What is it?
Sciatica is the everyday name for pain that runs from your lower back through your buttock into your leg, sometimes down to your foot. You often feel tingling, numbness or weakness too. Doctors call it lumbosacral radicular syndrome: an irritated nerve root in your lower back.
In most cases a herniated disc is behind it, with a bulging disc pressing on the nerve. In people over 60, a narrowed spinal canal can also be the cause.
Ordinary lower back pain can also spread into your leg without a trapped nerve. Our herniated disc page covers the most common cause in more detail.
Common causes
- A herniated (bulging) disc
- A narrowed spinal canal, mainly over 60
- Work with a lot of twisting
- Being overweight
- Smoking
How we diagnose
We ask where the pain spreads, how it started and what makes it better or worse. Your physiotherapist tests sensation, strength and reflexes in your legs. A few nerve tests show whether a nerve root is irritated, or whether the pain comes from your back or hip.
A scan is not needed in the first weeks. If there is a reason for one later, your GP arranges it.
Treatment approach
The first weeks are about staying active. Your physiotherapist explains where the pain comes from, and together you decide which activities suit you now and how to build them up.
If the pain limits your work, sport or sleep, you work on strength and mobility with exercises. If the nerve is very irritable, you first aim for less pain; otherwise an exercise may briefly increase the pain, as long as it settles within half a day.
Expected recovery
In 3 out of 4 people the pain is gone within three months, without surgery. If things go well, you build your activities back to your old level over 6 to 12 weeks.
If the pain has not eased enough after 6 to 8 weeks, your physiotherapist refers you back to your GP.
