Sciatica

Sciatica is the pain caused when your sciatic nerve is pinched or compressed. You usually feel this pain in your buttock or leg. There are things you can do to reduce your pain and make it less likely to happen in the future.

Key points

  • The sciatic nerve is the longest nerve in your body. It runs from the back of your pelvis down through your buttocks (bottom) and legs to your feet. 
  • When this nerve is compressed or pinched, the pain can be mild or severe. You will feel it down one buttock and leg.
  • Some people call this a ‘trapped nerve’.
  • The pain usually goes away in a few weeks, but it can last up to a year.

Call 111 and ask for an ambulance if you experience the following:

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

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

What are the causes of sciatica? 

The most common cause of sciatica is a slipped disc. Discs sit between the bones of your spine (the vertebrae). A slipped disc is when a disc gets damaged and presses on your nerves. As we get older, our discs get less flexible and are more likely to slip.

Less common causes of sciatica are:

  • spinal stenosis which is a narrowing of the nerve passages in the spine
  • ankylosing spondylitis, 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. 

Who is most at risk of getting sciatica?

Your risk of getting sciatica increases based on the following factors:

  • age – peak risk is 45–64 years
  • height – the taller you are, the greater your risk
  • if you smoke
  • if you’re stressed
  • if your work involves strenuous physical activity, such as frequent lifting, especially while bending and twisting
  • if your job involves driving, especially if it causes vibration of your whole body.

What are the symptoms of sciatica?

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

  • pain which tends to start in the lower back and buttocks and runs down one leg past the knee and sometimes into the calf and foot. The pain often feels worse in the leg than in the back. The pain may range from mild to severe burning or a shooting pain.
  • numbness, weakness or pins and needles in a part of your buttock, leg and foot.
  • lower back pain.

 Sneezing, coughing or sitting for a long period of time may make the pain worse.

How is sciatica diagnosed?

See your doctor if your pain is severe, ongoing or getting worse. They may ask you to do a simple test in which you lie flat on your back with your legs straight, and lift one leg at a time. If lifting one of your legs causes pain or makes your symptoms worse, this usually suggests sciatica.

How is sciatica treated?

Most often sciatica will get better in about six weeks without any treatment. See the self-care section below for how you can look after yourself while you have it. If needed, you can take painkillers such as paracetamol and anti-inflammatory medicine such as ibuprofen.

If it doesn’t get better within a few weeks, your doctor may recommend:

  • stronger painkillers such as codeine or tramadol.
  • physiotherapy
  • injections of anti-inflammatory and painkilling medication into your spine
  • manual therapy to manipulate your spine or massage it. This is usually carried out by physiotherapists, chiropractors or osteopaths.
  • in rare cases, surgery to correct the problem in your spine.

How can I care for myself with sciatica?

You can treat the symptoms yourself by:

  • taking anti-inflammatory or painkilling medicine
  • doing gentle stretching exercises for sciatica
  • staying active
  • exercising – swimming may help as it’s not weight-bearing so doesn’t put stress on your back
  • using hot or cold packs on the sore areas
  • having warm baths
  • using ergonomic furniture, such as chairs with lumbar support
  • doing gentle exercises for sciatica.

Traditional advice for treating sciatica recommended complete bed rest. However, this is no longer recommended and may make it worse.

How can I prevent sciatica?

You can minimise your risk of getting sciatica by looking after your back in the following ways:

  • learn how to lift properly
  • get close to the item you are lifting
  • lift with your legs, bending your knees and moving forward from your hips
  • lift gradually and slowly, rather than jerking
  • pivot with your feet; don’t twist your back while lifting
  • try to keep the object close to your body through the lift
  • exercise regularly
  • stretch before and after exercise
  • choose the right mattress so that it is firm enough to support your body and keep your spine straight, but isn't too hard.

Learn more

Sciatica Better Health, Australia, 2015
Sciatica NHS Choices, UK, 2016
Exercises for sciatica NHS Choices, UK, 2015

References

  1. Sciatica NHS Choices, UK, 2016
  2. Diagnosis and treatment of sciatica Kos BW, van Tulder MW, Peul WC. BMJ 2007;334;1313-1317.
  3. Leg pain (sciatica) Iowa Clinic, US, 2013
  4. Management of non-specific back pain and lumbar radicular pain BPJ 2009 June; 21.
  5. Sciatica Better Health, Australia, 2015
  6. Exercises for sciatica NHS Choices, UK, 2015
  7. Taking care of your back Physiotherapy NZ, 2013
  8. Warm up, cool down and stretch ACC, NZ, 2002
  9. What type of mattress is best for people with low back pain Harvard health Publications, US
Credits: Health Navigator Editorial Team.