Sciatica 

 

Sciatica is the name given to any sort of pain caused by irritation or compression of the sciatic nerve.

The sciatic nerve is the longest nerve in your body. It runs from the back of your pelvis, through your buttocks, and all the way down both legs, ending at your feet.

The pain of sciatica is usually felt in the buttocks and legs.

Most people find it goes away naturally within a few weeks, although some cases can last for a year or more.

This topic covers:

Symptoms

When to seek medical advice

Causes

Treatment

Prevention

Symptoms of sciatica

When the sciatic nerve is compressed or irritated, it can cause:

• pain
• numbness
• a tingling sensation that radiates from your lower back and travels down one of your legs to your foot and toes
• weakness in the calf muscles or the muscles that move the foot and ankle

The pain can range from being mild to very painful, and may be made worse by sneezing, coughing or sitting for a long period of time.

While people with sciatica can also have general back pain, the pain associated with sciatica usually affects the buttocks and legs much more than the back.

When to seek medical advice

See your GP if your symptoms are severe, persistent or getting worse over time.

Your GP can usually confirm a diagnosis of sciatica based on your symptoms and recommend appropriate treatment. Sometimes they may refer you to a specialist doctor or a physiotherapist for further help.

A simple test, known as the passive straight leg raise test, can also help your GP identify whether you have sciatica.

This test involves lying flat on your back with your legs straight, and lifting one leg at a time. If lifting one of your legs causes pain or makes your symptoms worse, this usually suggests sciatica.

You should immediately call 999 for an ambulance if you experience all of the following:

• tingling or numbness between your legs and around your buttocks
• recent loss of bladder or bowel control, or both
• sciatica in both of your legs

Although it's rare, these symptoms can be a sign of a serious condition called cauda equina syndrome.

Causes of sciatica

In the vast majority of cases sciatica is caused by a slipped disc. A slipped disc occurs when one of the discs that sit between the bones of the spine (the vertebrae) is damaged and presses on the nerves.

It's not always clear what causes the damage, although as you get older your discs become less flexible and more likely to rupture.

Less common causes include:

• spinal stenosis – narrowing of the nerve passages in the spine
• spondylolisthesis – when a vertebra slips out of position
• a spinal injury or infection
• a growth within the spine – such as a tumour
• cauda equina syndrome – a rare but serious condition caused by compressed and damaged nerves in the spinal cord

Treating sciatica

Most cases of sciatica pass in around six weeks without the need for treatment.

A combination of things you can do at home – such as taking anti-inflammatory painkillers for any back pain, staying active and exercising, and using hot or cold packs – may help reduce the symptoms until the condition improves.

Further treatment may be needed in some cases, such as:

• an exercise programme under the supervision of a physiotherapist
• injections of anti-inflammatory and painkilling medication into your spine
• stronger painkiller tablets
• manual therapy (treatments such as manipulating the spine and massage, usually carried out by physiotherapists, chiropractors or osteopaths)
• psychological therapy and support

In rare cases surgery may be needed to correct the problem in your spine.

Read more about treating sciatica.

Preventing sciatica

You can minimise your risk of a further episode of sciatica by:

• adopting a better posture and lifting techniques at work
• stretching before and after exercise
• exercising regularly

While sleeping, your mattress should be firm enough to support your body while supporting the weight of your shoulders and buttocks, keeping your spine straight.

If your mattress is too soft, place a firm board under the mattress. Support your head with a pillow, but make sure your neck isn't forced up at a steep angle.

Read about:

How to lift correctly

How to sit correctly

How to warm up before exercise

Stretching after exercise