Sciatica
Also known as Lumbar radiculopathy
This article is general health information for the selected condition. It is not a diagnosis and does not replace clinical judgement. If you have questions or need treatment advice, please consult a qualified healthcare professional.
What is sciatica?
Sciatica is pain caused by irritation or compression of a lumbar nerve root, producing pain that radiates from the lower back down the back of the leg, often with numbness or weakness. Most cases improve within six to twelve weeks with conservative care. A small number of red flag presentations need emergency assessment.
Causes
- Lumbar disc herniation pressing on a nerve root
- Spinal stenosis narrowing the nerve canal
- Spondylolisthesis
- Piriformis syndrome in some cases
- Rarely tumour or infection
Symptoms
- Pain radiating from the lower back into the buttock and leg
- Pain typically below the knee
- Numbness or pins and needles in a nerve distribution
- Weakness of the foot or leg
- Pain worse on coughing, sneezing or sitting
- Symptoms usually on one side
Risk factors
- Age between 30 and 50
- Occupations involving heavy lifting or prolonged driving
- Obesity
- Sedentary lifestyle
- Smoking
- Previous back injury
Diagnosis
- History and neurological examination of the legs
- Straight leg raise testing
- Assessment of power, reflexes and sensation
- MRI only if symptoms persist or red flags are present
- Screening for cauda equina red flags at every assessment
Treatment
- Staying active and avoiding prolonged bed rest
- Analgesia, with neuropathic agents used selectively
- Physiotherapy and graded exercise
- Nerve root injection for persistent severe pain
- Surgical discectomy for progressive weakness or refractory pain
- Emergency surgery for cauda equina syndrome
Self care
- Stay as active as pain allows and avoid prolonged bed rest
- Continue walking and gentle movement
- Use heat or cold packs for comfort
- Take regular pain relief rather than waiting for severe pain
- Avoid prolonged sitting and take frequent breaks
- Do prescribed physiotherapy exercises consistently
- Adjust car seat and workstation to reduce lumbar strain
When to see a doctor
Book an appointment if:
- Pain not improving after four to six weeks
- Increasing leg weakness
- Numbness that is spreading
- Pain preventing sleep or work despite pain relief
- Recurrent episodes
- Pain in both legs
Some symptoms need emergency care rather than an appointment. See the warning signs listed above.
Prevention
- Stay physically active and build core and back strength
- Lift with the legs and avoid twisting under load
- Take breaks from prolonged sitting or driving
- Maintain a healthy weight
- Stop smoking, which affects disc health
- Set up your workstation properly
Outlook
Most sciatica improves substantially within six to twelve weeks with conservative management, and staying active produces better outcomes than rest. A minority need injection or surgery, and discectomy gives rapid relief for appropriately selected patients. Cauda equina syndrome is rare but requires emergency surgery to prevent permanent damage.
Common questions
What is cauda equina syndrome?
A rare emergency where nerve roots at the base of the spine are compressed. Warning signs are numbness in the saddle area, difficulty passing or controlling urine, bowel incontinence, or weakness in both legs. It needs immediate hospital assessment.
Should I rest until it settles?
No. Prolonged bed rest slows recovery. Staying as active as pain allows, with gradual return to normal activity, produces better outcomes than resting.
Is surgery usually necessary?
Most people improve without it. Surgery is considered for progressive neurological weakness, cauda equina syndrome, or severe pain that has not settled after six to twelve weeks of conservative treatment.
References
Important: Dard AI is not a medical device and does not diagnose, treat, or replace clinician judgement. This article is general information only. Always consult a qualified healthcare professional about diagnosis and treatment, and seek emergency care for severe or rapidly worsening symptoms.