ORTHOPEDIC CONCERN

Sciatica

Also called: bad back, back pain, slipped disc, sciatica, herniated disc, spine pain, stiff back, cant bend, back goes, locked back

Sciatica describes pain and other symptoms caused by irritation or compression of the sciatic nerve or the nerve roots that form it. Symptoms commonly travel from the lower back or buttock into one leg and may include sharp pain, tingling, numbness or weakness.

TYPICALLY OCCURS

Disc problems, nerve compression and spinal changes

TREATED BY

Spinal surgery, injections, physiotherapy and pain management

ALSO LINKED TO

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Why it happens?

Sciatica develops when one or more of the nerve roots that contribute to the sciatic nerve become irritated or compressed in the lower spine. The sciatic nerve is the body’s largest nerve and travels from the lower back through the buttocks and down each leg. Because of this pathway, irritation near the spine can produce symptoms much further down the leg. Pain may feel burning, shooting or electric and can sometimes extend into the calf, foot or toes. Tingling, numbness and muscle weakness can also occur depending on which nerve root is affected.

A herniated or prolapsed disc — often called a slipped disc — is a common cause of sciatica. The discs between the vertebrae act as cushions, and when part of a disc bulges or protrudes, it can irritate a nearby nerve root. Age-related changes in the spine can also reduce the space available for nerves. Conditions such as spinal stenosis, where the spinal canal or nerve passages become narrower, and spondylolisthesis, where one vertebra moves relative to another, can sometimes produce sciatic symptoms.

Several factors may increase the likelihood of developing lower-back and nerve problems, including ageing, previous back injuries and activities that repeatedly place stress on the spine. However, sciatica is a symptom pattern rather than a single disease, and not every pain travelling into the leg is caused by the sciatic nerve. Muscle, hip and other spinal conditions can produce similar symptoms. Identifying the location of the pain, associated neurological symptoms and underlying cause is therefore important, particularly when symptoms are persistent, severe or worsening.

How far along is it?

Early

Intermittent pain, tingling or discomfort develops in the lower back, buttock or upper leg. Symptoms may appear with certain movements or after prolonged sitting.

Moderate

Pain travels more consistently down the leg and may be accompanied by numbness or tingling. Sitting, walking, bending, coughing or certain movements may aggravate symptoms.

Advanced

Pain becomes severe or persistent, and noticeable numbness, muscle weakness or reduced function may develop. Progressive neurological symptoms require medical assessment.

What addresses it?

Treatments that address this

Laser disc decompression→Spinal fusion surgery→Epidural steroid injection→

Mild sciatica can sometimes improve over several weeks, but medical assessment is worthwhile when symptoms are severe, repeatedly return, progressively worsen or fail to improve. Pain accompanied by persistent numbness or weakness should also be assessed.

Seek urgent medical attention if sciatica is accompanied by numbness around the genitals or buttocks, difficulty starting or controlling urination, loss of bowel control, or severe or worsening weakness in both legs. These can be warning signs of cauda equina syndrome, a rare but serious condition requiring emergency assessment.

Quick Questions:

What does sciatica feel like?

Sciatica commonly causes sharp, burning or shooting pain that travels from the lower back or buttock into one leg. Tingling, pins and needles, numbness or weakness can occur alongside the pain.

What is the most common cause of sciatica?

A herniated or prolapsed disc is a common cause. The protruding disc can irritate or compress a nerve root in the lower spine, producing symptoms along the pathway of the sciatic nerve.

Does sciatica go away on its own?

Many episodes improve over time with conservative management, although recovery varies according to the underlying cause and severity. Persistent, worsening or recurrent symptoms should be professionally assessed.

Does sciatica always require surgery?

No. Most cases do not require surgery. Depending on the cause and severity, management may include maintaining appropriate activity, pain relief, physiotherapy or injections. Surgery may be considered for certain cases involving persistent symptoms or significant nerve compression.