Sciatica — leg pain from a nerve in your back

Get help straight away if

These are uncommon, but they need same-day care — go to an emergency department, do not wait for an appointment.

• Bladder or bowel dysfunctionDifficulty initiating micturition, impaired sensation of urinary flow, retention with overflow incontinence, or loss of sensation of rectal fullness / faecal incontinence
• Saddle / perineal / genital sensory lossPerianal, perineal or genital numbness or paraesthesia (saddle anaesthesia) — unilateral or bilateral
• Bilateral sciaticaRadicular leg symptoms affecting both legs — a red flag for cauda equina compression
• Progressive or bilateral leg motor weaknessSevere or progressive bilateral neurological deficit — major motor weakness of knee extension, ankle eversion or foot dorsiflexion

Contact us promptly if

Not an emergency, but worth being seen sooner rather than waiting it out.

• Suspected malignancyPrior cancer, unexplained weight loss, night pain, or new back pain age > 50
• Suspected spinal infectionFever, IV drug use, immunosuppression, or recent systemic infection
• Suspected fractureSignificant trauma, or minor trauma with osteoporosis / long-term corticosteroids
• Severe or progressive neurological deficitWorsening single-level motor/sensory loss (e.g. progressive foot drop) not meeting cauda-equina criteria — urgent, not emergency

What usually happens

It often sounds worse than it is. Most sciatica settles over weeks with time, movement and simple pain relief, and never needs surgery or a scan.

Staying as active as the pain allows helps more than resting in bed. Gentle ordinary movement is treatment, not risk — even when it is uncomfortable.

A scan early on usually changes nothing. Imaging is useful when it would change what we do, which is why we do not order it for everyone at the first visit.

At your appointment

We will ask where the pain travels, what makes it better or worse, and whether anything has changed in your strength, sensation, bladder or bowels.

We will examine your back and legs — reflexes, power and sensation — to work out which nerve is involved and whether it is settling or progressing.

Most people leave with a plan for pain control and movement, and a clear point at which to come back. Referral and imaging are for the cases that need them.

Worth asking

• —Which nerve do you think is involved, and what does that mean for me?
• —What should I be doing — and what should I avoid — over the next two weeks?
• —How long would you expect this to take to settle?
• —What would make you want to see me sooner, or arrange a scan?