Quick Pain Relief & Cure of Sciatic Pain:
While exercise can be helpful for any kind of pain, ‘caution’ should be kept in mind. So before beginning any exercise, please seek advice from your primary physician.
Hot and Cold Packs for Sciatica
According to MayoClinic.com, hot and cold packs can provide adequate pain relief. Although each effect of the two therapies may differ from one another, they both work at a deeper level.
View Hot Cold Packs on Amazon
Ice alleviates pain by reducing inflammation or swelling that compresses the sciatic nerve. On the other hand, heat packs can be useful in relaxing the tight muscles on the lower back.
If you are not sure when to use cold packs or hot compress, read this article on Ice and Heat therapy for lower back pain.
Deep Breathing Exercises (DBE) for Sciatica
DBE, short for Deep Breathing Exercises can induce alpha brain waves which calm the brain’s stress response system resulting in low anxiety levels and stress. This type of brain waves also stimulates the release of beta-endorphins or brain chemicals that work as natural pain relievers.
Yoga for Sciatica Nerve Pain
Sciatica may seem difficult to treat, but many sufferers benefit from a little bit of stretching and yoga. Yoga can soothe and reduce flare-ups by strengthening the back.
Back strengthening improves flexibility and helps relieve the compression on the nerve root.
Posture Correctors and Back Supports for Sciatica Pain
Research suggests that an incorrect posture can lead to a lot of back problems, including sciatica. Sciatica occurs when anything is impinging the sciatic nerve, and if you have poor posture, the misalignment of the bones or muscles can put up pressure on the sciatic nerves.
If you have poor posture, you can use posture correctors, and lumbar back supports such as pictured below to prevent further misalignment of the spine or muscles from creating a much better pathway for your sciatic nerve.
View Lumbar Back Support on Amazon
Car Wedge Cushions for Long or Short Car Rides
Car Seat wedges are cushions designed to help and encourage correct posture when sitting along with providing the necessary support your hips need for those long driving sessions.
Wedge cushions help by creating a cushion between the nerves in your legs and the seat beneath you. This helps in preventing them from being compressed as much.
They are usually made of memory foam material, and their purpose is to keep the pelvis and back in a comfortable angle. What sets them apart from memory foam cushions is their triangular shape; hence, the term wedge.
Seat wedge cushions are also not limited for car use, and many companies have built various kinds of wedge pillows or cushions for back support. You can use them on office chairs, living room couches, or dining chairs.
Progressive Muscle Relaxation
In some cases, Progressive Muscle Relaxation (PMR) can be helpful as well. It is a widely used relaxation technique that aims to reduce muscle tension exacerbated by psychological stress.
Cognitive Behavioral Therapies
Cognitive Behavioral Therapy or (CBT) is a non-pharmacological form of treatment started by Dr. Aaron Beck a few couples of years ago. This therapy is useful as it helps patients to reduce pain by harnessing the power of thoughts and behaviors.
CBT sessions are available for individuals or as a group. It can also prevent acute back pain from progressing to chronic injury.
10 Top Common Questions for Sciatica Pain
Q: Is Sleeping in a Recliner Good for Sciatica?
Sleeping in a recliner can be quite helpful for your sciatica. A recliner provides you with the support you need to keep the pressure off your sciatica nerve. Moreover, recliners are overall very comfortable and can help you get better sleep.
Q. How to Stretch the Sciatic Nerve in Bed?
There are several stretches you can do in bed that might help your Sciatica. For instance, you can lie in your bed and then bend your knees in front of you.
Then, you can cross your right ankle on your other knee and make a '4' shape. Then cross your fingers under your left knee and pull it towards yourself.
Hold this position for around 30 seconds and repeat the procedure for the other leg.
Q. Why Does Sciatica Feel Worse in the Morning?
Sleeping habits can worsen sciatica pain in the morning. You might be putting additional pressure on your sciatic nerve by sleeping in an awkward position. You must sleep in a way that distributes your weight evenly and does not put additional pressure on your sciatica nerve.
To prevent awkward sleeping you can invest in an ergonomic pillow that will help you relieve pressure from your back. You can also do stretches as soon as you wake up in the morning to deal with the pain.
Q. How to Stop Sciatica Morning Pain?
It is best to be very cautious of how you sleep if you have sciatica pain. Make sure that you do not sleep awkwardly and don't put a lot of pressure on the leg with the sciatica pain.
Q. How to Sleep with Sciatica in Left Leg?
If you have pain in your body's left side, you must sleep on your right side and press on a pillow between your legs.
Q. Is Bed Rest Good for Sciatica?
Most doctors suggest that it is best for the patient to be active in the initial stages of sciatica. If the pain gets unbearable and they seek medical attention, bed rest may be unavoidable.
Q. Why Is Sciatica Worse at Night?
When you lay down you put additional pressure on your nerves and that can heighten pain. Moreover, most people sleep in cold temperatures and some people become sensitive to cold temperatures because of the pain.
Doctors also conclude that Sciatica pain worsens at night because at night people are usually left to their devices, they have nothing to distract their mind from the pain and that is when they notice their pain the most.
Furthermore, at night when your body starts preparing for rest your hormone levels change and that can contribute to pain. For instance, cortisol levels drop when your body is preparing to sleep, that can cause your inflammation to rise and add more to your pain levels.
Your medication might wear off during the night as most people take them during the day. This can also be a factor of why your sciatica is worse at night.
Q. What Causes Sciatica Hip Pain?
If the Sciatica nerve is pinched you may experience hip pain as your body starts to favor the side affected by the pinched nerve.
That adds more pressure to your hips, this can lead to excessive pain and if you have excessive weight or a degenerative joint disease you are likely to experience more pain.
Q. What Causes Sciatica in the Buttocks?
The Sciatica nerve originates from the buttocks and if it is pinched, patients are likely to experience great pain. The piriformis muscle in the buttocks presses on to the Sciatica that can increase pain levels.
Furthermore, patients are also likely to experience numbness and tingling as they perform activities. However, there can be other reasons for pain in the buttock such as muscle strain, a herniated disc and a degenerative disc.
Q. Is it Better to Sit or Lay Down with Sciatica?
Maintaining the same position for long periods if you have sciatica pain is not advisable. Doctors suggest that patients should keep alternating between positions, so that they can regulate the pressure your body exerts on the nerve.
It would be best to keep alternating between sitting and standing so that the pain is regulated and the blood flow is undisturbed.
Know More About Various Treatment Options for Sciatica
Sciatica treatment plans and methods may vary from patient to patient. Some may benefit more from exercise, but others may not. Treatment therapy can only be effective if you know the underlying cause of your sciatica.
If you have no idea what causes your sciatica, discuss possible diagnostic or assessment procedures with a doctor to fully understand the causes, symptoms, complications, and appropriate treatment modalities for your Sciatica.
Read Related Article: "5 Best Shoes for Sciatica Nerve Pain"
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