Sciatica: Symptoms, Treatment and Emergency Signs

Sciatica describes pain and other nerve symptoms caused by irritation or compression of a nerve root in the lower back. Symptoms usually travel from the lower back or buttock down one leg and may reach the foot or toes. Sciatica is a symptom rather than a disease in itself.

Symptoms

Sharp, burning or electric pain down the buttock and leg
Tingling or pins and needles
Numbness in part of the leg or foot
Weakness in the leg, ankle or foot
Pain that worsens with coughing, sneezing, bending or prolonged sitting

Leg pain is often more noticeable than back pain and usually affects one side. Pain limited to the lower back without symptoms travelling down the leg is less likely to be sciatica.

Common causes

A herniated spinal disc is a common cause. Other causes include narrowing around the nerves, called spinal stenosis, age related changes in the spine, a vertebra slipping forward, and less commonly an injury, infection or tumour. In many people, symptoms improve as irritation and inflammation around the nerve settle.

Diagnosis

A healthcare professional usually diagnoses sciatica from the symptom pattern and an examination of strength, sensation, reflexes and movement. A scan is not routinely needed when symptoms are improving and there are no warning signs. MRI may be considered when a serious cause is suspected, weakness is progressing, symptoms persist despite appropriate care, or a procedure is being planned.

Self care and treatment

Continue normal daily activity as far as pain allows and change position regularly. Prolonged bed rest can increase stiffness and slow recovery. Gentle walking and a gradual return to usual activity are often helpful. A physical therapist can recommend exercises suited to the symptoms and examination findings.

Heat or a wrapped cold pack may provide short term comfort. Pain medicines are not suitable for everyone and evidence differs between products. Ask a pharmacist or healthcare professional about safe options, particularly if you have kidney, stomach, heart or liver disease, take other medicines, are pregnant or are older.

Persistent or severe sciatica may need a structured exercise program, physical therapy and a review of pain management. Selected people with severe acute symptoms may be offered an epidural injection. Surgery may be considered when nerve compression causes persistent disabling pain or progressive neurological problems and imaging confirms a treatable cause.

Emergency warning signs

Call local emergency services or attend an emergency department immediately if you have any of the following:

Numbness around the genitals, anus or inner thighs
Difficulty starting urination, inability to urinate or new loss of bladder control
New loss of bowel control or inability to sense the need to pass stool
Severe or worsening weakness or numbness in both legs
Sciatica affecting both sides together

These symptoms may indicate cauda equina syndrome, a rare but serious compression of the nerves that requires emergency assessment.

When to arrange medical advice

Seek medical advice if pain is severe, is getting worse, has not improved after several weeks, or prevents normal activity. Prompt assessment is also important for progressive leg or foot weakness, fever, unexplained weight loss, a history of cancer, recent serious injury, immune suppression, or pain that is constant and severe at night.

Reducing future problems

Regular physical activity, gradual strength and mobility work, a safe lifting technique and changing position during long periods of sitting may help. Smoking cessation supports spinal and general health. No posture or exercise can guarantee that sciatica will not return, so choose sustainable habits rather than rigid rules.

Related information

Find more guidance about back, joint and nerve related symptoms in our Pain and Musculoskeletal Health and Brain and Nervous System sections.

Sources

Using this information

This information supports general understanding and preparation for a conversation with a qualified healthcare professional. It does not replace an individual medical assessment, diagnosis or treatment.

Reviewed: 28 August 2026