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Advice for Sciatica
Sciatica is pain that radiates along the path of the sciatic nerve from the lower back or buttock down one leg, often below the knee. It is usually caused by nerve root compression from a herniated lumbar disc, but spinal stenosis, degenerative changes, piriformis syndrome, trauma, infections, or tumors can also be responsible. Symptoms commonly include sharp, shooting or burning pain, numbness, tingling, and possible muscle weakness in the affected leg, typically worse with sitting, coughing, or bending. Diagnosis relies on clinical history and neurological exam, with MRI reserved for severe, progressive, atypical, or non?resolving cases. First?line management is conservative—staying active as tolerated, short?term analgesics, guided physiotherapy, and targeted exercises—while injections or surgery are considered for persistent severe pain or significant neurological deficit. Seek urgent care for new bowel or bladder dysfunction or rapidly worsening leg weakness.
Sciatica typically causes sharp, shooting, or burning pain that radiates from the lower back or buttock down one leg, often below the knee. You may experience numbness, tingling, or a pins?and?needles sensation in the leg or foot. Muscle weakness in the affected leg or foot can occur, sometimes causing difficulty lifting the foot or walking. Symptoms often worsen with sitting, coughing, sneezing, or bending forward. In severe cases you may have loss of bowel or bladder control or progressive weakness, which requires immediate medical attention.
Sciatica is most commonly caused by a herniated lumbar disc that compresses or irritates a nerve root. Spinal stenosis (narrowing of the spinal canal) can compress nerve roots and produce sciatica, particularly in older adults. Degenerative disc disease and spondylolisthesis (vertebral slippage) can alter spinal alignment and pinch nerves. The piriformis muscle can irritate the sciatic nerve (piriformis syndrome), producing similar symptoms. Trauma, such as a fall or accident, can damage or inflame spinal structures and nerves. Less commonly, tumours, spinal infections, or inflammatory conditions can compress the nerve. Conditions that increase risk of sciatica include obesity, diabetes, pregnancy, smoking, heavy or repetitive lifting, and prolonged sitting or a sedentary lifestyle.
