Clinically reviewed by What is sciatica
Sciatica is not a diagnosis on its own. It is the name for pain that travels along the sciatic nerve, which runs from the lower back through the buttock and down the back of the leg. Something is irritating or compressing that nerve, and the job of the assessment is to find out what.
In Urdu the complaint is usually described as kamar se taang tak dard, pain from the back down the leg.
The most common cause is a disc in the lower back pressing on a nerve root. It is treatable, and most cases settle without surgery.
Symptoms you might have
- Pain travelling from the lower back or buttock down the back of one leg
- Usually one leg, not both
- Burning, shooting or electric pain rather than a dull ache
- Pins and needles or numbness in the leg or foot
- Worse on sitting, bending forward, coughing or sneezing
- Weakness in the leg or foot in more severe cases
- Often worse first thing in the morning
Why it happens
- A disc bulge or herniation in the lower back pressing on a nerve root, the most common cause
- Spinal stenosis, a narrowing of the space the nerve passes through, more common with age
- Spondylolisthesis, where one vertebra has slipped forward on another
- Piriformis syndrome, where a tight muscle in the buttock irritates the nerve
- Prolonged sitting, particularly on a motorbike or at a desk without back support
- Heavy lifting with a bent and twisted back
- Pregnancy, where the weight and the change in posture load the lower back
When you should see a physiotherapist
Come in if the pain has lasted more than a week, if it travels below the knee, if there is numbness or tingling, or if sitting has become difficult.
Do not wait several months hoping it settles. Nerve pain that is left alone can become harder to treat, and the longer a nerve is irritated the longer it takes to calm down.
Go to a hospital the same day if you have numbness around the groin or back passage, if you have lost control of your bladder or bowels, or if both legs are weak. These are signs of a serious compression that needs urgent surgical assessment.
Also see a doctor promptly if the leg is becoming visibly weaker, for example if you cannot lift your foot properly when walking.
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اپائنٹمنٹ کے بارے میں پوچھیںAppointment ke liye poochein
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How it is treated
Treatment begins with working out where the irritation is coming from, because sciatica from a disc, from stenosis and from the piriformis muscle need different approaches. The same exercise can help one and worsen another.
Treatment includes:
- Specific directional exercise, usually movement in the direction that draws the pain back out of the leg and towards the spine
- Manual therapy to the lower back and hip to restore movement
- Nerve mobilisation to free the sciatic nerve to glide, done gently
- Electrotherapy, ultrasound and TENS for pain control in the acute phase
- Dry needling for the buttock and back muscles where they are in protective spasm
- Core and hip strengthening once the pain has centralised, to stop it returning
- Practical changes to sitting, driving, lifting and sleeping
Most sciatica does not need surgery. Surgery is considered when there is progressive weakness, when bladder or bowel function is affected, or when several months of proper treatment have not helped.
Exercises, and what to avoid
What helps
- Lying face down, then propping on the elbows, for most disc-related sciatica. The aim is for leg pain to move up towards the back, which is a good sign
- Gentle sciatic nerve glides, moving the nerve rather than stretching it hard
- Walking, little and often, starting with a few minutes
- Glute and core strengthening once the leg pain has settled
What to avoid
- Sitting for long periods, which loads the disc more than standing does
- Repeated forward bending and toe touching in the acute phase
- Hard hamstring stretching while the nerve is irritated. It feels like a tight hamstring but it is a sensitive nerve, and stretching aggravates it
- Complete bed rest beyond a day or two, which makes recovery slower
- Any exercise that makes the pain travel further down the leg. That is the signal to stop
What you can do at home
Keep moving. Short walks several times a day are better than lying still.
Break up sitting every 20 to 30 minutes. If you ride a motorbike, that counts as sitting, and it is often what keeps sciatica going in this part of Pakistan.
Sleep on your side with a pillow between the knees, or on your back with a pillow under the knees.
Heat usually suits sciatica better than ice, because the muscles around the spine go into protective spasm. Fifteen to twenty minutes of a hot pack on the lower back and buttock.
Avoid lifting with a bent and twisted back. Bend the knees and keep the load close.
How long it takes
Most sciatica improves substantially within six weeks and settles within three months.
You should feel some change within the first two weeks of starting proper treatment. The most useful early sign is not that the pain is less, but that it has moved: pain that was in the calf moving up to the thigh or buttock means the nerve is being decompressed, even if the back feels no better yet.
Longstanding sciatica, sciatica with significant leg weakness, and sciatica from spinal stenosis take longer and need more patience.
What slows recovery most is continuing to sit for long periods and stopping the exercises as soon as the pain eases.
Urdu / Roman Urdu
Choose your reading script / اپنی پسند کا رسم الخط منتخب کریں
اردوUrdu script
شیاٹیکا میں درد کمر یا کولہے سے شروع ہو کر ٹانگ کے پیچھے سے نیچے تک جاتا ہے۔ یہ اکثر ایک ہی ٹانگ میں ہوتا ہے، اور بیٹھنے، جھکنے یا کھانسنے سے بڑھ جاتا ہے۔
زیادہ تر وجہ کمر کی ہڈی کے بیچ کی ڈسک کا دباؤ ہوتا ہے جو نس پر پڑتا ہے۔
اچھی بات یہ ہے کہ زیادہ تر لوگوں کو آپریشن کی ضرورت نہیں پڑتی۔ صحیح ورزش، مینول تھراپی اور بیٹھنے اٹھنے کے طریقے میں تبدیلی سے چھ ہفتے میں کافی بہتری آ جاتی ہے۔
ایک اہم نشانی: اگر درد ٹانگ سے اوپر کمر کی طرف واپس آنے لگے، تو اس کا مطلب بہتری ہو رہی ہے، چاہے کمر ابھی بھی دکھ رہی ہو۔
اگر پاخانے یا پیشاب پر کنٹرول ختم ہو جائے، یا دونوں ٹانگیں کمزور ہو جائیں، تو فوراً ہسپتال جائیں۔
Roman Urdu
Sciatica mein dard kamar ya kolhe se shuru ho kar taang ke peeche se neeche tak jata hai. Ye aksar ek hi taang mein hota hai, aur baithne, jhukne ya khansne se barh jata hai.
Zyada tar wajah kamar ki haddi ke beech ki disc ka dabao hota hai jo nas par parta hai.
Achi baat ye hai ke zyada tar logon ko operation ki zaroorat nahi parti. Sahi warzish, manual therapy aur baithne uthne ke tareeqe mein tabdeeli se chhe hafte mein kaafi behtari aa jati hai.
Ek ahem nishani: agar dard taang se upar kamar ki taraf wapis aane lage, to iska matlab behtari ho rahi hai, chahe kamar abhi bhi dukh rahi ho.
Agar pakhane ya peshab par control khatam ho jaye, ya dono taange kamzor ho jayen, to foran hospital jayen.
Treatment at the clinic, and online
INFORMATION → INDIVIDUAL CARE
A plan built around you.
Talk with Dr. Zahra Fatima, DPT. Understand your next steps, with guidance for your own symptoms and daily routine.
Talk it through
Discuss your symptoms, what you find difficult and what you want to get back to.
Understand your next steps
Use the consultation to discuss which care and exercises fit your situation.
Take your plan with you
Your online consultation includes a written plan you can refer to afterwards.
Questions people ask
How long does sciatica last?
Should I rest or keep moving with sciatica?
Is sciatica curable without surgery?
Why does stretching my hamstring make it worse?
Heat or ice for sciatica?
Can sciatica cause permanent damage?
Further reading from the NHS
Sciatica involves irritation or compression of the sciatic nerve and may cause pain, tingling or weakness in a leg. NHS: sciatica symptoms and care
Related conditions
- Carpal tunnel syndrome treatment
- Bell's palsy treatment and exercises
- Diabetic neuropathy treatment
- Numbness and tingling in the hands and feet
- Foot drop treatment