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 due to nerve damage in the central nervous system — so 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 also may increase your risk of developing sciatica.

Read on to learn about sciatica, its causes and symptoms, and the treatment options available.

What Is Sciatica?

“Sciatica” is the term used to describe pain that follows the course of the sciatic nerve in the body. The medical term 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, starting in the lower back and traveling 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 one of the most common complaints people have when they visit a doctor. Researchers estimate that sciatica affects between 10 percent and 40 percent of people at some point in their life.

Common Symptoms of Sciatica

Symptoms of sciatica follow the path of the nerve itself and can occur anywhere along that path. Pain typically starts from the lower back, then travels down to the buttocks and to the back of the thigh and calf. Pain can vary in intensity –– for some people, it’s a mild ache, and for others, it’s severe and sharp. The pain can also feel like an electric shock.

Members of MyMSTeam often describe their experiences living with this kind of pain. “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,” one MyMSTeam member shared.

Another wrote, “I’m having a serious issue with my sciatic nerve. Two weeks now, resting, icing, and stretching. The pain is hard! I called my neurologist, who said to start PT. Honestly, I don’t know if I can even get out to my van, and someone will have to drive me.”

Even though the sciatic nerve travels along both legs, sciatica pain typically affects only one side of the body. In addition to pain, numbness and tingling can occur. In more severe cases, the leg and/or foot can become weak.

Can MS Increase Your Risk of Sciatica?

Certain symptoms of sciatica and MS can overlap, sometimes making it hard to tell these two conditions apart. Back pain and leg pain in MS, along with muscle spasms and burning or tingling sensations, can mimic sciatica symptoms. But pain in MS is from lesions — damage or scarring — that cause inflammation in the central nervous system.

Research is limited as to whether MS increases the risk of sciatica, but some aspects of living with MS that may put you at higher risk. MS can lead to changes in lifestyle and the body that may put you at greater risk of developing sciatica. Some examples include prolonged sitting due to disability, weight gain, and living a sedentary lifestyle, all of which are known risk factors of sciatica.

One study in 2017 investigated the number of peripheral nervous system lesions 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) as compared to people without MS. This may suggest that people with MS could have a higher likelihood of sustaining damage to certain peripheral nerves too, including the sciatic nerve.

Additionally, since up to 40 percent of people will have sciatica at some point in their life, it only makes sense that people with MS will have it too. MS is most common in people aged 30 to 50 years old, and the same is true for sciatica. People with MS are also more likely to develop piriformis syndrome, which also causes low back pain and tingling in the legs.

There are some ways to help determine if pain you’re experiencing is from MS or sciatica. First, if you’re experiencing shooting pain down only one leg, it’s more likely sciatica. Second, consider if certain activities or events trigger the pain, such as weightlifting, an accident, or a relapse.

Other Risks Factors

Most often, sciatica is caused by age-related changes of the spine, leading to bulging or herniated discs that then compress the nerve and cause pain. However, there are a number of other risk factors that can contribute to the development of sciatica, including:

• Obesity
• Poor posture (especially while lifting weights)
• Prolonged sitting
• Tumor
• Blood clot
• Abscess
• Diabetes
• Back injury
• Smoking
• Osteoarthritis
• Certain jobs that require heavy lifting or back twisting

Diagnosis of Sciatica

A doctor can diagnose sciatica by taking your medical history and conducting a physical examination. During the examination, they may check your muscle strength and reflexes, such as by having you walk on your toes or heels or left your legs while lying on your back. They may use imaging tests, such as spinal X-rays, MRIs, and CT scans, to determine if you have sciatica and what’s causing it.

Treatment of Sciatica

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

There are several treatment options that may help you find relief if you’re battling sciatic nerve pain.

Conservative Treatment

Sciatica usually heals all by itself with time and rest. First-line medical treatment involves trying to limit the pain, which typically involves the use of:

• Hot or cold packs applied to muscles
• Nonsteroidal anti-inflammatory drugs (NSAIDS)
• Muscle relaxants
• Oral steroids
• Steroid injections around the nerve root
• Opioids
• Ion channel blockers
• Noradrenergic acting medications
• Local anesthetics (lidocaine patch)

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

Acute sciatica will typically get better in four to six weeks with conservative treatment. People living with chronic pain from sciatica lasting more than eight weeks usually have longer treatment courses.

Surgery

Generally speaking, if conservative treatment does not relieve pain after six to 12 weeks, or your leg weakness or numbness gets worse, a doctor may use advanced imaging — CT or MRI — to assess what’s happening. If they find a nerve root compression, surgery may be an option.

Because sciatica is caused by prolonged pressure on a spinal nerve, proper treatment is critical to avoiding long-term complications. If chronic pressure is not relieved on the nerve, complications may include:

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

Surgical treatment of sciatica typically involves either removing the part of the herniated disc that is impinging upon the nerve or removing part of the bone (e.g., bone spur) that is pressing against the nerve. Surgery is reserved for when sciatica is associated with new and significant weakness or bowel or bladder problems, or when it hasn’t gone away after conservative therapy.

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 not only help you identify the source of the pain but also work with you to develop 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 198,000 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.