Sciatica

What is it?

Sciatica is an umbrella term used to describe leg symptoms that arise from the back.

There are many different causes of sciatica.

Symptoms may come on suddenly and be constant or intermittent.

Typical symptoms/features

  • Leg pain on one or both legs
  • Tingling, pins and needles or numbness in the leg or foot
  • May have weakness in the calf or muscles around the ankle
  • Symptoms may come and go or be constant
  • Pain can be worse on coughing or sneezing
  • Symptoms often worse with staying in one position too long or bending

Management

  • Activity modification
    • When you first start noticing low back pain, it may help to reduce your activity for a short amount of time to allow the pain to settle
    • However, there is strong evidence that says keeping active and slowly returning to your normal levels of activity can actually help the pain to settle quicker
  • Ice or heat
  • Pain relief
  • Physiotherapy including range of movement exercises and a graded strengthening programme
  • Orthopaedic options- In more severe and/or prolonged cases, orthopaedic surgical opinion may be indicated to help with leg symptoms

Do I need imaging?

Imaging (X-rays or scans) are rarely required to diagnose sciatic pain.

Scans correlate poorly with symptoms. Most people without low back pain have changes on scans and x-rays which do not cause any pain at all.

However, MRI may be appropriate if symptoms do not improve with conservative measures and surgery is being considered.

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