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Sciatica

Sciatica is the medical term for a symptom that is usually caused by irritation of or injury to a nerve root in the low back. It feels like back pain that seems to travel down one or both legs, below the knee.

Most people with acute sciatica get relief within two weeks, with more than 75% reporting improved symptoms within four weeks.

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Related services include:

  • Orthopaedics.
  • Pain Management.
  • Rehabilitation.
  • Spine.

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  • What Is Sciatica?
  • How Do You Treat Sciatica?

What Is Sciatica?

Sciatica is the medical term for low back pain that radiates down one or both legs, below the knee.

Sometimes people experience sciatica more than once, and some people experience chronic sciatica that lasts for a long time. Most people with sciatica do not need surgery or any other medical procedure.

The name is confusing because the term “sciatica" sounds like a condition of the sciatic nerve – the long nerve that is responsible for movement and sensation in the leg, foot, and ankle. But sciatica is not a problem of the sciatic nerve.

What causes sciatica?

“Sciatica" is not actually a problem of the sciatic nerve itself.

Instead, sciatica is usually caused by irritation of or injury to one of the nerve roots that combine to form the sciatic nerve. Usually, the site of irritation or injury is at the spinal column in the lumbar spine (low back), and the source of irritation to the nerve root is a bulging disc.

Discs are small structures that act as shock absorbers between the vertebrae (bones of the spinal column). Even small disc bulges can cause significant back pain, and even a small amount of pinching around a nerve root in the low back can cause painful sciatica. Often, sciatica feels worse with certain movements or positions, and better with others.

When sciatica is accompanied by symptoms of nerve injury, such as focal numbness and weakness, the underlying problem is likely to be lumbar radiculopathy (nerve-root injury of the low back).

The likelihood that someone will experience sciatica may be increased if they have certain anatomical factors, including scoliosis, lumbar spinal-canal stenosis, and spondylolisthesis.

As with many symptoms, in rare cases sciatica can be caused by a tumor or an infection. Sometimes, the symptom of sciatica might be due to two separate problems – one causing back pain, and one causing leg pain.

Sometimes, no cause can be found for sciatica.

What are sciatica risk factors?

Sciatica most commonly occurs in middle-aged adults.

Episodes of sciatica are often triggered by some sort of movement, such as bending, lifting, or twisting. However, that does not mean that those movements should be avoided in the long-term. The best long-term plan is to gradually return a full range of normal activities.

How can I reduce my risks of sciatica?

The best things to do to reduce the risk of sciatica tend to be the things that are good for overall health:

  • Get enough sleep.
  • Eat nutritiously.
  • Exercise regularly.

That said, sciatica affects many people who are basically healthy. As with many other sources of discomfort, there can be a bit of randomness to who gets it and when.

If you are trying to reduce your risk of sciatica, it can be helpful to try to improve the way that you move. For example, increasing your core strength, improving your posture, increasing flexibility of muscles and ligaments, or changing the pattern in which you turn on different muscles (muscle memory), can help prevent sciatica.

We encourage people to “do what they train for, and train for what they do." This simply means you should practice movements like bending, lifting, and twisting so that you can do them fluidly, without fear, and without pain.

How common is sciatica?

Sciatic nerve pain is a common type of back pain affecting many people in the U.S. According to the American Medical Association (AMA), up to 40% of all Americans will experience sciatica at some point in their lives.

When should I see a doctor about my sciatica?

Contact your provider right away if you have sciatica pain along with other symptoms that could be serious, including:

  • A severe blow or fall.
  • Redness or swelling of the spine.
  • Pain that gets worse when you lie down.
  • Pain that wakes you up from sleep.
  • Unexplained fever.
  • Urinary or fecal loss of control.
  • Progressive weakness in your pelvis, buttocks, thigh, or leg, ankle or foot.

Also contact your provider if you have sciatica and:

  • Have had back pain before, but this time it feels significantly worse or different.
  • Have had sciatica for more than four weeks.
  • Have lost weight without trying to.
  • Use IV drugs or long-term steroids.

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How Do You Treat Sciatica?

The symptom of sciatica usually improves with time, whether it is due to lumbar radiculopathy or some other cause.

Sometimes over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can help with the pain. Sometimes exercises or stretches can help people feel better faster.

For example, some people feel better by bending forward at the waist, while other people feel better by extending at the waist. Often people feel better with standing or walking, rather than sitting.

In the early stages of recovery from sciatica, it is best to start moving in ways that feel good rather than ways that feel bad.

Nonsurgical treatment

Bed rest is not recommended when you have sciatica.

The pain often causes people to reduce their activities temporarily, but over time the goal should be to gradually return to your usual activities. Sometimes the recovery takes only a few days; other times it takes weeks or even months.

If sciatica pain is severe, some physicians might prescribe prescription pain medication. If a specific cause can be found on imaging of the low back, such as MRI, then you might be given an injection of corticosteroid around one of your lumbar nerve roots.

These injections are sometimes called epidural steroid injections or selective nerve-root blocks. While they do not fix anything or directly help with healing, epidural steroid injections can help make the pain less bothersome during the body's healing process.

Exercises and stretches for sciatica

Because sciatica typically improves on its own, the best treatment involves gradually reintroducing normal movement. It is generally recommended to start with lower-intensity exercise, such as walking or isometric core exercises, before starting higher-impact exercise, such as running or weightlifting.

Sometimes it can be helpful to work with a physical therapist to find ways of moving that are smoother and feel better. A physical therapist can also help with posture, endurance, strength, and/or flexibility in ways that will reduce the risk of sciatica recurring.

Surgical treatment

Surgery is only recommended in cases of severe chronic pain or progressive weakness when a specific explanation can be identified on diagnostic testing, and the anticipated benefits of surgery outweigh the risks.

In a patient whose problems are due to compression of a nerve root, surgery usually involves decompression, such as with discectomy which involves removal of part of the disc. Sometimes, if the decompression surgery is going to make the spine unstable, the surgeon will also perform a spinal fusion.

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By UPMC Editorial Staff. Last reviewed on 2025-06-26.

  • Medline Plus. Sciatica.
  • HealthDirect. Sciatica.
  • National Library of Medicine. Diagnosis and treatment of sciatica.
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