- Sciatica
- Back pain
- Herniated disc
Sciatica: why your leg hurts, how long it lasts and when it is urgent
Sciatica causes pain that travels from the lower back down the leg. We explain its most common causes, what helps recovery, and the warning signs that need immediate care.
PainManagement ER Published 2 min read
Pain that starts in the lower back or buttock and travels down the leg to the foot. That’s how sciatica is usually described, and it happens when something presses on or irritates the sciatic nerve.[1]
Symptoms
According to the NHS, sciatica causes pain, tingling, numbness or weakness, usually in the bottom, the back of one leg, the foot and toes. Also:[1]
- It can start suddenly or gradually.
- It often gets worse when you move, sneeze or cough.
- There may be back pain too, but it is usually less severe than the leg pain.
Most common causes
The most common cause is a slipped (herniated) disc, which becomes more likely with age. Other causes include spinal stenosis, spondylolisthesis and back injuries.[1] NIAMS lists these same conditions among the mechanical or structural causes of back pain.[2]
How long does it last?
Sciatica usually gets better in a few weeks to a few months, although it can last longer. It can also come back, even after you’ve recovered.[1]
What helps recovery
The NHS recommends:[1]
- Staying as active as you can and keeping up normal activities.
- Doing gentle exercise and recommended sciatica exercises.
- Using heat packs to ease the pain.
- Avoiding sitting or lying down for long periods, even if moving hurts.
On painkillers, the NHS notes that paracetamol (acetaminophen) is unlikely to help, and suggests asking a pharmacist.[1]
Treatment options as things progress
| Situation | Options the NHS mentions |
|---|---|
| First weeks | Exercises and stretches, painkillers, physiotherapy |
| Severe pain not helped by the above | Radiofrequency denervation, an epidural injection or decompression surgery |
Source: NHS, "Sciatica" (2024).[1] The right choice depends on each case and should be made with a professional.
For nerve-related pain, the CDC’s 2022 clinical guideline lists certain antidepressants and anticonvulsants, and capsaicin or lidocaine patches, as nonopioid options.[3]
When to see a doctor
The NHS advises seeing your doctor if:[1]
- The pain hasn’t improved after a few weeks of home care.
- The pain is getting worse.
- The pain is stopping you from doing normal activities.
Emergency warning signs
The NHS says to get emergency care (in the U.S., go to the ER or call 911) if you have:[1]
- Sciatica in both legs.
- Severe or worsening weakness or numbness in both legs.
- Numbness around the genitals or bottom.
- Difficulty starting to pee, being unable to pee, or losing control of peeing.
- Not noticing the need to poo, or losing control of bowel movements.
The NHS warns these symptoms can signal a serious back problem that needs prompt hospital treatment, and advises not driving yourself.[1]
If sciatica doesn’t improve or keeps coming back, an assessment can identify what is irritating the nerve and which treatment makes sense for you.
Sources
- Sciatica . NHS (UK National Health Service) , reviewed December 3, 2024.
- Back Pain . National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), NIH , reviewed February 2023.
- CDC Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022 . Dowell D, et al. MMWR Recomm Rep 2022;71(No. RR-3):1–95, CDC , November 2022.
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