Sciatica is pain that travels from the lower back or buttock down the leg, often below the knee, because a nerve root in the lower spine is irritated or compressed. The most common cause is a herniated disc. It can be very painful, but for most people it settles without surgery, and the disc material itself often shrinks over time. Some features need urgent care, and this page lists them first.
Numbness around the genitals, buttocks or inner thighs, new difficulty passing urine, loss of bladder or bowel control, or weakness in both legs. These can be signs of cauda equina syndrome. See red flags.
What it feels like
- Pain that runs down one leg, often worse than the back pain.
- Tingling, pins and needles or numbness in part of the leg or foot.
- Sometimes weakness, for example difficulty lifting the foot or standing on tiptoe.
- Pain that can be worse with sitting, coughing or bending.
Which part of the leg is affected depends on which nerve root is involved; see numbness and tingling.
What causes it
Most often a disc herniation presses on or inflames a nerve root. Less often the cause is narrowing of the spinal canal, more common in older adults; see spinal stenosis.
Will it get better?
For most people, yes, though it can take weeks to months. Herniated disc material is often broken down by the body: in observational series it shrank over a mean of about 8.7 months, while people felt clinically better much sooner, in a mean of about 5.7 weeks with non-surgical care.1 Larger and extruded herniations, which look worse on a scan, are the ones more likely to shrink. See can a herniated disc heal on its own?
Predicting who recovers is hard. A systematic review of prognostic factors in non-surgical sciatica found conflicting and mostly negative results for pain severity, neurological signs, symptom duration and scan findings, and noted that psychological factors were rarely studied.2
What helps
| Approach | Guidance |
|---|---|
| Stay as active as you can | Bed rest is not recommended; keep moving within comfort |
| Exercise | NICE suggests considering group exercise for low back pain with or without sciatica3 |
| Gabapentinoids, other antiepileptics, oral steroids, benzodiazepines | Not recommended by NICE for sciatica: no overall benefit and evidence of harm3 |
| Imaging | Only if the result would change management, such as when surgery is being considered3 |
| Surgery | An option for some people whose leg pain does not settle or who have progressive weakness; discuss with a specialist |
Living with it while it settles
- Change position often; long sitting is often the hardest.
- Short, frequent walks usually help more than rest. See walking for back pain.
- A scan showing a disc bulge is common even without pain, so it is not always the explanation.4
When to see a clinician
Soon, if leg pain is severe, you have numbness or weakness, or it is not improving after a few weeks. Urgently, for any of the signs at the top of this page.
Footnotes
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Prediction and mechanisms of spontaneous resorption in lumbar disc herniation: narrative review. 2024. ↩
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Prognostic factors in non-surgically treated sciatica: a systematic review. 2011. ↩
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Low back pain and sciatica in over 16s: assessment and management (NICE guideline NG59). 2026. ↩ ↩2 ↩3
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Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. 2015. ↩
General information, not medical advice. Every claim carries its source; where the evidence is thin, the page says so.Editorial policy · How we grade evidence · All sources · Disclaimer