An expert's guide to sciatica: causes, symptoms and treatment options

Sciatica is a common, painful condition caused by the compression of the sciatic nerve. In his latest article, highly-renowned orthopaedic surgeon Mr Nigel Gummerson explains this condition in detail, including the symptoms, causes and treatments available.

What causes acute sciatica?

For most patients, acute sciatica is due to a disc prolapse pressing on a nerve. As a consequence, the patients experience pain going down their leg in the distribution of that nerve.

Are some people more prone to developing this condition?

Unfortunately, wear and tear are common in all of us. We see wear and tear in children as young as four years old, and the chances of having wear and tear in our spines get higher and higher the older we get. This means that everyone is at risk of sciatica. Some families have a higher chance of sciatica than others.

There are a few lifestyle factors that increase the chance of wear and tear of the spine. For example, smoking increases the rate of wear and tear by a small amount. However, other things like sports and occupation have very little impact on the chance of wear and tear.

What symptoms do patients typically experience?

Most patients with sciatica would present with complaints of pain in the leg. Some also present with pain in the spine.

This pain in the leg can come with pins and needles, or numbness or sometimes a change in the temperature sensation. Some patients feel like their foot or leg is burning, and others feel as though their foot or leg is in a bucket of ice.

How long do cases of sciatica usually take to subside?

Most patients with sciatica will have symptoms that improve after six to twelve weeks. Leaving things alone is perfectly reasonable in the first instance. In a small proportion of patients, perhaps 5 – 10%, symptoms will persist and this is when it becomes worthwhile to look at other available treatments.

Is treatment always necessary?

Most people with sciatica will get better without treatment. Even if symptoms continue, if they are manageable, it is reasonable to leave it alone with no treatment. If the patient has symptoms disturbing their quality of life beyond 12 weeks, other treatments such as a nerve root block or surgery are options.

What can patients do at home to help relieve sciatic pain?

The natural history of sciatica is that it will improve with time for most people. While that process is happening, patients can take simple painkillers, while avoiding complex painkillers and morphine-based drugs which have been shown to do more harm than good in the longer term. Staying active and keeping the muscles in good condition is also very important.

Mr Nigel Gummerson is a leading orthopaedic surgeon based in Halifax, Leeds and Wakefield. If you are worried about sciatica or any other type of back or spinal pain, you can book a consultation with Mr Gummerson via his Top Doctors profile.