What is sciatica?
Sciatica refers to pain caused by irritation or compression of the sciatic nerve, which runs from your lower back, through your buttocks, and down the back of each leg. It is not a condition itself but a symptom of a nerve irritation or compression at the spine, where the nerve exits the spinal canal.
Common symptoms
- Pain radiating from the lower back into the buttock and down the leg
- Tingling, numbness, or pins and needles in the leg or foot
- Muscle weakness in the affected leg
- Pain that worsens with sitting, coughing, or sneezing
- Difficulty standing or walking due to leg pain
What causes sciatica?
- Disc problems
- Spinal stenosis (narrowing of the spinal canal)
- Spondylolisthesis (forward movement of a vertebra on another)
- Injury or trauma to the lower back
Diagnosis
Your clinician may diagnose sciatica based on:
- Your symptoms and medical history & physical examination is the most common way to diagnose this condition.
This is done with a combination of movement tests and nerve tests to assess how well the nervous system is functioning.
- X-rays tend not to add value to support a diagnosis
- MRI scans are sometimes needed to assess your spine, to see if there is compression or irritation of the nerves at the spine.
MRI scans do not always provide a clear answer regarding why you are experiencing symptoms but can be helpful to form a diagnosis for some people.
Self-care and management
1. Stay active
- Avoid prolonged bed rest—gentle movement helps recovery.
- Walking and light stretching can reduce stiffness and improve pain.
2. Pain relief
- Over-the-counter painkillers such as paracetamol or ibuprofen may help.
- Your GP may prescribe stronger medications if needed.
3. Heat or cold therapy
- Warm packs or cold compresses may ease pain and stiffness.
4. Gentle exercises
Try gentle movements to maintain as much flexibility as possible. Simple pilates, yoga or tai chi may be useful, or alternatively you may prefer some fresh air and simply go for a short walk.
When to seek medical advice
- You experience numbness, tingling, or weakness in your legs – consider attending your local emergency department ? CES PIL
- You have new difficulty controlling your bladder or bowels – consider attending your local emergency department ? CES PIL OR PHANTOM CES WEBPAGE?
- Pain is severe or getting worse consider contacting your GP, or self-referring to the MSK service.
Pain lasts more than 6 weeks – consider contacting your GP, or self-referring to the MSK service.
Recovery and outlook
- Time: Most people recover within 4 to 6 weeks with self-care.
- MSK rehabilitation may be recommended for persistent symptoms to improve your flexibility and strength.
- Nerve Root Injections are rarely needed and considered if there are signs of nerve root irritation. Sometimes these are used before surgery to assess whether an operation will be something that is likely to help.
- Surgery is rarely needed and only considered if symptoms are severe or long-lasting and are mainly considered for leg pain, where symptoms match your MRI scan.
Many people have symptoms of nerve root irritation, which whilst painful, may not have a surgical solution.
Useful links
Back pain | Causes, exercises, treatments | Versus Arthritis