Sciatica: symptoms, treatment, how long it lasts and when to get help

The NHS says symptoms usually affect the bottom and the back of one leg, often including the foot and toes. You may feel a sharp, burning pain down the back of the leg, tingling like pins and needles, numbness or weakness. Symptoms may come on suddenly but can also start slowly, and the pain may be worse when moving, sneezing or coughing.

You may also have back pain, but the NHS says it is not usually as bad as the pain in the leg, and you probably do not have sciatica if you only have back pain.

The NHS says treatments can include exercises and stretches, painkillers, and physiotherapy, including exercise advice and manual therapy such as massage. Physiotherapy is free on the NHS throughout the UK but waiting times can be long, and you can also get it privately.

If pain is severe and treatments have not helped, the NHS says you may be referred to a hospital specialist for a procedure to seal off nerves in the back so they stop sending pain signals (radiofrequency denervation), a painkilling injection such as an epidural, or decompression surgery, which can sometimes help relieve sciatica.

The NHS says sciatica usually gets better in a few weeks to a few months, but it can sometimes last longer. It can also return if you have had it before. See a GP if the pain has not improved after trying home treatments for a few weeks, is getting worse, or is stopping you doing normal activities.

The NHS says to carry on with normal activities as much as possible, try regular exercises for sciatica, start gentle exercise as soon as you can (anything that gets you moving can help) and hold heat packs to the painful areas. It says not to sit or lie down for long periods, because even if moving hurts, it is not harmful and can help you get better faster.

On painkillers, the NHS says to ask a pharmacist, noting that paracetamol is unlikely to help and it is not clear how much NSAIDs such as ibuprofen help with sciatica.

The NHS says sciatica happens when something presses or rubs on the sciatic nerve.

• a slipped disc, when a soft cushion of tissue between the bones in the spine pushes out; this is the most common cause and is more likely as you get older

• spinal stenosis, a narrowing of the part of the spine where nerves pass through

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

• a back injury

The NHS says to go to A&E or call 999 if you have any of the following. These could be symptoms of a serious back problem that needs to be treated in hospital as soon as possible. Do not drive yourself; ask someone to drive you or call 999.

• sciatica on both sides

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

• numbness around or under your genitals, or around your bottom (anus)

• finding it hard to start peeing, being unable to pee or not being able to control when you pee, when this is not normal for you

• not noticing when you need to poo or being unable to control when you poo, when this is not normal for you

The NHS page on back pain in pregnancy does not mention sciatica by name, but explains that ligaments soften and stretch in pregnancy, which can strain the joints of the lower back and pelvis. It advises paracetamol (unless your GP or midwife says not to), flat shoes, good support when sitting, rest, a warm bath or massage, and back care classes. If it is very painful, talk to your GP or midwife, who may refer you to an obstetric physiotherapist.

The NHS says to contact your GP or midwife urgently if back pain comes with fever, vaginal bleeding or pain when you pee, or if you are in your second or third trimester because it could be a sign of early labour. Call 999 or go to A&E if you lose feeling in one or both legs, your bottom or your genitals.

The NHS says there is a chance you could get sciatica again if you have had it, but you can reduce the chance.

• stay active and take regular exercise

• use a safe technique when lifting heavy objects

• have good posture when sitting and standing, and sit correctly when using a computer

• lose weight if you are overweight

• do not smoke, because smoking can increase your risk of sciatica

The NHS says back pain is very common and usually improves within a few weeks, and that sciatica (a trapped nerve) is one of several conditions that can cause back pain. It lists reasons to see a GP about back pain, including pain that does not improve after treating it at home for a few weeks, pain that is worse at night, unexplained weight loss, a lump in the back, or pain that is worse when sneezing, coughing or pooing.

The NHS says that in many areas you can refer yourself to community musculoskeletal (MSK) services for physiotherapy without a GP referral. A GP can refer to hospital specialists if pain is severe. You can also pay for physiotherapy, injections or specialist spinal consultations privately. NICE guideline NG59 on low back pain and sciatica sets out the care people in England should expect, so you can ask a provider how their approach compares.