Sciatica is pain caused by irritation or compression of the sciatic nerve, so the defining feature is that it travels. Typically into the buttock, down the back of the thigh and sometimes past the knee into the calf or foot, often with pins and needles, numbness or a feeling of weakness. Back pain that stays in your back is a different problem needing different treatment, and telling the two apart properly is the first useful thing an assessment does.
More information
How long does sciatica last
Longer than most people are told, and shorter than it feels while you are in it. Many cases improve substantially over several weeks to a few months, and most settle without surgery. Where a disc is pressing on the nerve, the disc itself frequently reduces over time. That is genuinely reassuring, and it is also why patience is part of the treatment.
What treatment involves
Settling the nerve irritation first, which usually means finding the positions and movements that ease it rather than aggravate it, and often means changing what you have instinctively started doing. Then restoring movement, then strength. We will be honest about the pace, because sciatica does not respond well to being rushed.
Medication is worth discussing with your GP alongside physiotherapy. NICE advises against gabapentinoids for sciatica, so if you have been offered something and are unsure, that is a conversation to have with them rather than with us.
When it needs urgent attention
Numbness around the saddle area, difficulty controlling your bladder or bowel, or weakness in both legs is an emergency and needs hospital assessment the same day. Progressive weakness in one leg, such as a foot you cannot lift properly, should be seen promptly.
Frequently Asked Questions
How do I know if it is sciatica?
How long does sciatica take to get better?
When is sciatica an emergency?
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