Living with joint, back or bone pain that won’t settle?
Message our care team on WhatsApp. Tell us what’s going on and we’ll help you find the right best orthopaedic surgeon — free, with no obligation.
Chat with our care team on WhatsAppNot sure who to see? Find the right specialist →
In a medical emergency, or for severe or sudden symptoms such as breathing difficulty, chest pain, fainting or stroke signs, call 995 immediately.
At a glance
- Sciatica is pain that radiates along the sciatic nerve — from the lower back, through the buttock and down one leg, sometimes as far as the foot.
- It is a symptom of an irritated or compressed nerve, most often from a slipped (herniated) disc, rather than a disease in itself.
- Most cases settle within a few weeks with simple measures such as staying active and physiotherapy.
- Certain “red-flag” symptoms — loss of bladder or bowel control, saddle numbness or worsening leg weakness — need emergency assessment.
Red-flag symptoms — seek urgent care
Go to A&E or call 995 without delay if you develop numbness around the genitals, buttocks or inner thighs (the “saddle” area), difficulty controlling or emptying your bladder or bowels, or severe or progressive weakness in one or both legs. These can indicate cauda equina syndrome, a rare compression of the nerves at the base of the spine that can cause permanent damage if not treated as an emergency.
Symptoms
Sciatica typically causes a sharp, burning or shooting pain that travels from the lower back into one buttock and down the back or side of the leg, sometimes reaching the calf or foot. It is usually one-sided. Alongside the pain, many people notice tingling, “pins and needles”, numbness, or weakness in the affected leg or foot. The pain is often made worse by sitting for long periods, bending, twisting, coughing or sneezing, and may ease a little when lying down or walking. The back pain itself is sometimes milder than the leg pain, which is the more troublesome feature for many people. Symptoms can range from a mild ache to pain severe enough to interfere with sleep and daily activities, and they may build up over hours or come on suddenly after a particular movement. Because the pattern follows the path of the nerve, you can often trace the discomfort as a line running down the leg rather than a vague, spread-out ache.
What causes it
Sciatica happens when the sciatic nerve or one of the nerve roots that form it is irritated or compressed. The commonest cause is a herniated (slipped) disc in the lower spine bulging onto a nerve root. Other causes include narrowing of the spinal canal (spinal stenosis), age-related wear of the discs and joints, and slippage of one vertebra over another. Less commonly, a tight or overworked buttock muscle (the piriformis) can irritate the nerve, and rarely an infection, injury or growth is responsible. Everyday factors such as heavy or awkward lifting, poor posture and prolonged sitting can trigger or worsen symptoms.
Who is at risk
Sciatica can affect anyone, but some factors make it more likely. These include being in middle age, when discs are more prone to wear and herniation; jobs or activities that involve heavy lifting, repeated bending or twisting, or long hours seated or driving; being overweight, which adds load to the spine; a sedentary lifestyle with weak core and back muscles; and previous back problems. Smoking may also affect disc health. Many people, however, develop sciatica without any obvious risk factor.
How it is diagnosed
A doctor can usually recognise sciatica from your description of the pain and a physical examination, without needing tests. The examination checks the movement, strength, reflexes and sensation in your legs, and often includes a “straight-leg raise” test, in which lifting the affected leg while lying down reproduces the shooting pain. Imaging is not needed for most people, because scans often show disc changes even in those without symptoms. An MRI scan is generally reserved for specific situations — for example, when pain is severe or has not improved over several weeks, when there is significant weakness or red-flag symptoms, or when surgery or an injection is being planned. Your GP or polyclinic doctor may refer you to an orthopaedic or spine specialist if the picture is unclear or symptoms persist.
Course and complications
The outlook is generally good. Most cases of sciatica improve within a few weeks and settle within a couple of months with conservative care, as inflammation around the nerve subsides. Some people have milder symptoms that come and go, and sciatica can recur. In a minority, pain becomes chronic (lasting several months or more) or is accompanied by lasting numbness or weakness in the leg or foot, which may need specialist assessment. Persistent nerve pain can also affect mood, sleep and the ability to work, so it is worth seeking help early rather than pushing through severe or ongoing symptoms. The most serious, though rare, complication is cauda equina syndrome, described in the red-flag box above, which is a surgical emergency requiring immediate treatment to protect the affected nerves.
How it is treated
Most sciatica is managed without surgery. The mainstays of care are:
- Stay active. Keeping gently mobile and continuing normal activities as far as pain allows speeds recovery; prolonged bed rest tends to slow it down and is no longer advised.
- Exercises and physiotherapy. A physiotherapist can guide stretching, strengthening and posture work to relieve pressure on the nerve and reduce the chance of recurrence.
- Pain relief. Simple pain-relieving and anti-inflammatory medicines can help you stay active and sleep better. Use them as advised by your doctor or pharmacist, and check that they are suitable if you have other health conditions.
- Self-care measures such as heat or cold packs, good sitting posture and safe lifting technique.
If symptoms are severe or persist despite these measures, a doctor may consider a targeted spinal (epidural) injection to reduce inflammation around the nerve. Surgery to relieve the pressure — for example removing part of a herniated disc — is considered for a small number of people with a confirmed disc pressing on a nerve and ongoing disabling symptoms, significant weakness, or red-flag features. Your specialist will discuss whether the likely benefits outweigh the risks in your case.
Living with it and self-care
Day to day, the aim is to keep moving while protecting your back. Gentle walking and the exercises your physiotherapist recommends help maintain strength and flexibility. Pay attention to posture: avoid slumping when seated, take regular breaks to stand and stretch if you sit or drive for long periods, and set up your workspace so screens and chairs support a neutral spine. When lifting, bend at the hips and knees rather than the back, keep loads close to your body, and avoid twisting while carrying. Maintaining a healthy weight, building core strength gradually, and returning to activity step by step rather than all at once all reduce the risk of recurrence. If a particular movement sharply worsens your pain, ease off and build back slowly. Regular low-impact activity such as walking, swimming or cycling helps keep the back healthy over the longer term, and staying physically active is one of the best ways to prevent future episodes. Applying heat before activity and cold after can ease discomfort, and simple pacing — spreading demanding tasks through the day and avoiding long unbroken periods in one position — makes flare-ups less likely. Keep track of what helps and what aggravates your symptoms, and share this with your doctor or physiotherapist so your plan can be adjusted.
When to see a doctor
See a doctor — a GP or polyclinic doctor is a good first stop — if sciatica is severe, is not improving after a few weeks of self-care, keeps returning, or is accompanied by leg weakness or spreading numbness. Seek urgent or emergency care (995 or A&E) for any of the red-flag symptoms above: saddle numbness, loss of bladder or bowel control, or severe or worsening leg weakness.
Common questions
How long does sciatica last?
Most cases improve within a few weeks with conservative care, though some take a couple of months, and it can recur.
Should I rest or stay active with sciatica?
Staying gently active is generally better than bed rest, which can slow recovery.
When does sciatica need surgery?
Surgery is considered for severe or persistent symptoms from a confirmed disc problem, or urgently for red-flag nerve symptoms.
Is sciatica the same as ordinary back pain?
No. Ordinary lower back pain stays mainly in the back, while sciatica is nerve pain that shoots down the leg, often with tingling or numbness. The two can occur together.
Do I need a scan for sciatica?
Usually not. Most cases are diagnosed from the history and examination; an MRI is generally reserved for severe or persistent symptoms, significant weakness, or when an injection or surgery is being considered.
Related guides
Sources
- HealthHub Singapore — sciatica and back pain.
- Ministry of Health Singapore — low back pain.
- UK NHS — sciatica.
This article is for general information only and does not replace a consultation with a qualified doctor. Please seek personalised medical advice for your situation.