Sciatica

Your sciatic nerves are the main nerves that run from your buttocks down the backs of your legs to your feet. Sciatica occurs when your sciatic nerve roots become irritated, inflamed or compressed (squashed), causing leg pain, tingling and numbness. It normally only affects one side of your body. While sciatica isn’t usually serious, it can be very painful and can significantly affect your quality of life.

The cost of your sciatica treatment will depend on your individual circumstances. At the time of your appointment your consultant will discuss all options with you and ensure all your questions are answered.

Our fixed-price packages include the cost of your surgery and all appropriate aftercare appointments. However, any pre-surgery diagnostic tests and your consultant's outpatient appointment consultation fee are charged separately.

Our flexible payment options help you spread the cost of your payment across a time period that suits you.

The symptoms of sciatica vary from person to person but usually affect your buttocks and the back of one leg, including your foot and toes. Symptoms may start suddenly or develop gradually. You may have different symptoms in different parts of your leg, for example, pain in one part, and numbness or tingling in another. Pain is often worse when you move, sneeze, cough or bend or lift your legs upwards while lying on your back.

Symptoms of sciatica may include:

• Pain: Sciatica pain is often described as a sharp, burning pain that shoots down the back of your affected leg. It may feel like a jolt or an electric shock. Some people with sciatic pain experience a mild ache in the back of the leg
• Paraesthesia: Tingling (pins and needles) in your affected leg
• Numbness: A lack of sensation in your affected leg
• Muscle weakness: Weakness of the muscles in your back and/or affected leg
• Loss of bowel or bladder control: Inability to control your bladder or bowels is a severe symptom that needs immediate medical attention

Sciatica occurs when the nerve roots of your sciatic nerve become compressed (pinched). This can happen for a variety of reasons, including:

• Degenerative disc disease: An age-related condition where the discs that cushion your spine begin to wear away
• Spinal stenosis: A condition where the space inside your backbone becomes narrowed, putting pressure on your nerves and spinal cord
• Herniated disc: A common condition where the soft inner part of a spinal disc bulges out and puts pressure on the nerve
• Injuries: An injury or trauma, such as a fall or direct blow to your lower back, can damage the nerve or soft tissues and may lead to sciatica
• Bone spurs (osteophytes): These are growths of bone that develop on your spine and can compress the nerve
• Spondylolisthesis: A condition where one of the bones in your spine (vertebra) slips forward
• Osteoarthritis: A common age-related condition where the cartilage in your spine wears down, leading to pain, stiffness and reduced mobility
• Tumours, cysts or other growths: Cancerous or non-cancerous tumours or cysts on the spine can compress the sciatic nerve
• Pregnancy: Sciatica in pregnancy can occur due to hormonal changes and a shift in your body’s centre of gravity, leading to pressure on the sciatic nerve

Sciatica can affect anyone and often has no known cause; however, you may have a higher risk of developing the condition if you:

• Have had sciatica before 
• Have a current or previous lower back injury
• Are between 30 and 50 years of age
• Are physically inactive 
• Have osteoarthritis 
• Are overweight or obese 
• Smoke 
• Have poor core strength
• Have a job that involves putting strain on your lower back, such as bending, heavy lifting, twisting, driving or sitting for long periods
• Have poor posture, or do not use the correct form when performing activities such as strength training or weightlifting
• Have diabetes or peripheral neuropathy

Sciatica can range from mild to severe, and while many people recover fully from the condition, others are severely impacted and unable to perform normal daily activities. In some cases, sciatica can lead to permanent nerve damage, which can result in chronic pain, weakness, numbness and/or a loss of bladder/ bowel function. Problems with balance and muscle weakness can also lead to an increased risk of falls.

At your first consultation, you will be seen by a consultant orthopaedic, spinal or neurosurgeon, a doctor specialising in conditions affecting the bones, spine or nerves. Your first appointment is important as it’s where you’ll first meet your consultant, the doctor responsible for your care.

At your appointment, your consultant will ask you about your symptoms, medical history and general health. They will spend time getting to know you, discuss your expectations for treatment and encourage you to ask any questions you may have. At Circle Health Group, we want you to be as well-informed and comfortable as possible during your time with us, so please discuss any questions or concerns with your consultant during your appointment.

It may help to write down any questions you may have before your appointment, so you don’t forget them. You may want to ask about:

• The probable cause of your sciatica
• The treatment options
• Things you can do at home to ease your symptoms
• When you can expect to see an improvement in your symptoms
• Any lifestyle changes you can make to reduce the risk of your sciatica coming back
• If surgery is recommended, what does the surgery involve, the type of anaesthetic that will be used, any possible risks or complications and the recovery time

Your consultant can usually diagnose sciatica using a combination of your symptoms, medical history and a physical examination. During your physical examination, your consultant will assess your reflexes, muscle strength, sensation and range of motion in your affected leg. They may ask you to perform some movements, such as walking and slowly lifting your legs off the ground while lying down.

In some cases, your consultant may order imaging tests like an X-ray, MRI or CT scan to examine your bones and soft tissue, which can help confirm your diagnosis and identify the underlying cause.

Your consultant may also request nerve conduction studies (NCS) or an electromyography (EMG) to assess your nerve function and help identify problems with your nerves. 

Mild sciatica usually resolves within a few weeks to a few months without treatment. If your pain is moderate to severe or you have other symptoms such as numbness, tingling, muscle weakness or loss of bladder/bowel control, make an appointment with a consultant.

There are several treatments for sciatica, including nonsurgical and surgical treatments. Depending on the cause, your consultant will likely try nonsurgical options first before considering surgery.

Nonsurgical treatments for sciatica 

Home care

Home treatments are often enough to treat mild sciatica. If your sciatica doesn’t improve after a few weeks of home treatments, make an appointment with a consultant.

• Heat/cold therapy: Applying ice packs wrapped in a cloth or towel for 20 minutes, several times a day, for the first few days can help reduce pain and swelling. After the first few days, switch to a heat pad or hot water bottle and alternate between the two, depending on which best relieves pain
• Posture: Ensuring you maintain a good posture, particularly when sitting, exercising, and lifting, can help prevent your sciatica from getting worse or coming back
• Over-the-counter medicines: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can help relieve pain, swelling and inflammation. Your pharmacist can recommend a suitable medication for your sciatica
• Exercise: Can help improve your muscle strength, flexibility and range of motion. Look for a qualified instructor with experience in sciatica and/or lower back pain
• Keep moving: Avoid sitting or lying down for long periods as this can make your sciatica worse
• Activity Modification: It is generally recommended to keep active with sciatica, but make sure you take adequate rest, pace yourself and avoid activities that trigger or worsen your pain

Other treatments

If home treatments are not effective in relieving your sciatica pain, your consultant may recommend other treatments such as: 

• Physiotherapy: Includes exercises and manual therapy to ease sciatica pain  
• Epidural steroid injection: A combination of long-term pain relief and steroids to reduce inflammation
• Psychological support: Can help you cope with the psychological effects of long-term pain

Surgical treatments for sciatica 

If other treatments haven’t worked to relieve your symptoms, your consultant may recommend surgery to stop your nerves from sending pain signals or relieve the pressure on your sciatic nerve. 
Some surgical procedures that can treat sciatica include:

• Radiofrequency denervation: This is a procedure to seal off some of the nerves in your back to prevent them from sending pain signals 
• Lumbar spinal decompression surgery: A procedure to treat conditions such as a herniated disc or spinal stenosis that could be causing your sciatica

At Circle Health Group, we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group, you can expect the highest standards of care, including:

• Flexible appointment times and locations that are convenient for you 
• The freedom to choose which hospital and consultant best suits your needs 
• Personalised, consultant-led treatment plans tailored to your individual needs 
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standard 
• A range of delicious, healthy meals 
• Affordable, fixed-price packages with aftercare included 
• Flexible payment options to help you spread the cost of your care

If you would like to see a consultant or learn more about private sciatica treatment, book your appointment online or call a member of our team today.

1. Sciatica, NHS
2. Sciatica, Johns Hopkins Medicine
3. Sciatica, OrthoInfo