If you’re living with multiple sclerosis (MS), you may have experienced shooting pain down one leg at one point or another. Some people wonder whether this type of pain is a symptom of MS or if it might be caused by another condition — namely sciatica.

“Have any of you ever had pain that feels like sciatica nerve pain? Is this MS? Or sciatica?” asked one MyMSTeam member. “My doctor says it is MS pain, but I feel like it is my sciatic nerve.”

Pain is a common symptom of MS, typically caused by nerve damage in the central nervous system. Pain sensations from MS and from sciatica can feel quite similar. It’s also possible to have both conditions at the same time. Certain aspects of MS may also increase your risk of developing sciatica.

Read on to learn how to tell if your pain is related to a pinched nerve or MS flare, as we discuss the causes, symptoms, and treatment of sciatica.

What Is Sciatica?

“Sciatica” is the term used to describe pain that follows the path of the sciatic nerve. The medical term for this is “lumbar radiculopathy.” The sciatic nerve is part of your peripheral nervous system, which is the part that lies outside your brain and spinal cord. It’s also the longest and thickest nerve in the body. It starts in the lower back and travels through the buttocks and down each leg.

Pain from the sciatic nerve develops when something — usually a herniated disc or a bony overgrowth — puts pressure against or compresses the nerve, leading to inflammation.

Sciatica is fairly common. Researchers estimate that sciatica affects between 10 percent and 40 percent of people at some point in their life.

Common Symptoms of Sciatica

The symptoms of sciatica follow the path of the nerve itself, and they can happen anywhere along that path. Pain usually starts in the lower back and travels down the buttocks and to the back of the thigh and calf. The pain can vary in intensity — for some people, it’s just a mild ache, while for others, it’s sharp and intense. The pain can also feel like an electric shock. You might also wonder, “Does sciatica cause swelling?” Yes, sometimes it can even make your leg swollen and inflamed.

Members of MyMSTeam often share their experiences with this kind of pain. One MyMSTeam member wrote, “Does anyone have any suggestions for sciatica pain? I have been dealing with some pretty horrible sciatica for the past five days, especially at night. I am not sleeping.”

Another member shared, “I’m having a serious issue with my sciatic nerve. It’s been two weeks now. I’ve been resting, icing, and stretching. The pain is hard! I called my neurologist, who said to start physical therapy. Honestly, I don’t know if I can even get to my van. Someone will have to drive me.”

Even though the sciatic nerve runs down both legs, sciatic pain typically affects only one side of the body. In severe cases, it can cause numbness, tingling, or weakness in the leg or foot.

Can MS Cause Sciatica?

Certain symptoms of sciatica and MS can overlap, which can make it hard to tell the difference between the two. Back pain and leg pain in MS, along with muscle spasms and burning or tingling sensations, can feel similar to sciatica. However, pain in MS comes from lesions — damage or scarring — that cause inflammation in the central nervous system . Sciatica, on the other hand, is most often caused by changes in the spine, such as herniated discs or bone spurs, that compress the nerve and cause pain. Research on whether MS increases the risk of sciatica is limited. However, some aspects of the condition may make you more likely to develop sciatica.

MS-Induced Lifestyle Factors

MS can lead to changes in your lifestyle and body that may increase your risk for sciatica. For example, sitting for long periods of time due to disability, gaining weight, and living a sedentary lifestyle, are all known risk factors for sciatica.

MS Lesions Along the Sciatic Nerve

A 2017 study looked at the number of lesions in the peripheral nervous system in people living with MS. The researchers found that people with MS had more lesions in the tibial and peroneal nerves (which are extensions of the sciatic nerve) compared to those without MS. This suggests that MS may increase the chance of damage to certain peripheral nerves, including the sciatic nerve.

Shared Risk Factors for MS and Sciatica

Since up to 40 percent of people will have sciatica at some point in their life, it’s no surprise that people with MS may also develop it. MS most commonly affects people aged 20 to 40, while sciatica is most common in people aged 30 to 50.

The Difference Between Symptoms of MS and Sciatica

There are some ways to tell the difference between MS pain and sciatica. What does MS leg pain feel like? One MyMSTeam member said, “I have constant pain and heaviness in both of my legs due to muscle spasms.” This type of pain is more typical of MS.

On the other hand, if you’re experiencing shooting pain down only one leg, it’s likely sciatica. Consider if your pain is triggered by certain activities or events, such as weightlifting, an accident, or an MS relapse. Identifying these triggers can help you and your healthcare provider determine whether MS or sciatica is causing the pain. The only sure way to tell the difference is by discussing your specific symptoms with your healthcare provider.

Diagnosis of Sciatica

To diagnose sciatica, a doctor will review your medical history and perform a physical exam. During the exam, they may check your muscle strength and reflexes by having you walk on your toes or heels or lift your legs while lying on your back. They may use imaging tests, such as spinal X-rays, MRIs, and CT scans, to determine whether you have sciatica and identify what’s causing it.

Treatment of Sciatica

Members of MyMSTeam have asked about treatment options for sciatica. One member asked, “Does anyone deal with sciatica pain? This sciatic nerve pain never seems to subside. I’ve tried everything — stretching/exercise/yoga, heating pad, ice pack, muscle relaxers, ibuprofen — and nothing has helped.”

If you’re dealing with sciatic nerve pain, there are several treatment options that may help you find relief.

Conservative Treatment

Sciatica usually heals on its own with time and rest. The first approach to medical treatment involves pain management, which may include:

• Hot or cold packs, applied to the muscles
• Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDS)
• Muscle relaxants
• Steroid injections
• Antidepressants
• Anti-seizure medications
• Noradrenergic acting medications, like some antidepressants

Physical therapy is often part of the treatment approach too. It can help correct posture and provide different exercise techniques to improve your core strength and range of motion. Sometimes, osteopathic or chiropractic manipulation is also used to treat sciatica. In addition, alternative therapies such as deep tissue massage, acupuncture, and yoga may also help.

Sciatica usually gets better in six to eight weeks with conservative treatment. People living with chronic pain from sciatica that persists beyond eight weeks usually have longer treatment courses and may need surgery.

Surgery

If conservative treatment does not relieve pain after six to eight weeks, or if your leg weakness or numbness gets worse, a healthcare provider may recommend imaging tests, like an MRI or CT scan, to assess what’s happening. If these tests reveal nerve root compression, surgery may be an option.

Because sciatica is caused by prolonged pressure on a spinal nerve, it’s important to treat it properly to avoid long-term complications. If pressure on the nerve is not relieved, complications may include:

• Worsening pain
• Weakness and/or loss of sensation in the leg
• Loss of bladder and/or bowel function
• Permanent nerve damage

Surgical treatment for sciatica typically involves either removing the part of the herniated disc that is pressing on the nerve or removing part of the bone (e.g., a bone spur) that is pressing against the nerve. Surgery is generally only recommended when sciatica is accompanied by weakness or bowel or bladder problems or when conservative treatments haven’t worked.

Contact Your Neurologist for Answers

If you’re concerned about what may be causing your leg pain — sciatica, MS, or something else — talk to your primary care provider or neurologist as soon as possible. They can help you identify the source of your pain and create a treatment plan that can help you manage these symptoms.

Talk With Others Who Understand

MyMSTeam is the social network for people with MS and their loved ones. On MyMSTeam, more than 218,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.

Have you experienced shooting pain down one leg? Did you figure out the cause? Share your experiences in the comments below, or start a conversation by posting on your Activities page.