Sciatica

Sciatica is a common condition, and you may also hear it called nerve root pain or radicular pain. The word describes pain you feel in the leg that often comes from the lower back.

The sciatic nerve starts in the lower back and runs all the way down the back of the leg into the foot. You can feel symptoms along any part of this nerve. They may come on suddenly or slowly, and they can be mild or severe.

Sciatica can cause several symptoms, and they vary from person to person. These can include:

• lower back pain
• leg pain, which often feels worse than the back pain
• a change in sensation in the leg or foot
• muscle spasms in the back
• weakness in the leg or foot

A change in feeling in the leg or foot can include:

• pins and needles
• numbness
• feeling hot or cold
• burning sensations
• shooting sensations
• sensations that are hard to describe

Sciatica happens when the nerves that run from your spine down into your legs become irritated. Often this comes from inflammation around the nerves. In some cases there is also pressure on a nerve, usually because of a change in one of the discs in the spine.

Most sciatica symptoms get better with time. Nerves are resilient, and in most people the inflammation and any disc changes settle down, which gives the nerves a chance to recover.

To diagnose sciatica, a doctor or another health professional will need to assess you. They'll ask about your back and leg problems and then examine you physically, which may include checking how well you can move and how strong you are.

Sometimes you may need a further examination, so that other possible health conditions can be ruled out.

In the early stages of sciatica, a scan rarely changes how the condition is managed. X-ray and MRI are generally not advised for people with sciatica. The reason is that changes in the structure of the spine are very common as people get older, and they are often found in people who have no symptoms at all.

A scan can be considered if your symptoms haven't changed for more than 12 weeks, they continue to greatly affect your quality of life, and you wish to consider surgery. Your doctor can talk this through with you.

Sciatica usually gets better within 12 weeks, though how long it lasts can differ a lot from one person to another. Some people find their symptoms take up to a year to settle, and in that time they can come and go.

Many things can affect how your symptoms feel, such as poor sleep, stress and your emotional wellbeing.

Sciatica can rarely lead to a condition called Cauda equina syndrome.

Cauda equina syndrome is rare, but it's a serious back condition and it can lead to permanent damage or disability. If you develop it, you'll need to be seen urgently by an emergency specialist spinal team.

• loss of feeling or pins and needles between your inner thighs or genitals
• numbness in or around your back passage or buttocks
• a different feeling when you wipe yourself with toilet paper
• more and more difficulty when you try to pass urine
• more and more difficulty when you try to stop or control your flow of urine
• loss of sensation when you pass urine
• leaking urine, or a recent need to use pads
• not knowing when your bladder is full or empty
• not being able to stop a bowel movement, or leaking
• loss of sensation when you pass a bowel motion
• a change in your ability to get an erection or ejaculate
• loss of sensation in your genitals during sexual intercourse

If you have had a new, significant injury to your back in the last 7 days, for example a fall from height or a direct blow to the back, you should also contact a doctor or the 16263 health line.

Most people get better from sciatica with time, a change in what they do each day, and pacing themselves so the nerves have a chance to adapt. Pain medicine, staying active and gentle exercise will also help.

The nerve can stay sensitive for a while, so build up how much you do slowly. Moving little and often is the approach that's recommended.

Sometimes a back problem means you need to take a little time off work so you can recover. How long you stay off depends on the nature of your condition and on what your job involves.

You don't have to be free of symptoms before you think about going back. Carrying on with work, or returning as soon as you're able to, will help your recovery. Getting back to your normal daily activities bit by bit can build up your strength and stamina.

Follow this advice and you should see gradual improvement over time. The biggest change in your symptoms usually comes within the first couple of weeks. Most problems should have improved within 6 weeks.

If your sciatica hasn't improved within 6 weeks of following this advice, or if your symptoms get worse at any time, talk to a doctor about them.

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With any health condition, it's also important to look after your mental wellbeing, because it can affect your recovery.