Sciatica living patient overview

Overview

Sciatica is a condition where a problem in your lower back, such as a slipped disc, presses on the sciatic nerve. This nerve runs from your lower back down through your buttock and leg. It causes pain, tingling, or numbness along the path of the nerve.

Yes, sciatica is very common. Up to 40% of people will experience it at some point in their lives.

Sciatica can affect anyone, but it is most common in people aged 30 to 50. It can also happen during pregnancy.

Symptoms

Common symptoms

• Pain that travels from your lower back down one leg, often described as sharp, burning, or shooting
• Tingling or pins and needles in your leg or foot
• Numbness in part of your leg or foot
• Weakness in your leg or foot

Symptoms in children

• Sciatica in children is rare, but when it occurs, symptoms are similar to adults: leg pain, numbness, or weakness. Children may also complain of a burning sensation in the buttock or leg.

Symptoms in older adults

• In older adults, sciatica may be caused by age-related changes like spinal stenosis (narrowing of the spine). Symptoms can include aching in the leg when walking that gets better when sitting down.

Causes

Main causes

• A slipped disc (herniated disc) in your lower back that presses on the sciatic nerve
• Spinal stenosis – narrowing of the spine that puts pressure on the nerves
• A bone spur or growth on the spine that irritates the nerve

Risk factors

• Age – most common between 30 and 50 years old
• Jobs that involve heavy lifting, lots of bending, or sitting for long periods
• Obesity – extra weight can strain the spine
• Diabetes – can increase the risk of nerve damage

When to see a doctor

See a doctor urgently if:

• If you have any of the emergency symptoms listed above (loss of bladder/bowel control, saddle numbness, sudden severe weakness)
• If the pain comes on after a major injury

Book a routine appointment if:

• If your pain lasts more than a week and does not improve with self-care
• If the pain is very severe or getting worse
• If you have numbness or weakness that is not improving

Diagnosis

Your doctor will ask about your symptoms and do a physical exam. They will check your strength, reflexes, and feeling in your legs. Most of the time, no special tests are needed.

Tests that may be done

• MRI scan – if symptoms are severe or do not get better, an MRI can show the cause of the nerve pressure
• CT scan – sometimes used instead of MRI
• Nerve tests like electromyography (EMG) – rarely needed, but can check how well the nerve is working

What to expect at your appointment

Your doctor may explain that sciatica usually gets better on its own. They will likely advise you to stay active as much as possible and use simple pain relief like paracetamol or anti-inflammatory medicines (talk to your pharmacist or GP about what is safe for you).

Treatment

The goal of treatment is to relieve pain and help you return to normal activities. Most people get better with simple measures and time. More serious cases may need extra help from a physiotherapist or specialist.

Self-care at home

• Continue your usual daily activities as much as you can – bed rest for more than a day or two can make things worse
• Apply heat or cold packs to the painful area for 15 to 20 minutes several times a day
• Gently stretch your lower back and legs (a physiotherapist can show you safe exercises)
• Over-the-counter pain relief such as paracetamol or ibuprofen (check with your pharmacist if these are suitable for you)

Medical treatments

If self-care is not enough, your doctor may recommend prescription pain relievers, muscle relaxants, or nerve pain medicines. They may also refer you to a physiotherapist for exercises and manual therapy. In some cases, a spinal injection (corticosteroid) around the nerve can reduce inflammation and pain. Always follow your doctor’s advice.

When is surgery considered?

Surgery is rarely needed. It may be considered if you have severe symptoms that do not improve after 6 to 8 weeks of treatment, or if you have worsening weakness or bladder/bowel problems. The most common surgery is a microdiscectomy to remove the part of the disc pressing on the nerve.

Living with this condition

Living with sciatica can be challenging, but most people find that symptoms improve with time. It may help to adjust your posture, take regular breaks from sitting, and avoid heavy lifting. Listen to your body and pace yourself.

Lifestyle tips

• Sit on a chair that supports your lower back – place a small pillow or rolled towel behind you if needed
• When lifting, bend your knees and keep your back straight
• Sleep on your side with a pillow between your knees to keep your spine aligned
• If you stand for long periods, rest one foot on a small stool to take pressure off your back

Diet and exercise

A balanced diet helps maintain a healthy weight, which reduces strain on your back. Gentle exercise like walking, swimming, or yoga can help keep your back and core muscles strong. A physiotherapist can guide you on safe exercises. Avoid high-impact activities until symptoms improve.

Mental health and emotional wellbeing

Chronic pain can be stressful and affect your mood. It is normal to feel frustrated, anxious, or low. Talk to your doctor if pain is affecting your mental health. They may suggest relaxation techniques, talking therapies, or support groups.

Prevention

You cannot always prevent sciatica, but you can reduce your risk by keeping a healthy weight, staying active, and using good posture. Avoid prolonged sitting and lift objects safely.

Complications

If left untreated

• Chronic pain that does not go away
• Permanent nerve damage leading to long-term numbness or weakness in your leg
• Loss of bladder or bowel control if the nerve compression is severe (cauda equina syndrome)

Long-term outlook

The outlook for sciatica is usually very good. About 80-90% of people recover within a few weeks to a few months with simple self-care. Even if symptoms take longer, most people do not need surgery. Staying active and following your doctor's advice gives you the best chance of a full recovery.

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