Sciatica: causes, symptoms, treatment and which doctor to see
What sciatica is, why it causes pain down the leg, how it is assessed, what helps it settle, and the warning signs that need emergency care.
What sciatica is
Sciatica is pain caused by irritation or pressure on the sciatic nerve or the nerve roots that form it in the lower back. The sciatic nerve is the largest nerve in the body. It runs from the lower spine through the buttock and down the back of each leg to the foot.
Sciatica is a description of symptoms rather than a diagnosis in itself. The most common cause is a herniated or slipped disc pressing on a nerve root. Other causes include narrowing of the spinal canal, called spinal stenosis, wear in the spinal joints, and, rarely, infection, tumour or injury.
The encouraging news is that most episodes of sciatica improve within weeks to a few months without surgery.
Symptoms
Sciatica usually affects one leg. Typical symptoms are:
- Leg pain that spreads from the lower back or buttock down the back or side of the leg, often below the knee into the calf or foot
- Buttock pain, which may be worse when sitting
- Pain that is sharp, burning or like an electric shock, and may be worse than the back pain
- Numbness or tingling, like pins and needles, in parts of the leg or foot
- Leg weakness, such as difficulty lifting the foot or standing on the toes
- Pain that gets worse with coughing, sneezing, bending or sitting for long
Pain only in the back or thigh, without spreading below the knee, is less typical of sciatica and may come from the muscles, joints or hip.
Causes and who is at risk
Sciatica is most common in middle age. You are more likely to have it if you:
- Do work involving heavy lifting, bending, twisting or long hours of driving
- Sit for long periods with little movement
- Carry extra weight, or are pregnant
- Smoke
- Have had a slipped disc or back problems before
- Are older, when spinal stenosis becomes a more common cause
Diabetes can damage nerves and cause leg pain and numbness that can be confused with sciatica, so tell the doctor if you have it.
How it is diagnosed
Diagnosis is usually based on your symptoms and a physical examination. The doctor will check your back, how you walk, and the strength, sensation and reflexes in your legs. The straight leg raise test, in which the doctor lifts your straightened leg while you lie on your back, often brings on leg pain when a nerve root is irritated.
An MRI shows discs, nerves and the spinal canal. It is not needed at first for most people, because most sciatica improves and the scan rarely changes early treatment. It is advised when there are warning signs, when weakness is getting worse, when pain has not improved after several weeks, or when an injection or surgery is being considered. X-rays do not show nerves or discs. Nerve conduction tests are sometimes used when the cause is unclear.
Which doctor to see
A general physician can assess and treat new sciatica. If pain is not settling, is severe, or comes with weakness, an orthopaedic surgeon, especially one who focuses on the spine, or a neurosurgeon can advise on further tests and treatment. Both treat sciatica without surgery in most cases.
Physiotherapists are allied-health professionals who guide the exercises that help most people recover. You can find orthopaedic surgeons in Bengaluru, neurosurgeons and physiotherapists on The Doctor Index.
Treatment
Staying active
Staying active is one of the most helpful things you can do. Rest briefly if pain is severe, but avoid long periods in bed, which slow recovery. Gentle walking, changing position often and gradually returning to normal activities help the nerve settle. Heat or cold packs can ease pain.
Pain relief
Pain relief may include anti-inflammatory medicines for a short time, or medicines that act on nerve pain prescribed by your doctor. Strong painkillers are generally avoided for sciatica because of side effects and limited benefit. Do not take anti-inflammatory tablets regularly without medical advice, especially if you have stomach, kidney or heart problems.
Physiotherapy
Physiotherapy includes exercises to improve movement, strengthen the back and core, and reduce nerve irritation, along with advice on posture and lifting. An active exercise programme usually helps more than passive treatments on their own.
Injections and surgery
An epidural steroid injection near the irritated nerve root may ease severe leg pain for a time, making it easier to stay active and do exercises. Surgery, such as removing part of a herniated disc or widening a narrow spinal canal, is considered when there is significant or worsening weakness, when severe pain continues despite several weeks of non-surgical treatment, or urgently when warning signs appear. Your surgeon will decide based on your examination and scan.
Living with sciatica
Once the pain settles, keep up your exercises. Break up long periods of sitting and driving, lift with bent knees and the load close to your body, keep a healthy weight and stop smoking. Sciatica can return, and the same approach usually works again. See your doctor if symptoms come back with new numbness or weakness.
When it is an emergency
Call 112 or 108, or go to the nearest emergency department straight away, if sciatica comes with:
- Numbness around the genitals, inner thighs or back passage
- New difficulty passing urine, or loss of control of the bladder or bowels
- Sciatica in both legs, or weakness in both legs
- Rapidly worsening weakness in a leg or foot
- Fever, unexplained weight loss, a history of cancer, or a recent fall or accident
The first three can be signs of cauda equina syndrome, a compression of the nerves at the base of the spine that needs urgent scanning and often surgery to protect bladder, bowel and leg function. Do not drive yourself to hospital.
Questions to ask at your appointment
- What is the likely cause of my sciatica?
- Do I need an MRI now, or only if it does not improve?
- Which activities are safe, and which should I avoid for now?
- Which exercises should I do, and should I see a physiotherapist?
- When would an injection or surgery be worth considering?
- Which symptoms mean I should come back urgently?
Common questions
Questions people ask
- How long does sciatica last?
- Many people improve within a few weeks, and most recover within a few months with activity, pain relief and exercises. Sciatica that is severe, keeps getting worse or lasts beyond a couple of months should be reassessed by a doctor.
- Is sciatica the same as a slipped disc?
- Not exactly. Sciatica describes pain along the sciatic nerve. A slipped disc is the most common cause, but spinal stenosis, wear in the spine and other conditions can also cause it. Your doctor will look for the underlying cause.
- Should I sleep on the floor or rest in bed?
- Long bed rest is not recommended, as it slows recovery. Sleep in whatever position is most comfortable, for example on your side with a pillow between your knees. A reasonably firm mattress is fine; there is no need to sleep on the floor.
- Will I need surgery for sciatica?
- Most people do not. Surgery is usually considered only for significant or worsening weakness, warning signs such as bladder or bowel problems, or severe pain that has not improved with good non-surgical treatment over several weeks.
This condition is usually assessed by an orthopaedic surgeon. Every profile shows the doctor’s registration and what has been checked.
Orthopaedic surgeons in Bangalore
A few orthopaedic surgeons listed on The Doctor Index. They are shown because of their speciality, not a stated interest in Sciatica; ask the clinic whether the doctor sees it.
Related conditions
Practical reading
All postsSources
- MedlinePlus, US National Library of Medicine — Sciatica
- NHS — Sciatica
- MedlinePlus, National Library of Medicine — Sciatica — Public-domain health-topic summary
- Human Phenotype Ontology Consortium — terminology definitions — HPO licence; definitions reproduced without alteration
Sciatica: causes, symptoms, treatment and which doctor to see is original text by The Doctor Index; the compiled source draft was used for research. Source: MedlinePlus, National Library of Medicine. Orphadata Science: Free access data from Orphanet. © INSERM 1999; July 2026 data, CC BY 4.0. This product uses the Human Phenotype Ontology (hp/releases/2026-09-01). Only sources listed for this article apply. Source material has been selected and arranged; HPO definitions are reproduced without alteration. No source organisation endorses this compilation. Köhler S et al. The Human Phenotype Ontology project: linking molecular biology and disease through phenotype data. Nucleic Acids Research 2014;42(D1):D966–D974. doi:10.1093/nar/gkt1026.
General information, not advice about your situation. Errors can be reported through the corrections process. Reference TDI-C-2105.