Spine Care
Sciatica
Sciatica is pain that radiates along the sciatic nerve — from the lower back through the hip and buttock and down one leg. It is a symptom, not a diagnosis, so finding the underlying cause is the first step toward effective treatment.
Symptoms
How Sciatica Feels
The pain typically affects only one side of the body. It can range from a mild ache to severe, debilitating pain — some people have intermittent symptoms, others constant discomfort.
- Pain starting in the lower back or buttock and travelling down the back of the thigh to the calf, ankle, or foot
- Often described as sharp, burning, or electric
- Numbness or tingling in the leg or foot, and weakness when lifting the foot
- Pain that worsens with sitting, coughing, or sneezing; difficulty standing or walking
Common Causes
What Causes Sciatica
Herniated Disc
The most common cause — disc material presses on the nerve root.
Spinal Stenosis
Narrowing of the spinal canal compresses nerves. More common with age.
Spondylolisthesis
One vertebra slips forward over another, pinching the nerve.
Piriformis Syndrome
The piriformis muscle in the buttock irritates or compresses the sciatic nerve.
Degenerative Disc Disease
Age-related changes reduce disc height and may cause nerve irritation.
Bone Spurs
Bony overgrowths can narrow the space available for nerves.
Risk Factors
What Raises Your Risk
- Age — disc changes are more common after 30
- Obesity, which increases spinal stress
- Prolonged sitting, especially with poor posture
- Jobs involving heavy lifting, twisting, or long-distance driving
- Diabetes and smoking, which affect nerves and spinal blood flow
Diagnosis
How Sciatica Is Diagnosed
- Clinical examination — testing reflexes, strength, and sensation; the straight-leg-raise test identifies nerve root tension.
- MRI — shows disc herniations, stenosis, and other soft-tissue causes.
- X-ray — shows bone alignment, fractures, and bone spurs.
- EMG / nerve conduction studies — used if the diagnosis is unclear or to assess nerve function.
Treatment · Step One
Non-Surgical Care First
Most sciatica improves within 4 to 6 weeks with conservative care. Surgery is rarely the first option.
- Activity modification — avoid prolonged sitting, take short walks, and avoid bending and heavy lifting.
- Medications — anti-inflammatories, muscle relaxants for spasm, and nerve-pain medication (gabapentin, pregabalin).
- Physiotherapy — core strengthening, stretching, and posture correction to help prevent recurrence.
- Epidural steroid injections — corticosteroid near the affected nerve root to reduce inflammation.
- Heat and ice — ice in the first 48 hours, then heat to relax the muscles.
Treatment · When Needed
When Surgery Is Considered
Surgery is typically considered after 6 to 12 weeks of conservative treatment if symptoms remain severe. It may be recommended earlier if there is significant weakness, progressive neurological deficit, or cauda equina syndrome.
- Microdiscectomy — removal of the disc fragment pressing on the nerve. The most common surgery for sciatica caused by a herniated disc.
- Laminectomy — removal of bone to create more space for the nerves. Used for stenosis.
Prognosis
About 80 to 90 percent of people improve with
conservative treatment alone.
Red Flags
Seek Emergency Care
Go to an emergency department immediately if you experience any of the following — they may indicate cauda equina syndrome, which requires urgent surgery:
- Loss of bladder or bowel control
- Numbness in the groin, inner thighs, or buttocks (saddle anaesthesia)
- Sudden severe weakness in both legs
- Rapidly worsening symptoms
Get Started
Is Sciatica Affecting Your Day?
If sciatica is affecting your daily life, call +966 50 580 8852 to schedule an evaluation with Professor Al-Othman.
Related
Related Spine Conditions
Disc Prolapse
The most common cause of sciatica — a herniated disc pressing on the nerve root.
Spinal Stenosis
Canal narrowing that compresses nerves and can produce sciatic pain.