In endometriosis, endometrial tissue spreads beyond the uterine lining. Generally, endometrial growths form in the pelvic region, but in the case of sciatic endometriosis, the growths form in areas near or on the sciatic nerve. The sciatic nerve extends through the hips and down each leg until reaching the knee, where it branches into smaller nerves. It is the most substantial and longest nerve in your body.

Endometrial growths on the sciatic nerve can compress the nerve, leading to pain, numbness, or tingling in the leg. Some people may experience drop foot, in which weakness makes it difficult to lift your foot.

“Sciatica” is the term for pain caused by irritation or pressure on the sciatic nerve. The prevalence of sciatica is high, with about 40 percent of people in the U.S. reporting that they’ve experienced sciatica at some point during their lifetime. Although sciatica is widespread among the general population, endometrial tissue joined to the sciatic nerve is considered quite rare. It is more common that endometriosis occurs near the nerve. Endometrial growths can cause pain up to an inch from any lesion.

If you have lower back pain or pain or tingling down the back of your leg, diagnostic tests can help your doctor determine whether your sciatica is related to endometriosis or other causes. If endometriosis is the reason for your sciatica, treatments like oral contraceptives or laparoscopic surgery can help address the root cause before it leads to more serious problems like neuropathy (nerve damage).

Diagnosing the Cause of Sciatica

Sciatica has many causes, and, for people diagnosed with endometriosis, it may or may not be related to the condition. To determine if your endometriosis and sciatica are related, try to determine whether your sciatica is more intense during your menstrual cycle or if the pain is the same regardless of menstruation. Sciatic endometriosis is sometimes called cyclic sciatica because its severity tends to fluctuate in response to hormonal shifts.

Other potential causes of sciatic pain include:

• Herniated disk (slipped disk)
• Piriformis syndrome (a gluteal muscle condition)
• Injury to the pelvis
• Spinal stenosis (compressed spinal nerve)
• Tumor near the nerve

Some of the general risk factors for sciatica include:

• Advanced age
• Arthritis
• Excess weight
• Diabetes
• Past injuries
• Smoking

If your doctor suspects that endometriosis is the cause of your sciatic pain, they will likely use laparoscopy (a minimally invasive surgery) to biopsy the area. Less invasive imaging technologies, such as magnetic resonance imaging (MRI), X-rays, and computed tomography (CT) scans, can also be helpful. If the biopsy shows that endometriosis is affecting your sciatic nerve, the doctor can recommend ways to alleviate your pain or to remove the lesion that’s surrounding the nerve.

Managing Endometriosis-Related Sciatic Pain

People describe sciatica as sharp, stabbing pain or pain that radiates and burns. The pain typically affects one side of the body and is most intense in the buttocks and down the leg, but it may be felt in the lower back as well. Extended periods of standing or sudden twists and turns can make sciatic pain worse. For some people, sciatic pain comes and goes, while for others, it’s constant.

If you suspect that you have sciatic endometriosis, it’s crucial to seek treatment sooner than later. When left untreated, sciatica, no matter its root cause, can progress to severe nerve damage. You may also develop unbalanced muscle weaknesses if leg pain from sciatica limits or affects your movement.

You may need to experiment with a few different methods before finding the best way to get a handle on sciatic pain from endometriosis.

Oral Contraceptives

Birth control pills or other forms of hormonal contraception can help treat endometriosis by regulating, shortening, or stopping the menstrual cycle. This approach may help address the root cause of your sciatica and thus alleviate sciatic pain.

Hot and Cold Therapies and Massage

Members of MyEndometriosisTeam have suggested tips for managing sciatic nerve pain. As one shared, “During the day, I try to find the spots that hurt the most and put Salonpas patches on them. I have a HoMedics massage cushion that helps, or I roll a tennis ball up and down my leg.” Another said, “A heating pad helps — or ice packs.”

Pain Medication

Research is mixed on whether anti-inflammatory medications (including nonsteroidal anti-inflammatory drugs, or NSAIDs, such as ibuprofen) are effective for endometriosis pain. Ideally, NSAIDs should be taken with food to reduce gastrointestinal upset. In addition, these medications work best when taken before the pain is expected to begin, so you may want to start them a few days before your period, when hormonal shifts cause endometrial tissue to build up and then shed.

Another potential option is codeine-based painkillers. However, a common side effect of these medications is constipation, so they may be problematic for people already experiencing pelvic pain from endometriosis. Ask your doctor before taking any pain medications to determine if they’re a good choice for you.

Physical Activity

Lifestyle changes can’t eliminate endometriosis, but physical activity, good posture, and a strong core can help reduce back pain and sciatica associated with the condition.

Other Pain Management Techniques

Some of the same pain management strategies for endometriosis may also help with sciatic pain. For instance, physical therapy, behavioral therapy, and acupuncture are all potential ways to help your body deal with chronic pain. One member of MyEndometriosisTeam shared, “Chiropractic care helped my sciatica immensely!”

Nerve Blocks

A sciatic nerve block is an injection that contains steroids and anesthetics. When administered by a health care professional, sciatic nerve blocks can provide significant pain relief for an extended time. The injection may be repeated on a scheduled basis to maintain pain control.

Laparoscopy

Sometimes problematic endometrial tissue may be surgically removed through a laparoscopy to alleviate sciatic endometriosis pain permanently. After an operation to remove endometriosis and relieve secondary pain or compression on the sciatic nerve, your gynecologist may prescribe hormone therapy to continue suppressing any remaining symptoms of endometriosis.

Talk With Others Who Understand

MyEndometriosisTeam is the social network for people with endometriosis and their loved ones. On MyEndometriosisTeam, more than 122,000 members come together to ask questions, give advice, and share their stories with others who understand life with endometriosis.

Do you have sciatica and endometriosis? Do the symptoms of one affect the other? Share your experience in the comments below, or start a conversation by posting on MyEndometriosisTeam.