Sciatica is a common condition that occurs when the sciatic nerve, which runs from the lower back down to the feet, becomes irritated or compressed. This can lead to a range of uncomfortable symptoms, most notably pain that radiates down the back of the leg and often reaches the feet and toes. While sciatica typically improves within a few weeks or months, it can persist longer in some cases and has the potential to return later in life [1].
The hallmark symptoms of sciatica include a sharp or burning pain that runs down one leg, as well as tingling sensations (often described as pins and needles), numbness, and muscle weakness [2]. These symptoms may appear suddenly or develop gradually, and they can worsen with movement, sneezing, or coughing. Although lower back pain can occur alongside sciatica, it's usually less severe than the leg pain. Fortunately, there are steps you can take to help ease sciatica symptoms.
Stay Active
Remaining active is key—continue with your regular daily activities as much as you can, and begin gentle exercises as soon as possible. Movement helps reduce inflammation and can speed up recovery [3]. Heat packs can also be applied to painful areas to provide comfort, and in the early days, cold therapy using ice packs may help reduce inflammation. It's important to wrap ice packs in a towel to avoid frostbite and limit each application to 15 to 20 minutes, followed by equal rest time in between. After a few days, consider continuing with hot compresses to help improve blood flow and aid muscle relaxation.
Over-the-counter pain relievers may also help address discomfort, but it's important to avoid being sedentary for long periods (e.g., prolonged sitting or lying down). Even if movement is painful or uncomfortable, becoming inactive when sciatic pain starts can slow your recovery.
If your symptoms have not resolved after a few weeks, if the pain dramatically worsens, or if the discomfort affects your ability to carry out normal activities, you should speak with a healthcare provider. In rare instances, immediate medical attention may be required for sciatic pain. Symptoms that warrant prompt treatment include sciatica that affects both sides of the body, severe or worsening leg numbness or weakness, numbness around the genitals or anus, or issues with bladder or bowel control [1]. These could indicate a more serious spinal issue that requires urgent hospital care.
Professional Support
For persistent or severe sciatica, a healthcare provider may prescribe stronger medication (e.g., paracetamol, weak opioids, muscle relaxants, corticosteroids, anticonvulsants) or refer you for physical therapy [3, 4]. This therapeutic approach plays an essential role in recovery, as physical therapists use a range of techniques, including targeted exercises and manual therapy, such as massage or mobilization. The treatment plan may also involve methods like low-level laser therapy (LLLT) or transcutaneous electrical nerve stimulation (TENS), which uses electrical impulses to reduce painful symptoms by blocking pain signals [5]. These approaches help relieve muscle tension, improve flexibility, and reduce pressure on the sciatic nerve.
Another major focus of physical therapy is strengthening and stabilization, particularly of the core, hips, and lower back. Strengthening these muscle groups supports the spine and improves posture, which can reduce strain on the sciatic nerve [3]. Physical therapists also educate patients on proper body mechanics, posture, and ergonomic changes at work or home to prevent future flare-ups. Additionally, they help individuals identify movements or habits that may aggravate their symptoms and offer safer alternatives.
Overall, to reduce the chances of sciatica returning, it's essential to stay active, maintain a healthy weight, use proper lifting techniques, and pay attention to your posture. With the right approach—combining self-care, professional support (e.g., physical therapy), and lifestyle adjustments—most people with sciatica can recover fully and reduce their risk of recurrence.
References
- Jensen RK, Kongsted A, Kjaer P, Koes B. Diagnosis and treatment of sciatica. BMJ. 2019;367:l6273.
- Ropper AH, Zafonte RD. Sciatia. N Engl J Med. 2015;372:1240-1248.
- Ostelo RW. Physiotherapy management of sciatica. J Physiother. 2020;66(2):83-88.
- Gimenez-Campos MS, Pimenta-Fermisson-Ramos P, Diaz-Cambronero JI, et al. A systematic review and meta-analysis of the effectiveness and adverse events of gabapentin and pregabalin for sciatica pain. Aten Primaria. 2022;54(1):102144.
Karagul S, Kibar S, Ay S, et al. Comparison of the effectiveness of TENS and low-level laser therapy applied to the sciatic nerve region in chronic lumbar radiculopathy. J Lasers Med Sci. 2024:15:e13.
