What Is Sciatica?
Sciatica is a type of nerve pain caused by irritation or compression of the sciatic nerve. The sciatic nerve travels from the lower back through the buttocks and down each leg.
Unlike ordinary lower back pain, sciatica commonly causes symptoms that travel from the lower back or buttock into the leg. You may experience sharp, burning or shooting pain together with tingling, numbness or weakness.
Sciatica often improves within several weeks to a few months, although recovery can take longer in some people.
Before deciding which sciatica treatment may be appropriate, it can help to understand what sciatic nerve pain actually feels like and how it differs from ordinary back pain.
What Does Sciatica Pain Feel Like?
Sciatica can feel different from person to person, but typical symptoms include:
- Sharp or shooting pain
- Burning pain
- Electric-shock-like sensations
- Tingling or pins and needles
- Numbness
- Weakness in the leg or foot
- Pain travelling from the lower back or buttock down one leg
The pain may become worse when coughing, sneezing or moving.
Although back pain can occur alongside sciatica, the leg pain is often more prominent.
This is why people sometimes describe sciatica as feeling like a nerve is being “pinched” or irritated.
What Causes Sciatica?
Sciatica happens when something irritates or compresses the sciatic nerve or one of the nerve roots that contribute to it.
Common causes include:
1. Herniated or Bulging Disc
A herniated disc is one of the most common causes of sciatica. A disc can bulge or herniate and irritate a nearby nerve.
2. Spinal Stenosis
Spinal stenosis occurs when spaces within the spine become narrower, potentially putting pressure on nerves.
3. Spondylolisthesis
This occurs when one vertebra moves out of its normal position relative to another.
4. Back Injury
An injury affecting the lower back can sometimes irritate the nerves associated with sciatica.
How to Treat Sciatica at Home
For many people, treatment initially focuses on maintaining movement and managing symptoms while the irritated nerve settles.
1. Keep Moving
One of the biggest mistakes people make with sciatica is staying in bed or sitting for prolonged periods.
The NHS recommends continuing normal activities as much as possible and gradually introducing gentle exercise.
Walking, gentle mobility exercises and other appropriate activities may help you remain active without placing excessive strain on your back.
However, exercises should be appropriate for your circumstances. If an exercise causes significant pain or makes your symptoms worse, stop and seek professional advice.
For medically reviewed guidance on exercises that may help with sciatica, see the NHS guidance on exercises for sciatica.
2. Try Heat
A heat pack placed over the painful area may provide temporary relief for some people.
Be particularly careful if you have numbness because reduced sensation can make it easier to burn your skin.
3. Avoid Staying in One Position Too Long
Long periods of sitting or lying down may make it harder to stay active.
Instead, try changing position regularly and incorporating gentle movement throughout the day.
4. Consider Physiotherapy
Physiotherapy can be useful when sciatica is affecting movement, daily activities or recovery.
A physiotherapist can assess your symptoms and recommend exercises appropriate for your condition.
NHS community musculoskeletal services may also provide access to physiotherapy in many areas.
What Medicines Are Used for Sciatica?
People often search for the best medicine for sciatica pain, but there isn’t one medication that is suitable for everyone.
The appropriate option depends on the severity of symptoms, your medical history, other medicines you take and whether you have conditions that make particular painkillers unsuitable.
A pharmacist or healthcare professional can help determine which option is appropriate.
NSAIDs Such as Ibuprofen
Non-steroidal anti-inflammatory drugs (NSAIDs), including ibuprofen, may sometimes be considered for pain.
However, NICE highlights that the benefits of NSAIDs for sciatica are limited and that potential gastrointestinal, kidney, liver and cardiovascular risks need to be considered. When prescribed, the recommendation is to use the lowest effective dose for the shortest appropriate period.
NSAIDs aren’t suitable for everyone, so don’t assume that ibuprofen or another anti-inflammatory is safe simply because it is available without a prescription.
Is Paracetamol Good for Sciatica?
Paracetamol is commonly used for general pain, but it may not provide much relief for sciatica.
The NHS specifically notes that paracetamol is unlikely to help sciatica.
If you’re unsure which painkiller is appropriate, speak with a pharmacist or healthcare professional rather than combining different medicines yourself.
What About Stronger Painkillers?
For severe pain, a healthcare professional may sometimes consider stronger prescription pain relief depending on the situation.
However, medicines such as opioids can cause dependence and other adverse effects. NICE therefore recommends caution with opioid medicines and does not recommend routinely using them for chronic low back pain.
This is particularly important when considering medicines containing codeine or other opioids.
Are Gabapentin or Pregabalin Used for Sciatica?
This is an important area where online information can be confusing.
Gabapentin and pregabalin are medicines used for certain types of neuropathic pain, but they should not automatically be considered standard treatments for sciatica.
NICE recommends against offering gabapentinoids for low back pain and has highlighted the limited evidence of benefit and potential harms in sciatica.
Therefore, people should not start pregabalin or gabapentin simply because their leg pain feels like nerve pain.
If these medicines are being considered, the decision should be made by an appropriate healthcare professional after assessing the cause of the symptoms.
Can Exercise Help Sciatica?
Yes. Remaining active and gradually returning to normal activities are important parts of recovery for many people.
NICE recommends considering exercise programmes for people with low back pain with or without sciatica, taking individual needs, preferences and abilities into account.
Examples of gentle activities may include:
- Walking
- Gentle mobility exercises
- Appropriate stretching
- Physiotherapy exercises
- Gradual strengthening exercises
There is no single exercise that works for everybody.
How Long Does Sciatica Take to Get Better?
Many cases of sciatica improve within several weeks to a few months.
However, recovery varies considerably depending on the underlying cause, severity of nerve irritation and individual health factors.
The NHS advises seeking medical advice if your symptoms have not improved after several weeks of home treatment, are getting worse or are preventing you from carrying out normal activities.
If your symptoms are persistent, worsening or significantly affecting your quality of life, don’t simply keep increasing pain medication without medical advice.
When Should You See a Doctor for Sciatica?
Speak with a healthcare professional if:
- Your pain is not improving after several weeks
- Your symptoms are getting worse
- Pain is interfering with normal activities
- You develop increasing weakness or numbness
- You are concerned about the cause of your symptoms
A healthcare professional can determine whether you need physiotherapy, additional investigations or another form of treatment.
When Is Sciatica an Emergency?
Although most cases of sciatica are not emergencies, certain symptoms require urgent assessment.
Go to A&E or call emergency services if you develop:
- Sciatica affecting both legs
- Severe or worsening weakness or numbness in both legs
- Numbness around the genitals or anus
- Difficulty starting urination
- Inability to urinate
- Loss of bladder control
- Loss of bowel control
These symptoms can indicate serious compression of nerves in the lower spine and require urgent medical assessment.
Do not attempt to treat these symptoms yourself with stronger painkillers.
Can Sciatica Come Back?
Unfortunately, having sciatica once does not guarantee that it will never return.
Staying physically active, using safe lifting techniques, maintaining appropriate posture and looking after your general health may help reduce the risk of future problems.
The key is not to focus solely on medication. Long-term management often involves maintaining movement and addressing contributing factors.
Frequently Asked Questions About Sciatica Treatment
What is the fastest way to relieve sciatica pain?
There is no guaranteed instant cure for sciatica. Gentle movement, avoiding prolonged sitting or lying, heat and appropriate pain relief may help manage symptoms while the underlying problem improves.
What is the best medicine for sciatica?
There is no single best medicine for everyone. NSAIDs may sometimes be considered, but they are not suitable for everyone and their benefit for sciatica is limited. A pharmacist or doctor can advise based on your circumstances.
Is walking good for sciatica?
Gentle movement and continuing normal activities as much as possible are generally encouraged. Walking can be a practical way to remain active, provided it does not significantly worsen your symptoms.
Is bed rest good for sciatica?
Prolonged bed rest is generally not recommended. The NHS advises remaining as active as possible and avoiding sitting or lying down for long periods.
Can sciatica go away on its own?
Yes. Many cases improve over several weeks to a few months without surgery. However, persistent or worsening symptoms should be assessed by a healthcare professional.
Should I take ibuprofen for sciatica?
Ibuprofen may be appropriate for some people, but NSAIDs are not suitable for everyone. NICE recommends considering individual risk factors and using the lowest effective dose for the shortest appropriate period when NSAIDs are prescribed.
Final Thoughts
Sciatica can cause intense shooting, burning or electric-like pain that travels from the lower back or buttock into the leg. Fortunately, many cases improve with time, appropriate activity and conservative treatment.
The most useful approach is usually more than simply finding a stronger painkiller. Staying gently active, avoiding prolonged inactivity, using appropriate pain relief and considering physiotherapy can all form part of a broader treatment plan.
Most importantly, don’t ignore neurological warning signs. New bladder or bowel problems, numbness around the genitals or anus, or severe/worsening weakness or numbness affecting both legs require urgent medical attention.
Medical disclaimer: This article is for general educational purposes and does not replace an assessment from a doctor, pharmacist or other qualified healthcare professional. Prescription medicines should only be used as directed by an appropriate prescriber.
