Sciatica

This information may be useful for those who have been diagnosed with sciatica. People who are experiencing new or ongoing symptoms should visit their healthcare professional for assessment, diagnosis or treatment.

What is Sciatica?

Sciatica is a common condition and can also be known as nerve root or radicular pain. Sciatica is a term used to describe pain felt in the leg but which often comes from the lower back.

The sciatic nerve starts in the lower back and goes all the way down the back of the leg into the foot. Symptoms can be experienced along any part of the nerve. They can have a sudden or slow onset and can vary from mild to severe.

Symptoms of sciatica  

Sciatica can have a range of symptoms, these can include:

lower back pain
leg pain, often this feels worse than back pain
a change in sensation in the leg or foot
muscle spasms in the back
a weakness in the leg or foot

A change in feeling in the leg or foot can include:

pins and needles
numbness
hot or cold
burning sensations
shooting sensations
sensations that can be hard to describe

What causes Sciatica? 

Sciatica can be caused by irritation of the nerves which travel from the spine down the legs.  This can be from inflammation around the nerves and in some cases from pressure, usually from a disc related change. 

Most symptoms of sciatica will improve with time. Nerves are resilient and in most cases inflammation and any disc changes resolve allowing nerves to recover. 

Diagnosing sciatica

In order for sciatica to be diagnosed you'll need an assessment from a healthcare professional.

They'll ask you questions about your back and leg issue and then carry out a physical examination. This may include checking your range of movement and strength.

You may sometimes need to have a further examination to rule out other possible health conditions.

Is a scan needed? 

A scan rarely changes how you manage the condition in the early stages. X-ray and MRI is generally not advised in people with sciatica. This is because structural changes of the spine are very common with age and often present in people who have no symptoms. 

A scan can be considered if your symptoms are unchanged for more than 12 weeks, continue to greatly impact your quality of life and you wish to consider surgery. Your healthcare professional can discuss this with you.  

How long does sciatica last? 

Sciatica usually improves within 12 weeks but this can vary significantly between individuals. For some people symptoms take up to a year to settle but can come and go within this time.

 It's important to remember, lots of things can influence symptoms such as poor sleep, stress and emotional wellbeing. 

When to get professional advice

Rarely, sciatica can cause a condition called Cauda equina syndrome to develop.

Cauda equina syndrome

Cauda equina syndrome is a rare but serious back condition which can lead to permanent damage or disability. If you develop this condition you'll need to be seen by an emergency specialist spinal team.

Urgent advice: Phone 111 as soon as possible if you have:

loss of feeling/pins and needles between your inner thighs or genitals
numbness in or around your back passage or buttocks
altered feeling when using toilet paper to wipe yourself
increasing difficulty when you try to urinate
increasing difficulty when you try to stop or control your flow of urine
loss of sensation when you pass urine
leaking urine or recent need to use pads
not knowing when your bladder is either full or empty
inability to stop a bowel movement or leaking
loss of sensation when you pass a bowel motion
change in ability to achieve an erection or ejaculate
loss sensation in genitals during sexual intercourse

If you have had a new significant trauma affecting your back in the last 7 days, for example a fall from height or a direct impact to the back area, you should also phone 111.

Treatment of sciatica

Most people will recover from sciatica with a combination of time, modifying activity, and pacing themselves to allow the nerves to adapt. Pain medication, staying active, and gentle exercise will also help.

The nerve can still be sensitive so it is recommended to build up your tolerance to activities slowly.  The little and often approach to movement is recommended.

Self help

There are some things you can do to help manage this condition yourself.

Visit our back problems page to find out how to help your sciatica symptoms

Work

A back problem can sometimes mean you need to take some time off work to help recovery. How long you're off will depend on the nature of your condition and your role at work.

You do not need to be symptom free before you consider returning to work. Continuing to go to work, or returning to work as soon as is possible for you, will help your recovery. Gradually getting back to your normal daily activities can help to build up your strength and stamina levels.

Help and support  

Following this advice, you should see gradual improvements over time.

You should see the biggest change in your symptoms within the first couple of weeks. Most problems should have improved within 6 weeks.

If your sciatica hasn’t improved within 6 weeks of following this advice, or if your symptoms get worse at any time, talk to a healthcare professional about your symptoms.

Find out about access to MSK services in your area

When dealing with any health condition it's important to also look after your mental wellbeing as this can impact your recovery.