Sciatica

What is sciatica?

Sciatica is a condition causing pain along the back of your body, from your lower back to your foot.

It’s caused by irritation or compression to the sciatic nerve. The sciatic nerve is the largest nerve in the body at up to 2 cm wide. It starts near the base of your spinal cord and runs down to your feet, helping you feel and move your legs.

Sciatica can be debilitating and keep you from doing your normal day-to-day activities, but it usually improves in a matter of months.

What are the symptoms of sciatica?

Sciatica is different for everyone. The pain usually starts at the back, runs along the bottom, the back of the thigh and calves, and ends on either the outside of the foot or at the big toe. It can come on suddenly or gradually. 

Some common symptoms include:

• Pain that feels like an electric shock

• Tingling or numbness in your skin

• Muscle weakness or fatigue

• A burning pain deep in the bottom

• A feeling of heaviness in one leg

• Pain that gets worse when you cough, sneeze, twist, bend or go to the toilet.

What causes sciatica?

The most common cause of sciatica is a herniated, or slipped, disc. 

The vertebrae in your spine are separated by discs that help absorb shock and make you flexible. The discs have a hard outer shell and a soft core. A herniated disc is when the outside of the disc cracks open and some of the soft core escapes. This can come into contact with the sciatic nerve and compress or irritate it, causing sciatica.  

Other causes of sciatica include osteoarthritis, infections, inflammation or stenosis (a narrowing of the spine where the nerves protrude).

Who is at risk of sciatica?

The most common age to get sciatica is between ages 30-40 but it can happen at any age.

How is sciatica diagnosed?

Sciatica is usually diagnosed by a doctor who will ask about your symptoms and do a physical examination. Imaging isn’t usually needed unless a doctor believes it would be useful to help determine the underlying cause.

How long does sciatica last?

Sciatica usually gets better within around 4-6 weeks, but it can last longer. Around a third of people will have pain for a year or longer.

How is sciatica treated?

The main treatment is a short course of medication to relieve the pain and lower inflammation. Sciatica used to be treated with bed rest, but now experts believe staying active is more likely to be beneficial. You might be referred to a physiotherapist who can help you with exercises. 

In some cases, a doctor might also recommend an injection of steroid medication into your spine to relieve the pain.

If the sciatica is caused by a herniated disc, surgery may be an option. However, most people do best with non-invasive treatment.

What can you do to treat sciatica yourself?

There are a few measures you can take on your own to help relieve the symptoms. 

• Lie on your side to help relieve the pain 

• Use a hot or cold pack to help relieve pain and decrease inflammation

• Avoid sitting or standing for a long time

• Do exercises to improve core strength

• Stretch your lumbar spine and hamstrings

• Regular exercise like walking or swimming

When should I talk to a doctor?

Make an appointment if sciatica is painful and interfering with your normal life. 

Go to A&E or call 999 immediately if:

• Your legs are weak or numb 

• Your crotch or bottom are numb

• You can’t control when you pee or poo

What can Livi do?

A Livi healthcare professional can help find out what might be the cause of your back pain. You can get advice on how to self-manage your problem with exercises and medications, and also discuss whether you may require a referral to a physiotherapist or musculoskeletal specialist now or in the future.