Sciatica is pain that travels from the lower back or buttock down the leg, often below the knee, caused by irritation of a nerve root in the lower spine. It is most often linked to a bulging or herniated disc. Many people improve over weeks to months without surgery, but some symptoms need urgent medical attention.
Also known as lumbar radiculopathy, trapped nerve in the back, nerve root pain, radicular leg pain
Symptoms
- Pain spreading from the buttock down the back or side of the leg, often below the knee
- Leg pain that is often worse than back pain
- Burning, shooting or electric-shock-like pain
- Pins and needles or numbness in the leg or foot
- Weakness in the leg or foot in some cases
- Pain made worse by coughing, sneezing or sitting for long periods
Causes and risk factors
- A herniated (slipped) disc pressing on or inflaming a nerve root – the most common cause
- Narrowing of the spaces the nerves pass through (spinal stenosis), especially in older adults
- Spondylolisthesis, where one vertebra slips forward on another
- Risk factors include increasing age, taller height, smoking and some physically demanding jobs or prolonged driving
What the evidence says helps
- NICE guidance for low back pain with or without sciatica recommends advice and information, encouragement to stay active, and support to keep working or return to normal activities.1
- Structured exercise may give a small extra short-term reduction in leg pain compared with advice to stay active alone, but in the longer term the two approaches appear similar.3
- NICE suggests manual therapy may be considered only as part of a package that includes exercise.1
- Evidence for medicines commonly used for sciatica, including anti-inflammatories and nerve-pain drugs, is low quality and their benefit is unclear. Medication decisions should be made with your GP or pharmacist.4
- For severe or persistent sciatica caused by a disc, surgery (discectomy) can relieve leg pain faster, but the advantage over non-surgical care tends to shrink over time. NICE suggests considering surgery when non-surgical care has not helped and scan findings match the symptoms.16
- Cauda equina syndrome is a rare emergency. Guidelines agree that numbness in the saddle area or new bladder or bowel problems need an urgent MRI scan.5
Things you can try at home
- Stay as active as you comfortably can – short, frequent walks are often easier than long ones
- Avoid long spells of sitting; change position regularly
- Try gentle movements that ease leg pain, and back off those that clearly make it spread further down the leg
- Use heat for comfort and talk to a pharmacist about pain relief that is safe for you
- Keep a note of any numbness or weakness so you can report changes quickly
When to get urgent help
Contact your GP urgently, call NHS 111, or call 999 in an emergency if you have:
- Numbness or tingling around your genitals, bottom or inner thighs (saddle area) – possible cauda equina syndrome, go to A&E or call 999 immediately
- New difficulty passing urine, loss of bladder or bowel control, or not knowing when your bladder is full – go to A&E or call 999 immediately
- Sciatica in both legs, or new weakness in both legs – go to A&E or call 999
- New loss of sexual sensation or function together with back pain – go to A&E or call 999
- Rapidly worsening weakness in one leg, such as foot drop – contact your GP urgently or NHS 111
- Sciatica with fever, unexplained weight loss or a history of cancer – see your GP urgently
How Apollo can help
We assess your nerves, strength and movement carefully, screen for warning signs and explain what is likely to be causing your symptoms. Care centres on keeping you active, with graded exercise, advice on managing work and daily activities, and hands-on techniques as part of an exercise-based plan where suitable. If your symptoms are severe or not settling, we will write to your GP to discuss further investigation or a specialist opinion.
No GP referral needed. Clinics in Sheringham, Coltishall and Norwich.
Related reading
Frequently asked questions
How long does sciatica last?
It varies. Many people improve over several weeks to a few months, but some have symptoms that last longer or come back. Persistent or worsening symptoms should be reviewed by a clinician.
Is walking good for sciatica?
For most people, gentle walking is helpful and fits with advice to stay active. Short, regular walks are often easier than one long one. If walking makes leg symptoms spread or numbness worsen, get it checked.
When does sciatica need surgery?
Most people do not need surgery. It may be considered when severe leg pain has not improved with non-surgical care and a scan shows a matching cause. Emergency surgery is needed for cauda equina syndrome.
References
- National Institute for Health and Care Excellence (2016, updated 2026). Low back pain and sciatica in over 16s: assessment and management (NG59). NICE. View source
- Konstantinou K, Dunn KM (2008). Sciatica: review of epidemiological studies and prevalence estimates. Spine. View source
- Fernandez M et al. (2015). Advice to stay active or structured exercise in the management of sciatica: a systematic review and meta-analysis. Spine. View source
- Pinto RZ et al. (2012). Drugs for relief of pain in patients with sciatica: systematic review and meta-analysis. BMJ. View source
- Hennessy O et al. (2025). Assessment and early investigation of cauda equina syndrome – a systematic review of existing international guidelines and summary of the current evidence. European Spine Journal. View source
- Liu C et al. (2023). Surgical versus non-surgical treatment for sciatica: systematic review and meta-analysis of randomised controlled trials. BMJ. View source
This page is general information, not a diagnosis or a substitute for medical advice. If you are worried about your symptoms, speak to your GP or a registered healthcare professional. Content prepared from the sources above, November 2026.
