Sciatica

Sciatica can happen for many reasons – from injuries to pregnancy, or underlying conditions such as osteoarthritis. Our pain medicine specialists are experienced in identifying the cause and delivering effective, personalised treatment.

What is sciatica?

Sciatica is a kind of pain that happens when one or more nerves that run down your lower back and into your legs get irritated, inflamed, pinched or compressed. It’s a very common condition, with an estimated 40% of people getting it at least once in their lifetime.

Sciatica can be caused by lots of different things. It’s usually not a serious or dangerous condition and most people with sciatica get better on their own with time and self-care treatments.

Sciatica usually improves within 12 weeks, but everyone has their own individual recovery process. For some people it can take up to a year to settle – and symptoms can come and go during this time.

At Welbeck, our consultants diagnose and treat patients with knee pain in our state-of-the-art Pain Medicine centre.

Paediatrics

We offer Sciatica appointments to referred paediatric patients aged 12 to 18. For full information on our paediatrics service, please visit our main Paediatrics page.

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Depending on the cause of your sciatica, you might experience:

  • lower back pain

  • leg pain that might feel worse than back pain

  • a feeling like bad leg cramp

  • pain that is sharp, zinging or ‘electrical’

  • pain that gets worse when you move, sneeze, or cough

  • a change in sensation or weakness in your leg or foot

  • pins and needles

  • numbness

  • burning or shooting feelings

  • heat or coldness

  • muscle spasms in your back

  • changes in bladder or bowel control

There are many different causes of sciatica, and you may have more than one at the same time. 

Conditions that can affect the sciatic nerve, include:

  • spinal disc issues, such as a slipped disc (herniation) or degenerative disc disease, alter the disc structure, causing it to press on 1 or more of the 5 nerves that make up the sciatic nerve

  • spinal stenosis – when the area of the lower spine that houses the nerves is narrowed, putting pressure on them

  • spondylolisthesis – when one of the bones in your spine slips out of position

  • osteoarthritis – when worn down and damaged discs and cartilage between vertebrae affect the nerve

  • back injuries – for example, from accidents or sports

  • pregnancy – having to carry additional weight, hormones that soften your ligaments and may affect joint stability, plus the baby’s position can put pressure on the sciatic nerve

  • tumours, cysts or other growths can push against the nerve

  • cauda equina syndrome – a rare, emergency condition that affects the nerves in the lower part of the spinal cord

Diagnosing your sciatica usually involves an initial consultation where our pain specialist will:  

  1. Take a history to get a full understanding of your pain and how it affects you – for example, how severe it is, where it is, what makes it worse or better, and how it affects daily life. They’ll want as much detail from you as possible, as this can help narrow down the cause.

  2. Do a physical examination of the painful area, and check your range of movement and strength.

  3. Review any relevant scans and other previous investigations.

  4. Talk through their initial findings and what will happen next.

They may also:

  • recommend further imaging tests such as MRI, CT scan or X-ray

  • recommend nerve studies such as electromyography (EMG), to measure nerve impulses and muscle response

If your sciatica is caused by health conditions, you may not be able to reduce your risk. But there are some lifestyle tips that can help reduce your lower your chance of developing sciatica. These include:

  • keeping an eye on your posture – stand up straight with shoulders gently back, avoiding slouching

  • stopping smoking if you smoke – smoking increases your risk of arthritis

  •  managing your weight if you are obese – extra weight puts more pressure on your joints

  • sitting correctly when at a work desk – do any health and safety checks of your workstation and follow their advice

  •  lifting any heavy objects using a safe technique

  • staying active –  regular movement helps keep your spine healthy, and a strong core offers support to your spine

  • staying safe when you’re physically active – stretch before and after exercise and sports,  wear protective gear, stop if you feel any pain

Complications are most likely to come if you don’t get your sciatica and its underlying cause diagnosed and treated. These might include worsening of the pain, or making the damage worse.

Your consultant will talk you through any potential complications of treatments you may need to manage the pain, such as medications or surgery.

Once your sciatica has been diagnosed, and your consultant is clear about the possible cause or causes, they’ll recommend the most appropriate next steps and will arrange treatment to ensure you make the best possible recovery. 

Treatment options for sciatica include:

  • medications such as pain relief, muscle relaxants and anti-inflammatories

  • physiotherapy

  • injections to relieve pain and inflammation

  • decompression surgery to remove portions of a vertebra or herniated disk to relieve pressure on the nerve

Our consultants have access to multidisciplinary teams who can be brought in to support your personalised pain management plan. 

At Welbeck, our pain medicine specialists are experts in their field and are dedicated to providing world-class care to every patient.

With access to colleagues across other specialties, our consultants are also able to refer within the Welbeck ecosystem if required to ensure you receive the treatment you need as quickly as possible, all under one roof.  

All appointments, testing, treatment, and follow-up appointments take place within our state-of-the-art facilities, enabling us to deliver accurate diagnostics and advanced treatments.

Your health is important to us, so we strive to offer same-day appointments whenever possible.

Our consultants are recognised by the major health insurance companies. If you have private health insurance, your treatment at Welbeck can begin once you have obtained authorisation. We also provide care to self-paying patients. Learn more about the different payment options at Welbeck.

Get in touch today to book an appointment.

Our locations

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London

1 Welbeck Street
Marylebone
London
W1G 0AR

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Frequently asked questions

You should get emergency medical attention if:

  • you have sciatica symptoms on both sides

  • the weakness or numbness in both legs is severe or getting worse

  • you feel numb around or under your genitals, or bottom (anus)

  • you have loss of bowel or bladder control

  • severe pain stops you from doing your normal activities and lasts for a few hours

  • you get sudden severe pain, numbness or any other sciatica symptoms immediately after an accident, fall or injury

You can often manage sciatica with self-care. If it doesn’t resolve after a few weeks, or you’re in a lot of pain, we recommend seeing a consultant. We aim to see you as quickly as possible, especially if you’re in a lot of pain. For self-care, you can:

  • carry on with your normal activities, including work, as much as possible – pace yourself and build up, as the nerve can still be sensitive

  • ask your consultant to recommend any exercises you could do

  • take painkillers such as ibuprofen

  • try ice packs in the first few days if you have swelling – always wrap the ice pack in a towel to prevent ‘ice burns’). Apply cold for 20 minutes at a time, several times a day

  • switch to a heating pad or warm compress in 20-minute bursts after a few days if there’s no swelling and your pain isn’t related to a recent injury

  • some people find switching between hot and cold packs helps

Mild cases of sciatica usually go away with time and self-treatment. Most people (between 80% to 90%) with sciatica get better without the need for surgery.

Our pain management specialists work with a range of other specialists, so if you are diagnosed with a health condition, such as rheumatoid or osteoarthritis, we can arrange onward consultations with them and create a pain management plan together.

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