Sciatica

What is sciatica?

Sciatica is the name for pain that starts in your back and goes down your leg. It occurs when pain travels along the path of the sciatic nerve.

The sciatic nerve comes from nerve roots in your lower spine. It travels through your hip and buttock and down the back of your leg to your knee. Branches of the sciatic nerve go all the way down to your foot.

Anything that presses on the sciatic nerve, or on one of its nerve roots, can cause sciatica. In most cases, the problem is in the spine — even though you feel the pain in your leg.

What are the symptoms of sciatica?

Sciatica is a type of nerve pain, which is usually a burning, stabbing or shooting feeling. It radiates from your buttock down the back of your leg. It often gets worse when you walk, cough, strain on the toilet or go up stairs. Most people only have symptoms in one leg.

You may also feel lower back pain. You might notice pins and needles, numbness or weakness in your leg.

What causes sciatica?

The causes of sciatica include anything that presses on the sciatic nerve or its nerve roots. Most of the time, sciatica is not caused by anything serious. Sometimes, however, sciatica can be caused by:

• a prolapsed disc
• a spinal injury
• bone spurs caused by osteoarthritis
• narrowing of the spinal canal
• a tumour
• an abscess

When should I see my doctor?

See your doctor if you have symptoms of sciatica. They can check what might be causing your symptoms.

It’s very important to see your doctor if you:

• have severe pain at night or when you lie down
• lose weight without trying to
• feel unwell or have a fever
• have tingling, numbness or weakness in both legs
• have had an injury
• feel unsteady when you walk
• have pain and are younger than 16 or older than 50

You should see your doctor again if your symptoms last longer than 4 weeks or become worse.

How is sciatica diagnosed?

Your doctor can usually diagnose sciatica by asking about your pain and examining your spine and legs.

Most people with sciatica don’t need any tests. Your doctor may, however, arrange an x-ray or MRI scan of your spine if you have symptoms that suggest a more serious cause for your pain. If you have no signs of a serious cause, your doctor is most likely to recommend you wait and see if your symptoms get better. If they don’t get better, your doctor might arrange an imaging scan to inform what to do next.

How is sciatica treated?

Sciatica usually goes away in time. If your first experience of sciatica is sudden and severe, you may need to rest in bed for a short time — but not for longer than 2 days. It’s important to return to activity as soon as possible, to prevent your back becoming stiff and weak. Ask your doctor or pharmacist about pain medicine, if pain is preventing you from regular activities.

Try to go to work and do your usual activities. Take regular breaks and change your position often.

Other treatments may include:

• pain relief medicines such as paracetamol and anti-inflammatory medicines
• heat or cold packs for pain relief
• gentle exercise and stretching
• physiotherapy
• medicines for nerve pain

If your symptoms persist, you might have an injection of steroid medicine into your spine. In rare cases you may need surgery.

Can sciatica be prevented?

You can lower your risk of sciatica by protecting your back, for example, by:

• maintaining good posture
• trying not to sit or stand for a long time — change positions frequently to reduce stress on your back
• maintaining a healthy weight
• getting regular exercise to improve your general fitness
• doing exercises to strengthen your core muscles
• lifting safely — bend your knees, not your back