What is Sciatica?
Sciatica refers to pain that radiates along the path of the sciatic nerve — the longest nerve in the body — which runs from the lower back through the hips and buttocks, down each leg. The sciatic nerve forms from multiple nerve roots at L3–S3 in the lumbar spine.
True sciatica is a symptom, not a diagnosis. It indicates compression or irritation of the sciatic nerve or one of its contributing nerve roots — most commonly due to a herniated disc at L4-L5 or L5-S1. It typically affects only one side of the body.
Common Misconception: Many people call any leg pain "sciatica." True sciatica specifically follows the distribution of the sciatic nerve. Accurate diagnosis is essential for effective treatment.
Symptoms
Sharp, shooting pain from lower back through buttock and down the leg
Electric shock or burning sensation along the leg
Numbness or tingling in the leg, calf, or foot
Muscle weakness — foot drop in severe cases
Pain that worsens when sitting, coughing, or sneezing
Difficulty walking or standing for prolonged periods
Causes
- Herniated or slipped disc (most common cause — 90% of cases)
- Spinal stenosis — narrowing of the spinal canal
- Degenerative disc disease and spondylosis
- Spondylolisthesis — vertebral slippage
- Piriformis syndrome — muscle spasm compressing the nerve
- Spinal tumour or cyst (rare)
Diagnosis
- Comprehensive neurological examination
- MRI of the lumbar spine — identifies disc herniation and nerve compression
- CT scan — bone assessment
- Nerve conduction study — assesses nerve function and severity
- SLRT (Straight Leg Raise Test) — clinical bedside assessment
Treatment Options
Frequently Asked Questions
How long does sciatica last?
Most cases of acute sciatica resolve within 4–8 weeks with conservative treatment. However, some patients develop chronic sciatica lasting months or years. If pain is severe, associated with weakness, or doesn't improve within 6 weeks, specialist evaluation is strongly recommended. Surgery provides rapid, lasting relief for the right candidates.
What makes sciatica worse?
Sitting for prolonged periods, coughing, sneezing, bending forward, and heavy lifting typically worsen sciatica. Activities that increase intra-abdominal pressure increase pressure on the herniated disc, which then presses harder on the nerve. Walking and lying down usually provide more relief than sitting.