Sciatica – pain felt in the buttocks and down the legs due to compression or irritation of the sciatic nerve – is very common and can be quite problematic for some people. But while there’s endless information about sciatica on the internet and lots of people have theories about how to deal with it, knowing where to turn for reliable advice can be trick
The good news is, sciatica can be treated and managed very effectively - but identifying the underlying causes and the most suitable path of action for you can make a big difference. Here, we look at 5 common sciatica myths and key points to keep in mind:
Reduced space between spinal joints (stenosis), or vertebra slipping out of place (spondylolisthesis), as a result of trauma or degenerative changes may also cause nerve irritation, and muscular issues can sometimes cause sciatica too. A key example is piriformis syndrome, where the piriformis – a small muscle in the buttocks – compresses the sciatic nerve. For chronic or severe sciatica, identifying the root cause is crucial for determining the best approach to treating and managing it. Find out more in our sciatica treatment page.
When our body hurts, it’s natural to think that rest is the obvious solution - but this isn’t necessarily the case. Being inactive may even make the problem worse or slow the recovery process. With sciatica, spending long periods sitting down can often worsen the pain, so it’s a good idea to get up and shift position frequently and remain reasonably active.
That said, there are times when rest is very important, and you may need to adapt your fitness regime or avoid certain activities for a while, and focus on physiotherapy and rehab to help the disc heal. A physiotherapist and rehab specialist with expertise in dealing with the precise cause of your sciatica will be able to guide you on the best course of action.
If you have chronic or severe sciatica, you may need to put your ‘big’ fitness goals on hold for a while – but that doesn’t mean you won’t be able to enjoy these things ever again.
When it comes to back pain, people who maintain a good level of fitness actually tend to have much better long-term outcomes. The important thing is to get the right guidance on managing the problem - so you can return to the activities you enjoy in the best shape possible and avoid a relapse or further injuries.
Alongside suitable pain management, tailored physiotherapy and rehab programmes can help address any underlying weaknesses or ‘problem areas’ unique to you, with exercises and advice specific to the activity you wish to pursue, whether that’s running, cycling, skiing, etc
It can take months for sciatica or an associated disc injury to get better – but very few people will end up needing surgery, which is usually a ‘last resort’ option. Many people find sciatica resolves itself, although there’s lots of evidence that engaging in things like physiotherapy can significantly improve chances of recovery and avoiding future flare-ups.
Even if sciatica is severe and impacting daily life, there are a number of treatments that can be tried before surgery is considered, such as steroid and nerve root block injections. These don’t ‘cure’ the problem but can alleviate pain and muscle spasms, sometimes for a number of months. Our ‘What are the best non-surgical treatment options for sciatica?’ information video explains more.
When suitable, decompression surgery – such as a microdiscectomy – can be highly effective. However, it’s also important to remember that surgery isn’t a 100% fix against further back pain or disc problems: Rehab and maintaining a healthy, active lifestyle will still be vital. Our ‘What are the surgical treatment options for sciatica?’ information video explains more.
The majority of the time, despite sometimes being nasty to endure, sciatica isn’t serious. Even with chronic sciatica lasting more than six weeks, symptoms will eventually resolve. That said, in more rare cases, sciatica can be associated with more serious problems.
Severe ongoing nerve compression can lead to longer lasting weakness and loss of nerve function, for examples, and a condition called cauda equine syndrome can also occur (where the ‘cauda equina’ nerves at the base of the spine become damaged). Symptoms include numbness in the groin, genitals and saddle area, severe leg weakness and reduced bladder and bowel control (including incontinence or an inability to pass urine) and if these occur, it’s important to seek urgent medical advice. Thankfully, cauda equina is rare but the damage can be permanent if not treated promptly.