Sciatica: Causes, Warning Signs and Recovery

Sharp, burning or electric pain shooting from the buttock down the back of the leg, sometimes to the foot. That's the classic description of sciatica. It can be more painful than the back pain that comes with it.

What sciatica is

Sciatica means the sciatic nerve, or one of the nerve roots that form it in your lower back, is irritated. It is a symptom with several possible causes:

• Disc herniation, the most common cause in younger and middle-aged adults (lumbar disc problems)
• Spinal stenosis, a narrowing of the spaces around the nerves, more common after 50 (spinal stenosis)
• Less often, a tight piriformis muscle in the buttock, or joint problems in the lower back

Typical signs

• Pain spreading below the knee, often worse than the back pain
• Tingling, pins and needles or numbness in the leg or foot
• Pain worse with sitting, coughing or sneezing
• Sometimes weakness, such as difficulty standing on your toes or lifting your foot

Warning signs that need urgent care

Go to a hospital the same day if you have numbness between the legs or around the back passage, new difficulty passing urine or controlling your bowels, or weakness in both legs. If your foot is getting weaker day by day, see a doctor urgently.

How long does it last?

For many people, sciatica improves significantly within 6 to 12 weeks. Some recover faster; some take longer. Pain levels often go up and down along the way, which is normal and not a sign of failure.

How physiotherapy helps

1. Find the cause and the easing positions. Many people find certain positions, such as lying on the stomach or gentle back extension, ease leg pain. Others are relieved by bending forward. The right direction depends on the cause.
2. Calm the nerve. Gentle nerve mobility exercises, manual therapy and sometimes traction can reduce irritation.
3. Keep you moving. Short, frequent walks and position changes stop you from stiffening up.
4. Rebuild strength. As pain settles, core, hip and leg strengthening reduces the chance of it coming back.

A sign you're improving

Pain moving back up from the foot towards the back, called centralisation, is usually a good sign, even if your back aches a little more for a while.

What to avoid

Sitting for long periods without a break, heavy lifting during the early flare, and stretching hard into pain. Hamstring stretches that send pain shooting down the leg often irritate the nerve further.