Everything you need to know about sciatica

Sciatica occurs when your sciatic nerve, the nerve that runs from your lower back to your feet, is irritated or compressed. It usually gets better by itself within around six weeks, but some people experience it for much longer.

If you’re living with sciatica and struggling to find the right treatment, you’re in the right place. We’ve answered the most commonly asked questions about sciatica, covering causes, symptoms, at-home management techniques, and available treatments.

What is sciatica?

Sciatica is a painful condition resulting in back pain that radiates down your leg to your ankle. It can be linked with numbness in your leg and weakness in your foot. The distribution of the pain is along the course of your sciatic nerve, which is the nerve that travels from your lower back through your hips and down each leg. Some people have sciatica for a few weeks, while others can experience it for months at a time. Some people experience the symptoms of sciatica constantly, while others have it in flare ups that come and go depending on many factors such as sitting down for too long, performing certain exercises, or wearing certain footwear.

Who can get sciatica?

Sciatica most commonly affects adults between 30 and 50 years of age. People who are more stagnant in everyday life, for example those who sit down a lot at a desk for work, are more likely to develop sciatica. Type 2 diabetes increases your risk of diabetes-related peripheral neuropathy, which is when the nerves that lie outside your central nervous system (the brain and spinal cord) become damaged. This can sometimes lead to sciatica.

What are the causes of sciatica?

The most common cause of sciatica is a disc prolapse, also known as a herniated disc or slipped disc. Your spinal discs are soft areas of tissue that act as cushions between your back bones (vertebrae), which are the bones in your spine. A herniated disc is when the nucleus pulposus herniates through annulus of the disc, which, in layman’s terms, essentially means that the soft cushion of tissue between your bones has pushed out. This compresses the adjacent nerve root and causes a very painful acute inflammatory reaction in the nerve.

A herniated disc can cause numbness or tingling in many areas of your body, including your lower back, your shoulders, back, arms, and even your hands.

Other causes of sciatica include gradual wear and tear of your spine through localised inflammation near the nerve, typically caused by ageing or overuse. Another is spondylolisthesis, which is where one vertebra slides forward on the other – catching the nerve. Spinal stenosis is another cause, which is the narrowing of the part of your spine where nerves pass through.

More rarely, a severe back injury or cancer might cause a sudden displacement of one of your spinal discs.

Is sciatica serious?

Sciatica itself is not typically considered a life-threatening condition, but it can be quite serious in terms of the pain and discomfort it causes. Chronic pain and the other symptoms of sciatica can have a significant impact on your quality of life.

What are the signs and symptoms of sciatica?

Compression of the roots of the sciatic nerve in your lumbar spine causes pain that radiates down your leg below your knee. You might feel a tightness in your leg and a cramping sensation in your calf and ankle.

The pain from sciatica can be sharp, shooting or burning in nature. It can also feel aching and constant in some cases.

Other symptoms of sciatica include numbness, tingling (often described as pins and needles), and weakness in your affected leg or foot. The pain may vary in intensity, and it can worsen with certain movements like sitting, standing, or coughing.

In severe cases with a large central disc prolapse, people can complain of bowel and bladder problems, such as insensate incontinence. This can cause issues with your bowel function. These symptoms suggest cauda equine syndrome and an urgent referral to A&E is needed.

What is the treatment for sciatica?

Treatment for sciatica aims to relieve pain, reduce inflammation and address the underlying cause of the condition. Some of the most common treatments for sciatica include:

Rest

Take it easy and avoid activities that worsen your pain – this is mostly for people who have less severe sciatica that can come in flare ups. You might have a good understanding of what causes you to flare and therefore a better understanding of how much rest you need to take and when to take it. If you are someone who gets flare ups but you’re not yet sure what causes them or how to handle them, speak to your doctor about the best ways to track your personal experience of sciatica.

Physiotherapy

The majority of cases of back pain with associated sciatica are effectively treated with physiotherapy rather than pain management or surgical procedures. Our expert spinal physiotherapists will initially analyse why the back pain and sciatica have occurred from a lifestyle and biomechanical perspective. Depending on the exact cause found for the back pain and sciatica, our physiotherapists will treat the symptoms with a comprehensive range of manual therapy and rehabilitative exercises.

Medications

Over-the-counter pain relievers such as paracetamol or ibuprofen can help reduce inflammation and pain, and there are also many prescription medications designed to do the same. If your pain and inflammation can be managed, it can allow you to continue with normal life for significant periods of time.

Steroid injections

Injecting corticosteroids into the area around the affected nerve can reduce inflammation and alleviate pain. You can get these injections every few months in some cases.

Back surgery for sciatica

In severe cases where conservative treatments fail, surgery may be considered to address the underlying issue, such as a herniated disc pressing on the nerve. Surgery is a significant undertaking that will only be considered if other options are not able to improve your quality of life.

Get help with Circle Health Group

At Circle Health Group we offer tailored treatment plans for sciatica; our orthopaedic consultants can help you with everything from medication to surgery. We also have bespoke aftercare programmes to help you recover from surgery as soon as possible. To book an initial consultation, call us or use our online booking system. You may need a reference letter from a GP, but our advisors will be able to help you arrange one.

If your sciatica is mild and you would like one of our chartered physiotherapists to help you understand your symptoms and work through them, you can refer yourself to any of our physiotherapy departments. Just give us a call to find your local service.