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What does sciatica mean?
The sciatic nerve helps carry messages between the leg and the nervous system. It is formed from several nerve roots leaving the lower spine. Irritation or compression of these structures can cause pain felt farther away, in the buttock and down the leg.
People often call this a trapped nerve. That is a simplification: symptoms can involve mechanical pressure, irritation and nerve sensitivity. It is not necessarily a nerve that one manoeuvre can instantly free. The word sciatica alone does not identify the cause of that irritation.
Understand the picture
Pain can be felt far from the back
Nerve roots
Nerve roots leave the lower spine.
Buttock and leg
Irritation can cause pain felt along the leg.
Foot and sensation
Tingling or changed sensation may reach the foot. Report any loss of strength as well.
Which symptoms may fit?
Pain commonly travels down the back or side of one leg, sometimes into the foot and toes. It may feel burning, electric or sharp. Tingling, numbness or weakness can accompany it. Leg pain may be worse than back pain; some people have very little back pain.
Coughing, sneezing, sitting or certain movements may alter symptoms, but none establishes the diagnosis on its own. The route differs between people. Hip, muscle or circulation problems can also cause leg pain. An accurate description is more useful than performing an online diagnostic test on yourself.
What can cause it?
A lumbar herniated disc is a common cause: disc tissue extends beyond its usual boundary and can irritate a nerve root. Narrowing of the spaces around nerves, called stenosis, can also produce symptoms. A vertebra slipping relative to another, or another condition, may sometimes be involved.
The history offers clues. Leg pain mainly brought on by walking and eased by sitting raises different questions from sudden electric pain after a period of back discomfort. These patterns guide assessment without allowing you to select the cause yourself. Herniated disc and sciatica are therefore not interchangeable terms.
What does the assessment look for?
Your doctor asks about onset, the path of symptoms, changes in sensation and daily difficulties. They may examine different muscle groups, reflexes and skin sensation. Some leg movements help assess how nerve structures respond, with results interpreted alongside the rest of the examination.
MRI is not routine for every recent episode. It becomes useful when neurological impairment is suspected, symptoms remain substantial or specialist treatment is being considered. An old image cannot explain every new symptom. Bring existing reports, but do not arrange a series of investigations yourself before consultation.
When should you avoid waiting?
Call 112 in Luxembourg for new bladder difficulty, loss of bladder or bowel control, numbness around the genitals or anus, or severe and increasing weakness in both legs. New sciatica on both sides also requires urgent assessment. These may indicate a serious problem affecting nerves at the bottom of the spine.
New weakness in one leg, such as a foot dropping or catching, needs prompt medical advice too. Do not wait until pain becomes unbearable. Fever, feeling unwell or rapid deterioration also needs reassessment. Trying a stretch must not delay medical help.
How can physiotherapy help?
Your physiotherapist helps you find ways to stay active with an acceptable response from the back and leg. Movement, strength, endurance and your priorities are considered. The programme changes according to your abilities and nerve symptoms monitored with your doctor.
Care may include explanations, progressive exercise and hands-on techniques when useful. No treatment can promise to permanently release a nerve in one session. The aim is to improve function, reduce difficulties and know when to adjust care. Worsening neurological symptoms calls for medical review even if some movements temporarily ease pain.
Chapter sources [5]
Medicines, injections and surgery: where do they fit?
Nerve pain does not always respond to medicines like muscular pain. Your doctor or pharmacist can discuss options, their limitations and risks in your circumstances. NICE guidance advises against several medicines previously used for sciatica, including gabapentinoids, because the balance of benefits and harms is unfavourable.
Do not start or stop prescribed medicines solely because of this article; some require supervised withdrawal. If pain remains disabling, a specialist may discuss an injection or surgery appropriate to the cause. Decisions depend on symptoms, progress and agreement between assessment findings, rather than the word sciatica alone.
Chapter sources [5]
Walking, sitting and sleeping with sciatica
Avoid spending a very long time in a position that maintains symptoms. Try simple changes: a different seat height, comfortable support, short breaks or shorter, more frequent walks. There is no compulsory sitting posture for every case of sciatica.
At night, find a comfortable support rather than forcing yourself onto one particular side. The aim is to keep manageable activities while limiting substantial, lasting aggravation. Notice what happens in the leg during and after activity. Seek help sooner if pain prevents sleep, walking or ordinary daily function, rather than waiting for several weeks.
Chapter sources [3]
In everyday life
Describe changes in a useful way
Path
Explain where pain begins and how far it travels.
Function
Separate movements that hurt from movements you cannot perform because of weakness.
Development
Describe changes since the start and your response to activity or treatment.
Why do stretches need to be adapted?
A pulling feeling behind the thigh can involve different structures. Pulling harder is not always the right response. Stop a stretch that increases electric pain, numbness or symptoms travelling towards the foot, and discuss the reaction with your clinician.
When appropriate, nerve mobilisation uses a specific technique and amount; it is not a search for the strongest possible stretch. Ask which movement to use, how often and when to stop. The general back exercises on our exercise page are discussion examples. They are not automatically a programme for sciatica with weakness or after surgery.
How long can sciatica last?
Improvement often occurs over weeks to a few months, but some episodes last longer and recurrence is possible. No fixed number of days predicts your recovery. Less pain, easier walking and better sleep are useful signs of progress, considered alongside strength and sensation.
Review care if you are not improving after a few weeks of appropriate management, symptoms are worsening or activities remain severely limited. Prepare three details: how far pain travels, which abilities have changed and what helps or aggravates it. Emergency signs need immediate help; they should not simply be recorded in a symptom diary.
Chapter sources [3]
Your questions
Can I have sciatica without low back pain?
Yes. The leg may be much more painful than the back, or be the main symptomatic area. This still does not establish the cause. Examination helps distinguish a nerve problem from other causes of leg pain.
Chapter sources [3]
Should I walk through the pain?
Adapted walking can help maintain activity, but forcing a large flare is not useful. Try shorter distances according to your care advice. New weakness, loss of sensation or bladder changes needs assessment rather than more walking.
Chapter sources [3]
How can I untrap the sciatic nerve?
There is no universal manoeuvre. The expression does not fully describe the range of causes. Assessment helps select useful treatment and movements; forceful stretching or manipulation cannot guarantee removal of the cause.
Sources and references
- [1] IQWiG · Bandscheibenvorfall
- [2] Assurance Maladie · Reconnaître une sciatique
- [3] NHS · Sciatica
- [4] NHS Dorset · Lumbar spinal stenosis
- [5] NICE NG59 · Low back pain and sciatica
- [6] CGDIS Luxembourg · 112
Text updated on
Medical review: awaiting Hasib Selimovic.