Sciatica

What happens when you have sciatica?

Sciatica is pain that travels down your leg. It happens when a large nerve called the sciatic nerve gets squashed or irritated. This nerve runs from your lower back all the way down to your feet.

The pain usually affects your bottom and the back of one leg. It can even reach your foot and toes.

What does sciatica feel like?

You might notice:

• Sharp, burning pain down the back of your leg
• Tingling feelings (like pins and needles)
• Numbness in your leg
• Weakness in your leg or foot
• Back pain (though this is usually not as bad as the leg pain)

The pain might start suddenly or build up slowly. It often gets worse when you move, sneeze, or cough.

Important: If you only have back pain with no leg pain, you probably don't have sciatica.

How can you help yourself feel better?

The good news is that sciatica usually gets better on its own within a few weeks to a few months. Here's what you can do:

Things that help:

• Keep doing your normal activities as much as you can
• Try gentle exercise - anything that gets you moving
• Use heat packs on painful areas (you can buy these from the pharmacy)
• Ask your pharmacist about painkillers (though paracetamol doesn't usually help much with sciatica)

Things to avoid:

• Don't sit or lie down for long periods
• Don't worry that moving will harm you - it actually helps you get better faster

When should you speak to your GP?

See your GP if:

• The pain hasn't improved after trying home treatments for a few weeks
• The pain is getting worse
• It's stopping you from doing your normal activities

Emergency warning signs

Call 999 or go to A&E immediately if you have:

• Sciatica pain in both legs
• Severe weakness or numbness in both legs that's getting worse
• Numbness around your bottom or private parts
• Problems starting to wee, can't wee, or can't control when you wee (if this isn't normal for you)
• Can't tell when you need to poo or can't control when you poo (if this isn't normal for you)

These signs could mean a serious back problem that needs hospital treatment straight away.

Don't drive to A&E - ask someone to drive you or call an ambulance.

What treatments might help?

If home treatments don't work, your GP might:

• Suggest specific exercises and stretches
• Prescribe stronger painkillers
• Refer you for physiotherapy
• Offer psychological support to help you cope with the pain

For severe cases that don't improve, hospital specialists might offer injections or surgery.

What causes sciatica?

Sciatica happens when something presses on the sciatic nerve. Common causes include:

• A slipped disc (when the soft cushion between spine bones pushes out)
• Narrowing of the spine where nerves pass through
• A spine bone slipping out of position
• A back injury

Can you prevent sciatica coming back?

While sciatica can return, you can reduce your chances by:

• Staying active with regular exercise
• Using good posture when sitting and standing
• Lifting heavy objects safely
• Maintaining a healthy weight
• Not smoking

Remember, if you're worried about any symptoms, speak to your GP for advice.

---

Based on NHS.uk guidance. Written by Dr Krishnan Pasupathi, NHS GP.