Sciatica
Sciatica refers to pain travelling from the lower back into the leg, usually caused by irritation or compression of a spinal nerve.
Symptoms can vary from mild discomfort to more persistent pain, tingling or weakness affecting daily activity.
At Total Spine Health, sciatica is assessed carefully to identify the underlying cause and provide clear, sensible advice on the most appropriate treatment.
AT A GLANCE
- Specialist assessment for leg pain linked to nerve irritation or compression
- Diagnosis of causes such as slipped disc, spinal stenosis and other lumbar spine conditions
- Clear advice on scans, investigations and treatment options
- Consultant-led care for persistent, severe or worsening symptoms
UNDERSTANDING SCIATICA
Specialist assessment for nerve pain affecting the lower back and leg
Sciatica is a term used to describe pain caused by irritation of the sciatic nerve, usually where it exits the spine in the lower back. It is commonly linked to conditions such as a slipped disc or spinal stenosis.
Symptoms may include pain radiating into the leg, tingling, numbness or weakness, which can vary depending on the level and severity of nerve compression.
A specialist spinal assessment helps identify the source of nerve irritation and whether symptoms are likely to settle with non-surgical care or require further investigation and treatment.
WHAT IS SCIATICA?
Understanding sciatic nerve pain
Sciatica is not a diagnosis itself, but a symptom of an underlying spinal condition affecting a nerve in the lower back.
It typically occurs when a disc bulge, prolapse or narrowing within the spine puts pressure on a nerve root, causing pain to travel along the path of the nerve into the leg.
Some episodes improve with time and simple measures, while others may persist or worsen, particularly if nerve compression is significant.
COMMON SYMPTOMS
Symptoms often linked to sciatica
Sciatica symptoms usually affect one side of the body and follow a nerve distribution down the leg. Symptoms can vary depending on the severity and cause of nerve compression.
- pain travelling from the lower back into the buttock and leg
- sharp, shooting or burning pain
tingling or pins and needles in the leg or foot - numbness in parts of the leg or foot
- muscle weakness in the leg or foot
- pain worsened by sitting, bending or coughing
- difficulty standing, walking or straightening the leg
COMMON CAUSES
What can cause sciatica?
Sciatica is usually caused by irritation or compression of one of the spinal nerves in the lower back. There are several common underlying causes.
Age-related changes in the discs, joints and surrounding tissues can reduce the space available for nerves and lead to irritation.
Sciatica symptoms can be caused not only by pressure on a nerve, but also by inflammation around the nerve root.
WHEN TO SEEK HELP
When specialist spinal advice may be helpful
Sciatica often improves over time, but specialist review may be helpful if symptoms are severe, persistent, worsening or associated with weakness.
- leg pain is severe or not improving
- symptoms have lasted several weeks
- pain is affecting walking, sleep or daily life
- numbness or tingling is becoming more noticeable
- there is weakness in the leg or foot
- symptoms keep returning
- previous treatment has not helped enough
Important note
Urgent medical assessment is important if sciatica is associated with loss of bladder or bowel control, numbness around the saddle area, rapidly worsening weakness, or severe symptoms developing suddenly.
DIAGNOSIS AND ASSESSMENT
How sciatica is assessed
A specialist assessment looks at the pattern of pain, the presence of nerve-related symptoms and any signs that a spinal nerve may be compressed.
- where the pain travels
- whether numbness, tingling or weakness are present
- how long symptoms have been present
- what makes symptoms worse or better
- whether symptoms affect walking, sitting or sleep
- any previous back or leg problems
- what treatment has already been tried
Examination may include assessment of movement, nerve tension signs, muscle strength, reflexes and sensation.
Where appropriate, further investigation may include:
- MRI scan
- X-rays
- CT scan in selected cases
- review of previous imaging
TREATMENT OPTIONS
Treatment for sciatica
Treatment depends on the underlying cause, how long symptoms have been present, whether neurological changes are present, and how much symptoms are affecting quality of life.
Many cases of sciatica improve without surgery. Treatment may include activity advice, pain relief, physiotherapy, guided rehabilitation and monitoring over time.
For some patients, an injection around the affected nerve may help reduce inflammation and pain. This may be considered when symptoms are persistent or severe.
Surgery may be considered where a nerve is clearly compressed and symptoms are severe, persistent or associated with weakness, or where non-surgical treatment has not provided enough improvement.
SELF-CARE AND RECOVERY
Practical steps that may help
Depending on the cause and severity of symptoms, practical measures can help support recovery while avoiding unnecessary aggravation.
- keep gently active where possible
- avoid prolonged bed rest
- change position regularly if sitting aggravates symptoms
- avoid repeatedly lifting, twisting or straining when pain is severe
- follow physiotherapy advice carefully
- seek review if weakness or numbness worsens
- pace recovery rather than returning too quickly to aggravating activity
FAQs
Common questions about sciatica
Does sciatica always start in the back?
Not always. Some patients mainly notice buttock or leg pain and may have very little back pain.
Is sciatica the same as back pain?
Sciatica refers specifically to nerve-related pain travelling into the leg, although it often occurs alongside lower back pain.
Do I need an MRI scan for sciatica?
An MRI is not always required. However, it can be very useful when symptoms are persistent, severe, associated with weakness, or when treatment decisions depend on understanding the cause of nerve compression.
Can sciatica get better without surgery?
Many patients improve with time and non-surgical treatment. Surgery is usually reserved for selected cases where symptoms are severe or not improving.
When is sciatica more serious?
Sciatica is more concerning when it is associated with significant weakness, worsening numbness, bladder or bowel symptoms, or severe persistent pain that is not improving.
RELATED CONDITIONS
Conditions linked with sciatica
RELATED TREATMENTS
Treatment pathways that may be relevant
- Spinal assessment and diagnostic review
- MRI and imaging-led evaluation
- Physiotherapy and rehabilitation advice
- Nerve root or epidural injection treatment
- Lumbar decompression surgery
- Lumbar discectomy
