A sudden, burning pain from the lower back that radiates down the buttock, along the thigh and right down to the calf. It can get worse when you cough, sneeze or sit for too long - and doesn't go away just by resting. These are the classic signs of sciatica.
Sciatica affects approximately 40% of all adults at some point in their lives. For most people it goes away within 6-12 weeks. But for some, the pain becomes long-lasting and limiting - and then it's time to seek help from a specialist.
In this article, we go through what sciatica is, what the causes can be, how we treat it - and above all: when it's time to see a doctor.
What is sciatica?
Sciatica is not a disease in itself – it is a symptom. The word comes from the sciatic nerve (nervus ischiadicus), the thickest nerve in your body. It runs from the lumbar spine, through the buttock and down the leg all the way to the foot.
When the sciatic nerve becomes pressed or irritated – usually up at the nerve root in the lumbar spine – it sends pain signals along the entire path of the nerve. This is why sciatica pain can often be felt all the way down the foot, even if the actual problem is in the back.
Symptoms – what sciatica feels like
Sciatica can take different forms, but there are classic signs:
- Radiating pain from the lower back down into the buttock, thigh or calf
- The pain is usually on one side (not both legs at the same time)
- Feels like burning, stinging or electric
- Gets worse when coughing, sneezing or wheezing
- Worsened by sitting still for a long time
- May be accompanied by numbness, tingling or weakness in the leg
- Sometimes sharp, stabbing pain during certain movements
- May disturb sleep
Unlike muscular back pain, which is mostly felt in the back itself, sciatica is characterized by the pain leaving the back and going out into the leg.
Causes of sciatica
Herniated disc
The absolute most common cause of sciatica is a herniated disc in the lumbar spine. The disc – which acts as a shock absorber between the vertebrae – can bulge and press on a nerve root. It gives the classic radiating pain.
Spinal stenosis (narrowing)
In older people, the spinal canal can become narrower over time. This squeezes the nerve roots and produces sciatica-like symptoms – often worse when walking, relieved when bending forward or sitting down.
Piriformis syndrome
The piriformis is a small muscle deep in the buttock. If it gets tight, it can pinch the sciatic nerve that passes under or sometimes through it. It gives sciatica pain without problems in the back itself.
Facet joint osteoarthritis
Arthritis in the small joints of the spine can cause radiating pain similar to sciatica.
Pregnancy
Growing fetus and hormonal changes can temporarily put pressure on the sciatic nerve. It usually disappears after delivery.
More rare causes
- Spondylolisthesis (vertebra slips forward)
- Tumors (very rare)
- Infection in the spine
Red flags – seek care immediately
The vast majority of sciatica cases are not dangerous. But some symptoms require urgent assessment:
- Sudden paralysis or severe weakness in one leg
- Incontinence – if you lose control of your bladder or bowels
- Broken anaesthesia – numbness around the genitals or inner thighs
- Fever along with back pain
- Pain after a trauma (fall, accident)
In rare cases, these symptoms can be signs of cauda equina syndrome – an acute condition in which many nerve roots are pinched at the same time. Seek care immediately.
When should you seek help?
Mild sciatica often heals on its own within 6-12 weeks. But you should contact an orthopedist or pain doctor if:
- The pain has been present for more than 4-6 weeks without improvement
- You have weakness or numbness in the leg
- Pain disturbing sleep several nights a week
- Ordinary painkillers are not enough
- Symptoms get worse instead of better
- You have had repeated episodes of sciatica
- Your health center has not progressed in the investigation
At Scandinavian Health Clinic in Mölndal you can see a specialist without a referral - usually within a few days.
Diagnosis - we investigate your sciatica
A specialist assessment for sciatica usually includes:
Doctor's call
We ask careful questions about the nature of the pain, when it started, what makes it worse or better. Just where the pain radiates gives important clues as to which nerve root is affected.
Clinical examination
We investigate:
- Reflexes in the leg
- Muscle strength (can you walk on your toes and heels?)
- Feeling in different areas
- Nerve stretch test (Lasègue sign)
- Mobility and pain during various movements
Image diagnostics
For prolonged or severe sciatica, we can order:
- MRI – shows soft tissue, discs and nerve roots in high detail
- X-ray – supplementary if necessary
- CT – sometimes alternative to MRI
Most people don't need x-rays or MRIs in the acute stage. If symptoms improve in a few weeks, diagnostic imaging is often unnecessary.
Treatment of sciatica
Keep moving - not bed rest
Once upon a time, bed rest was recommended for sciatica. Modern research shows that it's the opposite – calm, adjusted movement allows for faster healing. Don't lie still for too long - change your position and take short walks.
Pain-relieving drugs
- Paracetamol for mild pain
- NSAIDs (such as ibuprofen) help with both pain and inflammation
- Neuropathic drugs (gabapentin, pregabalin) can help with persistent nerve pain
- Muscle relaxation for a short period in case of muscle spasm
A specialist will help you optimize the combination – especially if ordinary painkillers are not enough. In case of severe nerve damage, a neurologist may also be relevant for further assessment.
Physiotherapy
Specific stretching exercises for the sciatic nerve and strength training for the trunk muscles are the basis of long-term treatment. A physiotherapist adapts the program to you.
Injection treatment (epidural blockade)
In severe sciatica that does not respond to other treatment, we can give an epidural cortisone injection. It reduces the inflammation around the nerve root and can provide significant relief – often for several months.
Surgery
The vast majority of sciatica patients get better without surgery. Surgery may be considered if:
- The pain is severe and continues after 6–12 weeks of conservative treatment
- There is clear weakness or loss of nerve function
- Diagnostic imaging shows a clear cause that can be corrected surgically
An orthopedist will help you assess when and if surgery is appropriate.
How long does it take for sciatica to go away?
Most will be significantly better within 6-12 weeks, and fully recovered within 3-6 months. With the right treatment – and without complications – you can expect:
- 1–2 weeks: Acute phase, worst pain. Movement is important.
- 2–6 weeks: Gradual improvement. Start with rehab exercises.
- 6–12 weeks: The pain subsides. Return to normal activities.
- 3-6 months: Full recovery for most.
If you don't see improvement after 6 weeks – see a specialist. The longer the pain persists, the more difficult it becomes to treat.
Self-help - what can you do yourself?
- Be active – short walks several times a day
- Heat for tense muscles, cold for acute inflammation
- Avoid sitting for a long time – change position every 20 minutes
- Sleep on the side with a pillow between the knees, or on the back with a pillow under the knees
- Learn to lift correctly – with your legs, not your back
- Stronger trunk muscles protect against future problems
Frequently asked questions (FAQ)
How do I know if I have sciatica or "regular" back pain?
Common back pain remains in the back itself. Sciatica radiates – usually to the buttock, thigh or calf, sometimes all the way down to the foot. Numbness or tingling strongly suggests sciatica.
Can sciatica become chronic?
Yes, but it's rare. Most get better within a few months. If the problems drag on over time and turn into chronic pain it is especially important to seek a specialist early.
Is it dangerous to exercise with sciatica?
No, movement is good. Avoid heavy lifting and violent movements during the acute phase, but gentle exercise helps healing.
Can sciatica cause me to lose strength in my leg?
Yes. If the nerve is pressed heavily, the muscle it supplies can become weaker. If you have severe muscle weakness – seek care immediately.
Does chiropractic or naprapathy work for sciatica?
Manual treatment may help in some cases, but there is mixed evidence. A medical assessment first is always best – sometimes manipulation can worsen the symptoms of a herniated disc.
Do I need an MRI?
Not always. In most cases of sciatica, clinical signs are sufficient. MRI becomes relevant if the symptoms do not improve, are atypical or in case of red flags.
Do I need a referral to see an orthopedist?
No. At the Scandinavian Health Clinic in Mölndal, you book an appointment directly without a referral.
How long is the waiting time?
Usually within a few days – in case of acute problems even faster.
Take sciatica seriously – but don't panic
Sciatica is painful, scary and often misunderstood. But in most cases it goes well with the right assessment and treatment. Don't let the pain linger for too long – the sooner you get help, the faster you'll be back to normal.
Book an appointment with a specialist in pain and orthopedics at the Scandinavian Health Clinic in Mölndal - without a referral, with a short waiting time and close to Gothenburg.
📞 +46 (0) 10-147 77 40 ✉️ [email protected]
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