Sciatica

Signs and symptoms of sciatica

Common signs and symptoms

Some of the more common signs and symptoms of sciatica are:

• Pain down the leg: Often described as sharp, searing, electric-shock or burning, usually on one side.
• Pins and needles or numbness: May feel in the leg or foot, often following the path of the nerve.
• Muscle weakness: Trouble lifting your foot or bending your knee on the affected side.
• Worse pain when sitting: Sitting puts extra pressure on the nerve roots.
• Improved comfort when walking or lying: Movement and certain positions can ease nerve pressure.

When symptoms may worsen

Sciatica pain often flares up:

• After long periods of sitting or standing
• When coughing, sneezing or laughing (it increases pressure on the nerve)
• During certain activities like bending or lifting
• At night, making sleep difficult

Treatment options for sciatica

Lifestyle changes and self-care

Many people improve their sciatica with simple measures at home:

• Stay active: Gentle exercise like walking or swimming helps keep your spine mobile.
• Posture: Sit in chairs with good back support, keep feet flat on the floor, and avoid slouching.
• Heat and cold packs: Alternating heat (to relax muscles) and ice (to reduce inflammation) can ease pain.
• Over-the-counter pain relief: Paracetamol or ibuprofen (if suitable for you) may help in the short term.

Doing these self-care steps can reduce pain, speed up recovery, and help you stay mobile while your nerve heals.

Physiotherapy

A physiotherapist will guide you through a personalised plan that often includes:

• Tailored exercises: You’ll learn specific stretches (like gentle hamstring and piriformis stretches) and strengthening moves (such as pelvic tilts and core activation) designed to support your lower back, improve posture, and ease pressure on the sciatic nerve.
• Manual therapy: Hands-on techniques, such as soft tissue massage, joint mobilisations, or gentle spinal manipulations, help to release tight muscles, improve spinal alignment, and boost blood flow for faster healing. 
• Posture and lifting advice: You’ll get practical tips for everyday activities, from setting up an ergonomic workstation and choosing supportive seating, to bending and lifting safely (using your legs not your back), so you avoid movements that might trigger a flare-up.

Working with a physiotherapist not only relieves current pain but also builds lasting strength and flexibility, reducing the likelihood of future sciatica episodes.

Medications

If simple self-care and physiotherapy don’t ease your sciatica, your GP may prescribe one or more of the following medicines, chosen to target different aspects of your pain:

• Stronger painkillers: Such as codeine-based medicines for short periods.
• Anti-inflammatories: Prescription NSAIDs to reduce nerve inflammation.
• Muscle relaxants: For severe spasms.
• Neuropathic pain drugs: Such as gabapentin or amitriptyline to calm irritated nerves.

By using the right combination of these medications under your doctor’s guidance, you can achieve quicker relief from intense sciatica pain, making it easier to keep moving and stick with your rehabilitation plan.

Surgery (if applicable)

Surgery is rarely needed but may be considered if you have:

• Progressive muscle weakness in your leg or foot
• Loss of bladder or bowel control (cauda equina syndrome – an emergency)
• Severe pain that doesn’t respond to other treatments after 6–12 weeks

Common operations include:

• Microdiscectomy: Removal of part of a herniated disc to relieve nerve pressure.
• Laminectomy: Removing a small section of bone (lamina) to widen the spinal canal in cases of stenosis.

When non-surgical treatments aren’t enough, surgery can provide lasting relief by directly relieving nerve compression.