What is sciatica?

Sciatica (or lumbar radicular pain) is pain that extends from the lower back and into the leg, usually below the knee and sometimes into the foot. For most people, this pain occurs when a disc in the spine is irritating one of the nerves that run from the spine into the leg.

What does sciatica feel like?

Sciatic pain can range from very mild to very strong. Often people can feel a burning, tingling or sharp feeling, while for others it is an ache. Some people can also feel numbness, pins and needles or weakness in the leg or foot.

How does sciatica change over time?

• Most people with sciatica start to improve within 6 weeks without intervention.
• For most people, pain does not get worse.
• After 3 months, most have much less pain, most no longer use medicine to manage their pain, and most are able to return to leisure activities (e.g. hobbies or sport).

What are your treatment options for sciatica?

1. Surgery: this means going to hospital (usually 2‒3 days) and rehabilitation (e.g. physical therapy).
2. Try other options first: this could include pain medicines, exercises, and manual therapy of the spine.

How well does surgery for sciatica work compared to trying other options first?

• Having surgery can help your leg pain improve faster in the first few months.
• By 12 months, most people in both groups (surgery and try other options first) are free of pain (about 95%).
• About 12% of people who have surgery for sciatica go onto have serious complications (e.g. less movement or sensation, or new sciatic pain).
• After 1 year, most people who try other options first do not end up needing surgery (61%).
• Having surgery does not guarantee that the pain will go away. A small number of people need surgery more than once (up to 10%).
• In the long-term, both treatment options are about the same. So, one good question to ask yourself is: can you wait?

To learn more, you can check out this patient decision aid.

As always, consult with a trusted health professional for advice specific to you.

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References

1. Ayre et al. (2024) (PMID: 38896009)