Sciatica is a condition that can lead to pain in the back and legs.
It occurs when pain travels along the path of the sciatic nerve. This nerve starts in your lower spine, and travels through your hip and buttock and down the back of your leg to your foot.
There are a range of different causes of sciatica. In most cases, the condition gets better over time, either on its own or with treatment.
Causes of sciatica
The causes of sciatica include spinal injury or trauma, bone spurs or other growths, narrowing of the spinal canal, or tight or swollen muscles in the buttock. In many cases, people can’t pinpoint a specific injury that caused the condition.
Risk factors for sciatica include:
- age-related changes to the spine
- obesity, which can put extra pressure on the spine
- occupations where you twist the spine or pick up heavy loads
- prolonged sitting
- diabetes, which can increase the risk of nerve damage
Symptoms of sciatica can include pain, tingling and numbness in the leg.
Sciatica is felt as nerve pain radiating from the buttock down the back of the leg, often when sitting, sneezing, coughing or going to the toilet. You may also feel lower back pain, and/or tingling, pins and needles, numbness or weakness in your leg.
Although sciatica pain can be severe, most people find their symptoms improve in time. As sciatica is seen as a more serious low back condition, it’s advisable to see your doctor within the first few days of getting the symptoms. To diagnose sciatica, the doctor will take a medical history and examine your spine and legs.
You should seek medical attention immediately if you have problems controlling your bladder or bowels, or have weakness, numbness or severe pain.
The Royal Australian and New Zealand College of Radiologists recommends that an x-ray or other imaging in response to low back pain is only needed if you have other significant symptoms as mentioned above. For further information, visit the Choosing Wisely Australia website.
Sciatica therapies can include drug treatment, lifestyle changes or surgery.
The choice of sciatica therapies depends on the length of symptoms and severity of your condition. These therapies include:
- special back care education
- physical therapies
- drug treatment
- lifestyle changes
Mild sciatic usually goes away in time. When you first experience sciatica, one or two days’ bed rest may be needed. However, it's important to return to activity as soon as possible, to help your spine stay strong.
Sciatica treatment includes analgesics such as paracetamol, anti-inflammatory drugs such as ibuprofen and physiotherapy. Most people with sciatica get better with conservative treatments such as physiotherapy.
You should see your doctor again self-care measures fail to improve your pain, if your pain lasts longer than a week, is severe or becomes progressively worse.
If your symptoms persist, an injection of anaesthetic into the spine may be needed or, in rare cases, surgery.
Looking after your back, managing your weight, and improving your general physical condition can all help prevent sciatica. Doing physical therapy at home, such as muscle strengthening exercise, can help to prevent sciatica coming back.
Last reviewed: August 2018