Sciatica – how to treat and prevent it

If sciatica is affecting your daily life, find out what can help plus take steps to stop it happening again.

What are the symptoms?

When to seek urgent help 

What causes it?

Who’s affected by sciatica?

Self-care tips

When to see a doctor

How is it diagnosed?

What are the treatments? 

Prevention tips

Where to get support

Different to regular back pain, sciatica affects the sciatic nerve, which runs from your lower back to your feet, causing distinctive feelings of tingling and numbness. Self-care steps can help to improve sciatica and prevent it from coming back.

Sciatica describes pain and other symptoms caused by compression (pressure) or irritation of the sciatic nerve, which runs from your buttocks to your feet. 

This can be due to issues such as a herniated disk (meaning the cushion of tissue between bones in your spine bulges out).

Sciatica usually gets better within 6 weeks, but it can last longer. 


## What are the symptoms?

Sciatica can affect your buttocks, the backs of your legs, feet and toes, and cause symptoms including:
- pain, which may be a burning, shooting or stabbing feeling
- tingling
- numbness
- weakness, which may affect movement in that leg.

It can also cause back pain, but that’s typically less severe than the pain affecting the other areas. 

Usually, pain is on one side of your body. You may find your symptoms are worse at certain times, such as when you move, sneeze, or cough.


Get help with this

## When to seek urgent help 

Get emergency medical help if you have sudden numbness or weakness in both legs, have numbness around your buttocks (anus) or under/around your genitals, the pain started after a violent injury, and/or you have issues controlling your bowels or bladder – these symptoms can indicate a more serious condition. 

## What causes it?

The symptoms of sciatica are caused by damage to, or something putting pressure on, the sciatic nerve – which is a bundle of nerves, from 5 roots that branch off your spinal cord. 

You have a sciatic nerve on each side of your body, and these split into other nerves below your knee. Any of these connected areas can be affected if something is pressing or rubbing on the sciatic nerve. The most common reasons for this include:

- a herniated disk, sometimes called a slipped, ruptured, or bulging disk, when an area of soft tissue between the bones in your spine pushes out
- spinal stenosis, a narrowing of the part of your spine that has nerves passing through it
- a back injury
- spondylolisthesis, when a bone in your spine slips out of position. 


## Who’s affected by sciatica?
Anyone can get symptoms but some factors can raise your risk, including:
- being overweight or obese, as this can mean your back muscles have to work harder
- work that involves heavy lifting or working in awkward positions – or work that involves sitting for long periods
- having type 2 diabetes, which is linked with damage to the nerves that can contribute to sciatica
- wear and tear due to aging, which can lead to conditions that cause sciatica
- a current or previous injury to your lower back
- using tobacco, which affects circulation and increases your risk of chronic pain conditions. 


## Self-care tips
Sciatica often gets better on its own with self-care steps. These include:

- staying active – you may benefit from resting at first but after the first 2 or 3 days, try to carry on with your daily life as far as you can. Bed rest isn’t recommended for sciatica
- taking some gentle exercise 
- trying gentle stretches for sciatica – your healthcare professional may be able to suggest some 
- using cold and heat packs – try applying a cold pack (wrapped in a cloth) to the painful area for up to 20 minutes several times a day. You could also try shop-bought heat packs after the first 2 or 3 days, and using alternate hot and cold methods
- if the pain is persistent, taking over-the-counter painkillers such as ibuprofen can be helpful. 

## When to see a doctor
Sciatica often feels better after a few weeks of self-care. See your healthcare professional if symptoms don’t ease, get worse, or are getting in the way of your normal activities.

Get urgent medical help if you meet any [red flag symptoms](https://www.livehealthily.com/health-library/conditions/sciatica#emergency-help), that could indicate a serious back problem. 


## How is it diagnosed?
Your healthcare professional will ask about your symptoms and medical history, and will carry out a physical exam, which may include:
- observing how you walk
- a straight leg raise test, where you lie on your back on a table, and your healthcare professional slowly raises each leg, while asking you when you start to notice symptoms – this helps them identify the underlying cause
- other tests to check strength and flexibility.

They may also order further tests, such as MRI scans and X-rays of your spine.


## What are the treatments? 

If self-care doesn’t improve your sciatica symptoms, your healthcare professional can offer a range of treatments. These include:

- a program of physical therapy aiming to ease the pressure on the nerve
- prescription medications, including anti-inflammatories to relieve pain
- spinal injections of medications such as corticosteroids (if pain is severe and other treatments have not helped), which may relieve symptoms for up to 3 months
- surgery – only recommended in severe cases. Surgery options include diskectomy, which removes any pieces of a herniated disk pressing on the sciatic nerve. 

Some people try complementary and alternative medicine to treat sciatica, such as massage therapy, chiropractic, and acupuncture. Your healthcare professional can advise.

## Prevention tips

The following steps can help to lower your risk of sciatica, or prevent it from happening: 

- make sure you have good posture, and if you work at a desk, check you’re sitting correctly
- stay active – include exercise that strengthens your core muscles (within the abdominals and back) and improves flexibility, such as strength training and stretching
- lose weight if you need to, and stay at a healthy weight
- prevent back injuries – for example, make sure you lift heavy objects safely
- don’t smoke or vape. 


## Where to get support

Support organizations offer information on everything from managing your condition to your rights at work when you’re living with pain. For example:

- [National Spine Health Foundation (US)](https://spinehealth.org)
- [The Bone Health Foundation (Australia)](https://www.bonehealth.org.au)
- [The Brain Charity (UK)](https://www.thebraincharity.org.uk/condition/sciatica)

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References

Charlotte Haigh

Jo Wheatley

Dr Tamer T Malak

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