Overview
Sciatica is pain that travels along the sciatic nerve, from the low back or buttock down the back of the leg. It is usually caused by irritation or compression of a lumbar nerve root.
Many cases improve within weeks with activity and conservative care. If pain persists or is severe, an epidural steroid injection or other options may be considered.
Watch: Sciatica explained
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Common symptoms
- Pain radiating from the buttock down the leg
- Numbness or tingling in the leg or foot
- Leg weakness
- Pain worse with sitting, coughing or sneezing
Causes and risk factors
- Herniated lumbar disc
- Lumbar spinal stenosis
- Spondylolisthesis
- Piriformis-related nerve irritation
How it is diagnosed
Diagnosis usually starts with a conversation about your symptoms and a physical exam. Depending on what we find, your clinician may order X-rays, an MRI or CT scan, or nerve tests. Imaging findings are interpreted together with your exam, because many people have changes on an MRI that do not cause pain.
Treatment options
Care is stepped: most people start with self-care and physical therapy, and move to the next step only if pain continues. Some problems, such as nerve weakness, may skip ahead. Your exam, imaging and goals decide which options fit you.
Self-care and lifestyle
Many cases of sciatica improve over weeks. Gentle walking, avoiding long sitting, heat and nerve-friendly stretches may help.
Physical therapy and medications
Physical therapy and short-term medicines, including anti-inflammatories or nerve pain medicines, may be used.
Injections and nerve blocks
An epidural steroid injection or selective nerve root block may calm an irritated nerve root and help confirm which level is involved.
Minimally invasive procedures
If stenosis is the cause, MILD may be an option. Spinal cord stimulation may be considered for long-lasting leg pain.
Surgical evaluation
Surgery such as microdiscectomy may be considered for leg pain that does not improve, or sooner for weakness. Loss of bladder or bowel control is an emergency.
Learn how we approach care: our care philosophy · nonsurgical options · second opinions.
When to seek urgent care
Call 911 or go to the emergency department for new or rapidly worsening weakness, numbness in the groin or inner thighs, loss of bladder or bowel control, severe pain after a significant fall or accident, or pain with fever or unexplained weight loss.
Frequently asked questions
How long does sciatica last?
Many episodes improve within four to six weeks. Some people have symptoms that last longer or come back.
When is sciatica an emergency?
Seek emergency care for numbness in the groin or inner thighs, loss of bladder or bowel control, or rapidly worsening leg weakness.
Can an injection help sciatica?
An epidural steroid injection may reduce nerve inflammation and pain for some patients, helping them participate in therapy. Results vary.
This page is general patient education and does not replace advice from your own clinician. Individual results vary.