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The Beyond Pain Foundation

Conditions we support

Conditions guide

Sciatica

Sciatica is pain, tingling or numbness that travels from your lower back down one leg, caused by an irritated or squeezed nerve. It can be very painful, but most people get better within weeks to months. This guide explains the causes, how long it lasts, the treatments available in the UK, and your rights at work.

Most common cause
A slipped disc
Most often affects people aged
40 to 50
Much better by 12 weeks
About half
Recovered after a year
About 3 in 4

This guide is general information, not medical advice. Medicines and treatments must be prescribed or recommended for you by a doctor or pharmacist. We do not give doses here.

What sciatica is

The sciatic nerve is the longest nerve in the body. It runs from your lower back, through your buttock and down the back of each leg to your feet. Sciatica is the name for symptoms caused when the nerve roots that form it are irritated or pressed on. Doctors may call it lumbar radiculopathy.

The leg pain is usually worse than any back pain. Back pain on its own is not sciatica.

It is most common in people aged 40 to 50. You are more likely to get it as you get older, if you do heavy lifting or twisting, sit for long periods, carry extra weight or smoke.

Many people worry sciatica means serious damage. In most cases it doesn't. The body often heals the cause on its own. A bulging disc can shrink back over time, which takes the pressure off the nerve.

Types and causes

Sciatica is a symptom with several possible causes. Doctors may also describe it by how long it has lasted.

Slipped disc

The most common cause. The soft centre of a disc bulges out and presses on or inflames a nerve root. See our slipped disc guide.

Spinal stenosis

Narrowing of the spaces around the nerves, usually with age. It can cause heavy, aching legs when walking that ease when you sit or lean forward.

Spondylolisthesis

When one bone in the spine slips forward over the one below it, narrowing the space for the nerve.

Acute sciatica

Symptoms that have lasted less than 3 months. Most people get better in this time.

Chronic sciatica

Symptoms that have lasted more than 3 months. Treatment choices change at this point, so ask for a review.

Bilateral sciatica

Sciatica in both legs at once. This can be a warning sign of cauda equina syndrome and needs urgent checking.

Rarer causes

An injury to the spine, or very rarely an infection or growth. Doctors look for signs of these when they examine you.

Symptoms and how long it lasts

Sciatica usually affects one leg. Symptoms can start suddenly or build up over time. You may have:

  • Sharp, shooting or burning leg pain
  • Pain in the buttock or down the back of the leg
  • Pins and needles
  • Numbness in the leg or foot
  • Weakness in the leg or foot
  • Pain worse when coughing or sneezing
  • Pain worse sitting or bending
  • Milder back pain

  1. First few weeks

    Early stage

    Pain is often at its worst. Keep moving gently, use painkillers that help, and try heat. Many people start to improve within 4 to 6 weeks.

  2. 6 to 12 weeks

    Settling

    Pain usually eases bit by bit. By 12 weeks, about half of people are much better. Physiotherapy can help you build up activity.

  3. After 3 months

    Persistent

    If severe pain hasn't eased, ask your GP about a specialist review. Injections or surgery may be discussed.

  4. Up to a year

    Recovery

    About 3 in 4 people have recovered after a year. Numbness can take longer to go than pain. Sciatica can come back.

Timings are typical ranges, not exact rules. Everyone recovers at a different pace.

When to get urgent help

Cauda equina syndrome is rare but serious. It happens when the nerves at the bottom of the spine are badly squeezed, and needs emergency surgery to prevent lasting problems with the bladder, bowel, sex and legs. Don't wait to see if it gets better, and don't drive yourself to A&E.

Call 999 or go to A&E if you have

  • sciatica in both legs
  • weakness or numbness in both legs that is severe or getting worse
  • numbness around your genitals or bottom, such as not feeling toilet paper when you wipe
  • difficulty peeing, or not being able to control when you pee or poo, if this isn't normal for you
  • new problems getting or keeping an erection, with any of the above

Call NHS 111 or your GP urgently if

  • weakness in your leg or foot is getting worse, such as your foot dragging or slapping as you walk
  • you have a high temperature or feel very unwell with back pain
  • the pain is so severe you can't cope at home

See your GP if

  • the pain hasn't improved after a few weeks of treating it yourself
  • the pain is getting worse
  • it stops you doing your normal activities or working
  • you have lost weight without trying, or have had cancer

Diagnosis and referral

A GP or physiotherapist can usually diagnose sciatica by asking about your symptoms and examining you. They test the strength, feeling and reflexes in your legs, and may ask you to lift your straight leg while lying down.

You don't usually need a scan. Scans are mainly used if you have warning signs, or if a specialist is considering injections or surgery. An MRI scan shows discs and nerves clearly. An X-ray can't show discs.

Your GP may refer you to physiotherapy, a community musculoskeletal (MSK) service, or a hospital spinal team if pain is severe and not improving.

You can often see a physio without your GP

In many areas you can refer yourself to NHS physiotherapy, and many GP surgeries in England have a first contact physiotherapist you can book through reception. NHS physio waits can be long. Check get NHS help for back or joint problems for your area.

Treatments and medicines

The main treatments are staying active, exercise and painkillers that help you keep moving. The evidence for medicines in sciatica is weaker than many people expect.

Exercise and physiotherapy

NHS physio, self-referral or GP referral

Gentle stretches and exercises, built up over weeks, help you move with less pain. A physio can tailor them to you and may add manual therapy such as massage or mobilisation alongside the exercise.

Anti-inflammatory painkillers (NSAIDs)

Ibuprofen from a pharmacy. Naproxen and others on prescription

These may take the edge off pain for some people, though the NHS says it isn't clear how well they work for sciatica. They aren't suitable for everyone, so ask a pharmacist first.

Weak opioids

Codeine on prescription. Low-strength co-codamol from a pharmacy

May be used for a short time for new, severe sciatica, with a plan to stop. NICE says opioids should not be used for chronic sciatica. They can cause drowsiness, constipation and dependence.

Nerve pain medicines

Prescription only

Some people with long-lasting nerve pain are offered medicines such as amitriptyline or duloxetine under NICE's nerve pain guidance. They are started low and can take a few weeks to help. Your GP should review whether they are working.

Psychological support and pain programmes

NHS Talking Therapies or a pain service

CBT and pain management programmes help you cope with pain, sleep and worry, and plan a return to activity.

Medicines NICE says not to use for sciatica

NICE advises against gabapentin and pregabalin (gabapentinoids), other anti-epilepsy medicines, steroid tablets and benzodiazepines such as diazepam for sciatica. Studies found no overall benefit and some harm. Paracetamol on its own is also unlikely to help.

If you already take one of these, don't stop suddenly, as some need to be reduced slowly. Ask your GP or pharmacist to review them with you.

Injections and surgery

Most people never need these. They are considered when pain is severe and hasn't improved with other treatment.

  1. Epidural steroid injection

    Relief can take a few weeks, and lasts days to months

    A local anaesthetic and steroid injected near the nerve. NICE says it can be considered for new and severe sciatica. It is done as a day case, and you will need someone to drive you home. It doesn't help everyone, and it isn't recommended for leg pain on walking caused by spinal stenosis.

  2. Radiofrequency denervation

    Relief can take 1 to 2 weeks

    Heat is used to stop small nerves sending pain signals. The NHS lists it as an option for some people with severe pain. Your specialist will check whether it suits the cause of your pain.

  3. Spinal decompression surgery

    Light work after about 2 to 6 weeks. Full recovery up to 12 weeks

    NICE says surgery can be considered when non-surgical treatment hasn't improved pain or function. A microdiscectomy removes the part of a disc pressing on the nerve. A laminectomy removes a little bone to make more space. Most people go home within 1 to 5 days. Leg pain improves well for most people, but back pain may not change.

    Risks: as with any surgery, there is a small risk of infection, nerve damage, a leak of spinal fluid, blood clots or the disc slipping again. Ask your surgeon about your own risks.

Self-help and living well

When pain is bad

  • Keep moving gently, even if it is only short walks
  • Avoid long periods sitting or lying down
  • Use a heat pack on your back or buttock
  • Try different positions, such as lying on your side with a pillow between your knees
  • Ask a pharmacist which painkillers suit you

As you recover

  • Do your exercises little and often
  • Build up activity slowly and pace yourself
  • Keep a regular sleep routine
  • Talk to someone if worry or low mood builds up
  • Stay active long term and stop smoking if you can

Tips for getting the best treatment

Keep a symptom diary

  • Score your leg pain and back pain separately, from 0 to 10
  • Note any numbness, weakness or changes in walking
  • Write down what medicines you take and whether they help
  • Record how far you can walk, how long you can sit, and how you sleep

This shows whether you are improving, and helps a specialist decide on treatment.

Questions to ask

  • Can I refer myself to physio, or see a first contact physiotherapist?
  • Is my leg weakness something to keep an eye on?
  • Are my medicines recommended for sciatica? Should any be stopped?
  • If I'm not better by 3 months, when should I be referred to a spinal specialist?
  • Would an injection or surgery suit me, and what are the risks?
  • Can I have a fit note suggesting changes at work?

You can ask for a second opinion if you are unsure about a recommended treatment. In England you usually have the right to choose where you are referred, which may shorten your wait.

Sciatica and work

Most people don't need long off work. Staying in work, with changes if needed, usually helps recovery.

Long-lasting or recurring sciatica can count as a disability under the Equality Act 2010 (the Disability Discrimination Act in Northern Ireland). This applies if it has a substantial (more than minor) effect on daily life and has lasted, or is likely to last, at least 12 months. Conditions that come and go can count.

If it does, your employer must make reasonable adjustments. These might include:

  • A sit-stand desk, so you can change position
  • A supportive ergonomic chair or seat cushion
  • A workstation assessment
  • Regular breaks to walk and stretch
  • Less lifting, or lifting aids
  • Less driving, or breaks on long journeys
  • Flexible hours or working from home
  • A phased return after time off

Access to Work is a government grant that can pay for specialist equipment and support at work. For advice on your rights, contact Acas or Citizens Advice.

Benefits

If you are off work, you may get Statutory Sick Pay from your employer for up to 28 weeks. If sciatica makes everyday tasks or getting around hard for 3 months or more, and it is expected to last at least 9 more months, you may get Personal Independence Payment (PIP), or Adult Disability Payment in Scotland. If you can't work, check Employment and Support Allowance or Universal Credit. Turn2us and Citizens Advice can help you check.

How The Beyond Pain Foundation can help

If NHS waits are too long, or the help you need isn't available to you on the NHS, we may be able to fund:

  • A course of private physiotherapy to get you moving sooner
  • A private consultation with a spinal specialist, or a private MRI scan your doctor has asked for
  • A private pain management programme
  • A sit-stand desk, ergonomic chair or supportive seating for work
  • Aids that make daily tasks easier while you recover

We fund treatment from registered practitioners. We can't pay for things you have already bought, debts or everyday living costs. Prices vary, so always get a written quote to include with your application.

Apply for funding Check the requirements

Support and sources

Arthritis UK

Charity (formerly Versus Arthritis)

Free helpline 0800 5200 520, Monday to Friday, 9am to 6pm. Information on back pain and sciatica.

arthritis-uk.org

Pain Concern

Charity for people living with pain

Helpline 0300 123 0789. Leave a message and they will usually call back the next working day.

painconcern.org.uk
Sources for this guide

Last reviewed: October 2026.