The sciatic nerve, medically known as the Nervus Ischiadicus, is the longest and thickest nerve in the body. It starts from the lower part of the spine and extends all the way down to the foot. Originating from the lower lumbar vertebrae L4 and L5, and receiving nerve roots from the sacral vertebrae S1, S2, and S3, it forms its general structure. It then passes through a perforated region inside the pelvis and reaches the thigh. Running along the back of the thigh, the sciatic nerve descends and branches off behind the knee joint, eventually reaching the foot. This long nerve pathway carries both motor and sensory fibers.

What Causes Sciatica?
Although sciatica is most commonly caused by a herniated disc, it can result from various other reasons. The sciatic nerve can be compressed or traumatized in three different areas: the lumbar spine, between the gluteal muscles, and behind the knee joint. As a result, symptoms may vary. Common causes include:

• Physical inactivity
• Heavy lifting (either occupational or sports-related)
• Obesity, which increases stress on the spine
• Diabetes, especially due to peripheral nerve damage
• Aging, as muscles, bones, and surrounding tissues weaken over time
• Trauma and pregnancy

What Are the Symptoms of Sciatica?
Pain is the most common and significant symptom. Sciatic pain originates from the lower back, radiates through the buttock, down the back of the thigh, and can continue to the leg and foot. This pain usually intensifies with movement and may be accompanied by numbness and muscle weakness.
In severe cases, the pain can restrict movement, making it difficult to bend or rotate the upper body. Often, the person cannot stand upright or may lean to one side. Pain, numbness, tingling, or a pins-and-needles sensation may be felt under the feet and toes.

How Is Sciatica Diagnosed?
The patient’s description of their symptoms is very important for diagnosis, as the pain’s characteristics are usually diagnostic. Numbness, pain, or tingling from the buttock to the heel is key for identifying sciatica. During the physical examination, the doctor performs stretching and relaxation tests that are highly indicative. Reflex tests, as well as assessments of motor and sensory function, are also essential.
If needed, advanced imaging techniques like MRI or CT scans can be used for differential diagnosis.

How Is Sciatica Treated?
One of the most important treatment approaches for preventing sciatica is strengthening the back and lower back muscles. Maintaining proper posture and avoiding poor sitting habits are essential. Supporting the back, waist, and arms while sitting, and avoiding prolonged standing, immobility, or heavy lifting can also help prevent sciatica.
The intensity of sciatic pain varies from person to person. Treatment should be tailored accordingly. In some cases, muscle relaxants and pain relievers may be sufficient, while more severe cases may require treatments such as epidural steroid injections. Physical therapy methods are especially crucial in managing sciatica. In rare cases, surgical intervention may be necessary.