Sciatica – causes, symptoms, and treatment

From restless.co.uk/health

Sciatica occurs when the sciatic nerve (which runs from the lower back to the feet) becomes irritated or inflamed. According to the NHS, one in 20 people with lower back pain in the UK will experience sciatica at some point in their lives.

While a sciatica flare-up often lasts no longer than six weeks, the intense pain and discomfort it causes can be debilitating. However, the good news is that there are practical steps you can take to manage symptoms and reduce your risk of flare-ups.

Here, we’ll explore exactly what sciatica is, including potential causes, and how to cope. We hope you find it useful.

What is sciatica?

The sciatic nerve is the longest and widest nerve in the human body, running from the lower back, through the buttocks, down the legs, and ending just below the knees. From here, it connects to other nerves, which continue down to the toes.

The sciatic nerve controls several lower leg muscles and supplies sensations to the skin of the feet and most of the lower legs.

Interestingly, sciatica isn’t a standalone medical condition but rather a symptom that can result from various underlying issues affecting the sciatic nerve, such as slipped spinal discs or other factors, including obesity. It happens when the sciatic nerve becomes irritated, inflamed, or compressed.

While sciatica is often mistaken for general back pain, it’s different because the pain and discomfort aren’t limited to the back area – and can radiate down your leg, sometimes all the way to your foot.

This pain and discomfort can vary in intensity between people but will often improve naturally within four to six weeks, even without specific treatment. However, for some, it can persist longer, which can be incredibly frustrating when it affects daily activities.

For more information on sciatica, you might like to watch this video on the NHS website.

What are the symptoms of sciatica?

The main, and often most debilitating, symptom of sciatica is experiencing sharp, shooting pains that can strike anywhere along the sciatic nerve – whether that’s in your lower back, buttocks, or down the back of either leg. These sudden pain episodes can be particularly distressing and unpredictable.

You might also notice other uncomfortable symptoms, such as numbness, weakness, and a pins-and-needles sensation in your feet, toes, or legs.

The pain and discomfort you experience with sciatica can vary significantly from mild to excruciating, and you may find it’s made worse by everyday activities like sneezing, coughing, or even just sitting for extended periods, which can make work or travel particularly challenging.

While some people with sciatica also experience back pain, this usually isn’t as intense as the pain you might feel in your buttocks, leg, or foot. According to the NHS, if you’re only experiencing back pain without leg symptoms, it’s unlikely to be sciatica.

What can cause sciatica?

As we’ve said, sciatica isn’t a medical condition in itself, but a common symptom of other underlying health issues that can affect the sciatic nerve.

It occurs when something presses or rubs on the sciatic nerve. The NHS states that causes can include…

• A slipped spinal disk – where a soft cushion of tissue between the bones in your spine bulges out.

• Spondylolisthesis – when one of the bones in the spine slips out of position.

• Spinal stenosis – which happens when the part of the spine where nerves pass through becomes too narrow.

• Back injuries – such as a pelvic fracture.

Experts estimate that around 90% of cases of sciatica result from a slipped disk in the spinal column.

There are also several risk factors for sciatica which can increase a person’s chance of being affected. These include…

Age

Research shows the risk of developing sciatica increases between the ages of 30 and 50.

This is due to age-related changes in the spine – including bone spurs and herniated disks – and natural age-related degeneration of bones, nerves, and muscles, which can increase the risk of inflammation.

Sedentary lifestyles

If your job requires you to sit for long hours, or circumstances have led to a more sedentary lifestyle, you may be at higher risk for developing sciatica. The same goes for lifting or carrying heavy objects.

Obesity

Carrying extra weight can put additional pressure on your spine, which may contribute to spinal changes and lead to the development of sciatica. This added pressure can also cause compression that irritates the surrounding nerves, potentially making symptoms more uncomfortable.

Research suggests that if you’re carrying extra weight, your body may also need more time to recover from sciatica, which can be frustrating when you’re already dealing with pain.

How is sciatica diagnosed?

If you think you may have sciatica, you don’t have to suffer in silence. It’s important to book an appointment with your GP. They’ll usually diagnose sciatica by discussing your medical history and symptoms with you, alongside a simple physical examination.

MRI scans aren’t usually needed to diagnose sciatica, but may be necessary in some cases. For example, if your symptoms aren’t improving or your doctor suspects a separate condition is causing the pain.

How is sciatica treated?

If you’re diagnosed with sciatica, your GP will likely suggest exercises and stretches to do at home. They may also prescribe painkillers – such as ibuprofen and aspirin – or creams designed to relieve nerve pain.

In some cases, your GP might also refer you for physiotherapy or psychological support. Physiotherapy for sciatica can include manual therapy techniques like massage and guided exercises.

If your symptoms are more severe and treatments from your GP and/or physiotherapist haven’t helped, you may be referred to a specialist. They then might offer treatments such as pain-killing injections, surgery, or a procedure that involves sealing off some of the nerves in your back.

You can read more about how sciatica is treated on the NHS website.

7 ways to manage sciatica at home

A sciatica flare-up typically begins to settle within four to six weeks, though it can sometimes last longer.

The good news is that experts recommend several gentle approaches you can try to ease symptoms and support your recovery – and, often, these can help reduce the likelihood of future episodes, too. We’ll explore some of these options below.

However, if symptoms don’t improve after a few weeks, are getting worse, or are making it difficult to manage your daily routine, the NHS recommends speaking to your GP.

1. Try gentle, low-impact exercise

The idea of staying active might feel overwhelming when you’re dealing with sciatica pain – it’s completely natural to want to rest when movement hurts. However, gentle activity can actually help ease some of the inflammation that’s causing your discomfort, though it’s important to listen to your body and go at your own pace.

The NHS recommends gentle, low-impact activities like swimming and walking – but remember, even a short, slow walk around the block counts as staying active. Every small step matters.

Physiotherapists often suggest exercises that strengthen the core, gently improve hip and spine mobility, and improve or maintain lower body flexibility. Simple exercises like knee-to-chest stretches and rotational stretches are sometimes recommended, though it’s important to do what feels comfortable for you.

It’s worth avoiding exercises that stretch the hamstrings – such as squats and bending forward to touch your toes – as these can sometimes worsen sciatica symptoms.

For further guidance, the NHS offers exercises for sciatica online, which you can explore at your own pace.

Remember, if you feel any increase in pain during exercise or stretching, it’s important to stop and speak with your GP about what might work best for your particular situation.

2. Consider using cold and heat therapy

Some people find that cold and heat therapy helps with their sciatica symptoms.

Heat therapy – such as using a heating pad* – can promote tissue healing. Studies show that applying heat to the lower back can provide pain relief, improve muscular strength, and increase flexibility in the affected area.

Meanwhile, cold therapy can be applied by placing an ice pack* over the lower back. Research suggests that cold therapy may help reduce inflammation and swelling, as well as decrease muscle spasms, by cooling muscle fibres.

Hot and cold therapy are recommended by the NHS but, experts generally advise applying heating pads or ice packs for no longer than 15 to 20 minutes at a time, with breaks in between, to avoid damaging skin.

You can read more about cold and heat therapy for sciatica on Spine Health’s website.

3. Make small dietary adjustments

As mentioned, being at a higher weight places extra pressure on the spine and causes compression, which can cause or aggravate sciatica.

Alongside staying active, making simple dietary changes – like eating more fruits and vegetables, practising mindful eating, and choosing lean protein sources – can help with maintaining a healthy weight.

For healthy diet tips, you may like to explore our diet and nutrition section. Here, you’ll find everything from vitamins and minerals guides to quick and easy diet swaps for a healthier lifestyle.

4. Walk around 1-2 times an hour

Sitting for long periods can worsen sciatica by placing pressure on your glute muscles, lower back, and sciatic nerve.

There’s also evidence that sitting down too much can cause sciatica.

While this can be tricky if you have a desk job or other commitments that involve sitting, experts recommend getting up and walking around every 30 to 40 minutes – even just standing and gently moving for a minute or two can help. And, where possible, sitting on a supportive chair instead of a sofa is preferable for support and posture. Some people also find standing desks to be helpful for managing sciatica symptoms.

5. Explore anti-inflammatory foods

Adding more anti-inflammatory foods to your diet – such as berries, avocados, broccoli, and whole grains – can be particularly beneficial for reducing sciatica symptoms.

Meanwhile, research has found that processed foods, which are high in sugar, salt, and saturated fat – such as processed meats, ready meals, and fizzy drinks – have the opposite effect. These can increase inflammation and aggravate sciatica symptoms, so it can be helpful to reduce your intake.

For more information, you might like to read our articles: 14 anti-inflammatory foods and 9 simple ways to cut back on added sugar.

6. Always warm up before lifting weights

Strength training has many health benefits, including improved balance and a reduced risk of osteoporosis.

However, research has found that certain exercises that involve heavy resistance can aggravate sciatica if performed without a proper warm-up. So, it’s important to always warm up before exercising.

Experts often recommend low-impact exercises like brisk walking and dynamic stretches. 

7. Take steps towards quitting smoking

We all know that smoking is bad for our health, and research suggests that it can increase our risk of developing chronic pain, including sciatica.

This study found that chronic pain sufferers who smoke experienced greater pain intensity and physical functioning fatigue than those who didn’t.

If you’d like to stop smoking, you might find it helpful to read our article: 7 tips for quitting smoking – remember, any step towards quitting, no matter how small, is a positive one.

Final thoughts…

According to the NHS, more than 80 out of 100 people will experience back pain at some point in their lives and of these, it’s estimated that one in 20 will experience sciatica.

However, while the condition can be painful and distressing, it can be reassuring to know that most cases improve on their own.

If yours doesn’t seem to be settling or if you’re struggling to manage your symptoms day-to-day, it’s worth speaking to your GP or a physiotherapist, who may be able to offer additional guidance, treatment options, or referrals to other services that could help.

For further reading, head over to our general health section. Here, you’ll find information on everything from gut and lung health to longevity solutions and ways to boost vision.

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Sciatic Nerve Pain Relief at Night

From sleepfoundation.org

Sciatica broadly refers to pain, tingling, or other discomfort along a sciatic nerve. Each sciatic nerve runs from the lower back and pelvis down the back side of the leg and into the feet. As a result, a person with sciatica may experience pain or other sensations in the lower back, leg, or even foot. If unaddressed, pain triggered by sciatica can lead to poor or insufficient sleep. 

What Is Sciatica?

Sciatica is pain or other uncomfortable feelings in the lower back, legs, or feet caused by a problem with a sciatic nerve or sciatic nerve roots. A person may develop sciatica if a sciatic nerve is irritated, compressed, or damaged.

The sciatic nerves are the body’s two longest and thickest nerves. Each runs from the lower back to the foot and is nearly the width of a finger. The sciatic nerves are responsible for providing feeling in several parts of the leg and foot and controlling muscles behind the knee and in the lower leg. 

Although some people may use the term sciatica to refer to any pain in the back or legs, sciatica is pain that specifically comes from the sciatic nerve. Sciatica commonly causes lower back pain, but only about 5% of people who report pain in the lower back have sciatica. 

Typically, sciatica affects adults over 20 years old. People in their 40s are most likely to experience the disorder. Limited research suggests that a person’s genetics may affect their likelihood of developing sciatica.

Research on the frequency of sciatica by gender is mixed. Some evidence suggests men aged 30 to 50 have a higher chance for the disorder, while other evidence shows no difference between genders.

Symptoms of Sciatica

Symptoms of sciatica vary but usually occur on one side of the body along the sciatic nerve. Common symptoms of sciatica include: 

• Pain
• Numbness
• Tingling
• Aching
• Burning
• Weakness 

These sensations may occur in a number of regions. People with sciatica commonly report pain in the lower back, which includes muscles and nerves at the base of the spine. 

Sciatica often causes pain or a sensation of burning in the buttocks and may also cause pain in the hips, calves, soles of the feet, and toes. In some cases of sciatica, one leg may feel unusually weak or heavy, causing a person to trip while walking. 

A person with sciatica may feel different uncomfortable sensations at the same time, such as numbness in one part of the leg and pain in another.

Causes of Sciatica 

Sciatica is caused by compression, irritation, or other damage to the sciatic nerve. In some cases, health care providers cannot identify the source of sciatica. However, a number of conditions can trigger sciatica.

• Slipped, bulging, or herniated disk: A protruding or ruptured spinal disk is a top cause of sciatica. If one of the soft disks in between each bone along the spine leaks or breaks open, it can irritate the sciatic nerve. Heavy lifting or sitting in the same position for too long can lead to a slipped disk. 
• Spinal stenosis: Commonly caused by arthritis of the spine, spinal stenosis makes the backbone become narrow. When the backbone narrows, it can compress the sciatic nerve. Typically, spinal stenosis occurs in adults over 60 years old.
• Pelvic fracture or injury: A person can injure or break a pelvic by playing sports or through falls and other accidents. A pelvic fracture may affect the sciatic nerve roots in the lower spine, leading to sciatica.
• Osteoarthritis: Osteoarthritis wears down cartilage at joints throughout the body, including the lower back and hips. As a result, the bone may develop a lump that can affect the sciatic nerve. 
• Spinal tumour or blood clot: In rare cases, a tumour or mass of blood can press on the sciatic nerve and cause pain. 

Certain behaviours may worsen sciatica, such as bending the spine, holding your breath, standing for a long time, or sudden movements like coughing, sneezing, or laughing.  

What Is the Best Sleeping Position for Sciatica Pain?

Research is limited on the best position to sleep in specifically to relieve sciatic nerve pain. The best way to sleep with sciatica can depend on the individual and may require trying different sleeping positions to find the one that is most comfortable. 

For some people with sciatica, sleeping on one side may relieve their back pain. Experts recommend that side sleepers with back pain bend the top knee and place a pillow between the knees. If the person with sciatica and back pain prefers sleeping on their back, a pillow under their knees  can reduce pressure on the back.

If the person with sciatica has difficulty finding a comfortable sleep position, or if they have trouble sleeping because of sciatica pain, they should talk with their health care provider. 

How to Sleep With Sciatica





For some people, sciatic nerve pain may resolve without treatment. However, some at-home management steps and lifestyle changes may help improve sciatica for people whose symptoms do not go away on their own. 

• Use cold and heat for pain relief: Cold and hot packs can reduce inflammation and provide comfort at the painful area. Experts recommend using ice during the first two or three days of pain, then using heat.
• Use pain relievers short-term: Over-the-counter pain relievers can reduce sciatica symptoms when used for a short period of time. 
• Avoid triggering activities: Excessive sitting or standing in one position can cause sciatica to flare up. Adjusting your office chair or car seat could help you avoid making the pain worse. You may also rearrange items in the home for ease of access, such as moving objects from low cupboards to waist-level counters or higher cabinets. 
• Continue light exercise: Experts recommend reducing activity levels following the initial onset of sciatica pain. However, they also recommend gentle forms of exercise, such as swimming or walking.
• Try strengthening exercises and stretches: Perform exercises that strengthen the back and the core. Gently stretch the lower back muscles and hamstrings. 
• Limit bed rest: Avoid spending too much time in bed, even if you are in pain. People with lower back pain who stay active recover more quickly. 

Scientific research on the best mattress for sciatica pain relief is limited. But people with sciatica who struggle to get comfortable at night may also consider whether their current mattress meets their needs. Because people with sciatica have pain in the lower back or hips, they may need a mattress that supports these pressure points and keeps the spine correctly aligned. 

Researchers have conducted some studies on mattresses for back pain, with somewhat mixed results. In one review of studies regarding the best mattresses for back pain, researchers concluded that a medium-firm mattress improves sleep quality and reduces the risk of developing back pain. By contrast, a few small studies have found that a softer mattress or a mattress that conforms to the back can relieve back pain.

When to See a Doctor

If at-home methods do not relieve your sciatica pain, or if the pain interferes with your sleep and day-to-day life, contact your health care provider. A doctor can evaluate your symptoms, identify potential causes of the pain, confirm a sciatica diagnosis, and develop a treatment plan.

Typically, a doctor first tests your reflexes, strength, and ability to sense feeling, in order to confirm that you have sciatica. Then, if you have experienced the pain for six to eight weeks, a doctor may perform imaging, such as a CT scan or MRI. These types of imaging help the doctor determine if something abnormal in the spine is causing the sciatica.

Your health care provider may recommend additional medical treatments for sciatica. These might include muscle relaxants, prescription pain relievers, and local injections for pain relief. They may also recommend that you consult with a physical therapist, receive a deep tissue massage, or try acupuncture. In some infrequent cases, they may recommend surgery. 

Medical Disclaimer: The content on this page should not be taken as medical advice or used as a recommendation for any specific treatment or medication. Always consult your doctor before taking a new medication or changing your current treatment.

https://www.sleepfoundation.org/physical-health/sciatic-nerve-pain-relief-at-night

Shocked to be diagnosed at 26: ‘I thought sciatica was an older person’s condition’

From sgh.com.sg

SINGAPORE – In 2021, after months of inactivity during the Covid-19 pandemic, Mr Muhammad Zaki Saifee decided to hit the gym.

He attempted a set of dumbbell lunges, then woke up the next day with searing pain radiating from his lower back to his left calf.

“It was a seven out of 10 kind of pain,” says Mr Zaki, 28. “I thought it was just because I hadn’t exercised in a long time, so I brushed it off.”

For the next few years, the pain recurred every few months, usually after intense workouts following a period of rest.

But in early 2024, the discomfort escalated into something more serious. While at work, Mr Zaki, a product consultant in the IT industry, bent down to lift an object and suddenly froze mid-movement.

“I got stuck halfway. I couldn’t go up, I couldn’t go down. The pain was 10 out of 10. It was excruciating,” he recalls.

He took a cab to Mount Alvernia Hospital, where a physical check-up and scan revealed the cause – a herniated disc pressing on a nerve, resulting in sciatica.

Sciatica is a type of pain that occurs when the sciatic nerve – which runs from the lower back through the buttocks and legs – becomes compressed or irritated.

People often experience shooting pain, tingling, numbness or a burning sensation in the buttocks, thighs, calves or feet. The pain may worsen when sitting, coughing or sneezing, and it typically affects only one side of the body.

This can be caused by a herniated disc, spinal stenosis (narrowing of the spine that presses on nerves) or other conditions that put pressure on the nerve.

Mr Muhammad Zaki Saifee was diagnosed with sciatica at age 26 and had a herniated disc pressing on a nerve, causing the condition.     ST PHOTO: NG SOR LUAN

More young people with the condition

Two doctors tell The Straits Times that they are now seeing more young patients with the condition traditionally associated with older adults. This is linked to factors such as a sedentary lifestyle, sudden bursts of exercise, poor form at the gym and bad posture.

Dr Bernard Lee, senior consultant pain specialist at Singapore Paincare Centre, says sciatica is more commonly associated with adults above 50 years old. Age-related degenerative spine changes such as slipped disc, arthritis or spinal stenosis increase the risk of nerve compression.

While the majority of his sciatica patients are above 50, he says there has been about a 10 per cent rise in patients in their 20s to 40s in the last three years.

Dr Lee says the increase is largely driven by a sedentary lifestyle, prolonged sitting or standing, poor posture and high-intensity physical activities that place stress on the lower back and sciatic nerve.

When combined with a genetic predisposition, these factors can cause sciatica to appear earlier than it would from age-related degeneration alone, adds Dr Lee.

Long hours of sitting or standing can raise risk

Prolonged sitting is one of the key contributing factors he sees in his younger patients.

“When you spend long hours at a workstation, gaming or studying, the supporting back and core muscles gradually weaken. Many people are not aware of this until years later, when the cumulative strain shows up as chronic back problems or even sciatica,” he says.

Dr Lee also notes that he often sees younger people spending long hours on their mobile phones.

The habit of craning the neck forward while scrolling not only strains the neck, but also increases the load on the lumbar spine. Over time, he cautions that this can aggravate or cause disc bulges, which may compress the sciatic nerve.

Dr Thomas Tan, head and consultant of neurosurgery service at National Neuroscience Institute at Sengkang General Hospital, is now seeing a growing number of younger patients between the ages of 18 and 25, without giving specific figures.

This is often due to reasons like lifting heavy weights the wrong way, being overweight or having poor form at the gym.

“We see many people who do deadlifts come to the clinic with back pain that shoots down their legs. Some get better with rest, avoiding heavy lifting, and getting physiotherapy, but others may need surgery if the pain does not improve,” says Dr Tan.

                                  Prolonged sitting is one of the causes of sciatica. PHOTO: PIXABAY

At Singapore General Hospital, Dr Ou Yang Youheng, consultant at the department of orthopaedic surgery, says the incidence of sciatica appears to be the same over the years and the age range of patients has not decreased.

Patients as young as 18 years old have sought treatment for sciatica, and the oldest patients can be up to 100 years old, says Dr Ou Yang.

What shocked Mr Zaki most was getting the condition at his age.

“I thought sciatica was an older person’s condition. To get it at 26 was upsetting because I still have so many years ahead, but my body is already in pain,” says the bachelor.

Dr Lee says genetics could be a factor affecting spine health. Mr Zaki’s 40-year-old sister has ankylosing spondylitis, a type of arthritis that results in chronic inflammation of the spine.

Years of dance training, which puts unusual strain on the hips and spine, may have contributed to his condition too.

Dr Lee notes that younger patients who are active in sports or high-intensity workouts often develop back pain from repetitive strain, heavy lifting or poor technique. Activities such as martial arts or racquet sports can put pressure on the lower back and compress the sciatic nerve.

The good news, he adds, is that these cases are usually treatable in younger patients and less likely to become chronic if managed early.

Mr Zaki, who saw Dr Lee, underwent two minimally invasive procedures – neuroplasty to relieve nerve compression, and radiofrequency ablation to block pain signals – in 2024.

After treatment, he went through several weeks of physiotherapy for recovery, strengthening of muscles and restoring range of motion.

The treatment helped reduce the intensity of his pain, which is now limited to the back. However, his condition still affects his life from time to time.

As a street dancer specialising in a style of dance called “popping”, he often pays the price after competitions. “Every time I dance, it hurts. The next day, I’ll feel it at a six out of 10,” he says.

Today, Mr Zaki manages his condition through walking and careful strength training, while also making small adjustments to his daily routine.

“I’ve learnt to be cautious, like always holding the railing when I step off a bus. It’s about listening to my body and making adjustments so I can keep moving,” he says.

Piano teacher Eileen Ng, 34, first experienced sciatica during her second pregnancy in October 2023.

She recalls suddenly losing strength in her left leg while walking, accompanied by a sharp pain shooting from her buttock to her upper thigh.

The episodes would strike without warning a few times a week, forcing her to stop and sit for a while.

“I tried prenatal massage and prenatal physiotherapy, but they didn’t help,” says Ms Ng, who is married and has two children aged 18 months and three years.

Her gynaecologist attributed the pain to nerve compression from the pregnancy and said it would likely resolve after delivery.

But after giving birth in February 2024, the pain worsened. What used to occur occasionally while walking became a daily struggle that could strike even when she was sitting or lying down.

At its peak, the pain would flare up several times a day and last up to 10 minutes each time, leaving her unable to carry out simple chores at home. 

Forced to drag herself around on the floor

On some occasions, she had to drag herself around on the floor just to move about. Once, she was late for a piano lesson as the pain made walking impossible.

Desperate for relief, Ms Ng tried physiotherapy again after delivery, but it did not work. It was only after she visited Dr Lee’s clinic in 2024 that she was diagnosed with sciatica.

She underwent a platelet-rich plasma procedure at Mount Alvernia in June 2024. The treatment involves using concentrations of a patient’s own blood platelets and injecting them into the affected areas.

Dr Lee says they stimulate healing by causing a temporary, low-grade inflammation at the injection sites, promoting tissue repair, healing and growth.

The treatment brought about significant improvement for Ms Ng. Instead of daily attacks, she now experiences only mild, occasional pain once every six to eight months.

Dr Ou Yang says 80 per cent of patients will respond to conservative treatment consisting of a combination of physiotherapy, activity modification and pain medications.

Most cases resolve within three to six months.

Surgery is typically reserved for patients who have symptoms that can cause permanent nerve injury, such as in patients with motor weakness. Symptoms include the inability to tiptoe or walk normally without a limp, or bladder and bowel incontinence, says Dr Ou Yang.

Those who do not respond to approximately six weeks of conservative treatment are also considered for surgery.

Surgery options for sciatica include discectomy (removal of herniated disc material) and laminectomy (removal of part of the vertebra to relieve nerve pressure). Sometimes, after relieving nerve compression, metal plates or screws are inserted to stabilise the spine, says Dr Lee.

Mr Zaki advises young adults not to dismiss back pain that radiates down the leg as normal, and to seek medical attention promptly.

“Back pain is something that I hear very often among friends and family members. It’s better to get it checked out and treated than live with it,” he says.

https://www.sgh.com.sg/news/patient-care/shocked-to-be-diagnosed-at-26---i-thought-sciatica-was-an-older-