Sciatica (Pain Down the Leg)
Sciatica is pain that travels from the lower back or buttock down the back of the leg, sometimes to the foot, because the sciatic nerve or one of its roots is irritated. The commonest cause is a bulging or slipped disc in the lower back; in older adults narrowing of the spinal canal is also common. In Nigeria it is often described as waist pain that has gone into the leg, and is treated with rubbing, injections from a chemist or long bed rest. Most sciatica improves over six to twelve weeks. Staying active and doing the right exercises, often guided by a physiotherapist, helps it settle. A small number of people need an injection or surgery, and a few have warning signs that need emergency care.
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Symptoms
- Pain running from the buttock down the back or side of the leg, often below the knee
- Leg pain that is worse than the back pain
- Tingling, pins and needles or numbness in the leg or foot
- Pain worse on sitting, coughing or sneezing
- Weakness in the leg or foot, such as difficulty lifting the toes
- Low back pain or stiffness, often called waist pain
When to See a Doctor
See a doctor or physiotherapist if leg pain is severe, lasts more than a few weeks, or keeps you from work or sleep. See a doctor promptly if the leg or foot is getting weaker or numbness is spreading, as an MRI may be needed. Go to an emergency department immediately for loss of bladder or bowel control, difficulty passing urine, numbness around the back passage, genitals or inner thighs, or weakness in both legs. These are signs of cauda equina syndrome, where the nerves at the base of the spine are compressed, and delay can cause permanent damage.
Treatment options
- Staying active within the limits of pain rather than bed rest
- Physiotherapy: nerve and back exercises, posture and a graded return to activity
- Pain relief, including medicines that act on nerve pain, prescribed by a doctor
- Heat and gentle movement for muscle spasm
- An MRI scan for severe or worsening symptoms, weakness, or pain that has not improved after several weeks
- Steroid injection around the nerve root, or surgery to free the nerve, when symptoms persist or weakness progresses
What it costs on Mezo
Published cash prices for the treatments used for this condition.
Common Questions
How long does sciatica take to heal?
Most people improve within six to twelve weeks, and many much sooner. Pain that is not improving after that, or that is getting worse, should be reviewed by a doctor.
Is sciatica the same as waist pain?
Not quite. Waist pain usually means pain in the lower back. Sciatica is pain that travels down the leg because a nerve is irritated. The two often come together, and leg pain below the knee points to the nerve.
Do I need surgery for sciatica?
Most people do not. Surgery is considered when pain stays severe despite several weeks of good treatment, when the leg is getting weaker, or immediately if there are signs of cauda equina syndrome.
What exercises help sciatica?
Walking, gentle back and nerve-gliding exercises, and stretches for the hips and hamstrings help most people. The right exercises depend on what is irritating the nerve, which is why a physiotherapist assesses first.
Need Help?
Paid online. Assessment and a home exercise programme on the first visit.
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