Sciatica
What is sciatica?
Back pain is very common and between 12-40% of people with back pain will experience nerve pains that travel into their leg. This pain travels through the buttock and down the leg, often reaching the foot as it follows the path of the sciatic nerve.
It can affect anyone, at any age. It can be mild but usually is rather severe. It is often felt alongside tingling and numbness too.
90% of cases resolve with no specialist help at all. Over 70% of people report improvements in symptoms within 4 weeks but the average for meaningful ease can be 6-12 weeks.
Our nerves leave the spine through small tunnels made up mostly by the bones of the spine. Some of these nerves in our lower back then merge to form the sciatic nerve. This happens on both sides of the spine and we therefore have a sciatic nerve running down each leg. If these nerves leaving the spine are irritated by the surrounding tissue it can cause us pain anywhere along the nerve.
Our discs are the spacers of our spine and are well anchored to the bones so do not slip. They do bulge and we see this in most people even when they have no pain. It is thought that sudden and more active bulges can be a cause of many sciatic episodes. These do resolve as our discs continually change (bulge but then reabsorb).
Ask for an urgent GP practice appointment or call 111 if:
You have back pain and
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- a high temperature
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- you’ve lost weight without trying to
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- there’s a lump or swelling in your back or your back has changed shape
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- the pain does not improve with relative rest and is much worse at night
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- you have new and significant weakness of the muscles in your leg
Call 999 or go to A&E if:
You have back pain and:
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- chest pain
- It started after a serious accident, such as a car accident
- pain, tingling, weakness or numbness in both legs
- numbness or tingling around your genitals or buttocks
- difficulty peeing
- loss of bladder or bowel control (peeing or pooing yourself)
- New inability to gain or maintain an erection.
For more information please read this leaflet.
For information in more languages on these matters please visit this page.
Imaging
It’s important to stress that imaging of the spine is not indicated for the majority of cases as it is so likely to get better. Also, the culprit of the pain if often not seen on imaging. Nerve irritation is commonly the issue with nothing structurally pressing on it so there is often nothing to see.
In some cases, if sciatica goes on for a long time (usually longer than 2-3 months), or is very severe, you may be referred to a specialist team who may discuss imaging with you.
GPs and Physiotherapists do not need an MRI scan to start actively treating you. The main aim of an MRI is to see if a referral to a consultant surgeon may be useful.
With simple advice and by keeping moving as much as your pains allow you to, most people will see a great improvement in their sciatica and back pain within a few weeks of it starting and will settle fully.
Facts (and myth busting) about back pain
10 Facts every person should know about back pain
For those who unfortunately have persisting or progressive pains then consider seeking specialist advice for the appropriate help and guidance.