Sciatica – Understanding Your Symptoms and Treatment Options Bradley Stoke
- Daniel Taylor
- May 19
- 6 min read
Updated: Jul 7
Sciatica is a very common cause of back and leg pain worldwide. It is characterised by lower back pain associated with nerve pain that radiates down the leg and, in more severe cases, can travel all the way into the foot.
Common symptoms include:
Sharp or burning nerve pain
Tingling sensations
Numbness
Pain into the hamstring, calf, and foot
Weakness or heaviness in the leg
Sciatica is most commonly caused by a disc bulge or disc herniation in the spine. This can place pressure on the nerve as it exits the spine, leading to irritation and inflammation of the neural tissue.
What Does Sciatica Feel Like?
Sciatica symptoms can vary from mild discomfort to severe, debilitating pain. In the early stages, the pain can be extremely intense and may significantly affect walking, sleeping, sitting, and day-to-day activities.
How Long can sciatica Last
The natural history of sciatica is generally favourable, with most people improving without surgery. Research suggests that many cases of sciatica improve significantly within the first 6–12 weeks. However, recovery times can vary considerably from person to person.
Some episodes may settle within a matter of days or a few weeks, whilst others can take 6–9 months or longer to fully resolve. Factors that can influence recovery include the size of the disc herniation, the degree of nerve compression, activity levels, general health, and whether symptoms have been present for a prolonged period before treatment is sought.
If nerve symptoms such as pain, numbness, tingling, or weakness persist beyond 8–12 months, there is a possibility that the nerve has sustained more permanent damage. In these circumstances, complete resolution of symptoms may become less likely, although treatment can still help improve pain, function, and quality of life. Persistent symptoms should be assessed by an appropriately qualified healthcare professional, and further investigations such as MRI scanning may be recommended.
Self-Treatment for Mild Sciatica
In milder cases, symptoms can often be managed with simple conservative measures, including:
Medications from your pharmacist. This includes paracetamol and ibuprofen. If these medications are not helping you could also consider purchasing co-codamol from a pharmacy. This contains a weak opiod's & paracetamol which can sometimes be more effective than paracetamol alone.
Heat packs. I recommend that you apply the heat to the lower back region as this is commonly the source of your pain. I would recommend that you apply heat to the lower back 2-3 times a day to help improve blood flow and promote healing.
Gentle mobility exercises - See the video below.
McKenzie Lumbar Extensions for Sciatica
One of the most commonly prescribed exercises for sciatica is the McKenzie lumbar extension exercise, sometimes referred to as "press-ups" or "prone extensions."
The principle behind the exercise is to repeatedly extend the lower back, which may help reduce pressure on a disc bulge and encourage disc material to move away from the irritated nerve root. In some patients, this can lead to a phenomenon known as centralisation, where pain moves out of the leg and becomes more localised to the lower back. Centralisation is generally considered a positive sign and is often associated with a better prognosis.
The potential benefits of McKenzie lumbar extensions include:
Reducing leg pain and sciatica symptoms
Improving spinal mobility
Encouraging centralisation of symptoms
Reducing stiffness in the lower back
Improving posture and movement patterns
Helping patients return to normal activities more quickly
It is important to note that McKenzie extensions are not suitable for everyone. Whilst many patients with disc-related sciatica respond well to extension-based exercises, some patients may find their symptoms worsen. For this reason, exercises should be tailored to the individual and ideally guided by a qualified healthcare professional.
A general rule is that if the exercise causes pain to move out of the leg and towards the back, this is usually a favourable response. If symptoms travel further down the leg or become significantly worse, the exercise should be stopped and reassessed.
How to Perform a McKenzie Press-Up
Lie face down on a firm surface.
Place your hands beneath your shoulders.
Slowly push your upper body up whilst keeping your hips and pelvis relaxed on the floor.
Hold for 1–2 seconds.
Lower yourself back down.
Repeat 10 times, several times throughout the day as tolerated.
The aim is to help keep the nerve mobile, reduce stiffness, and gradually free up the entrapment around the irritated nerve.
You can also find some helpful exercises on our YouTube channel
Treatment for Moderate to Severe Sciatica
In more severe cases, prescribed medications may be required to help manage the pain whilst the body recovers naturally.
At Elite Joint Solutions we offer a range of treatments designed to help facilitate recovery and adequately manage your symptoms.
These include:
In more severe cases of sciatica, prescription medications may be required to help manage symptoms whilst the body undergoes its natural healing process.
These may include:
Dihydrocodeine – a stronger painkiller that can help reduce moderate to severe pain and improve day-to-day function.
Naproxen – an anti-inflammatory medication that may help reduce inflammation around the affected nerve root, disc, and facet joints.
Amitriptyline, Nortriptyline, or Duloxetine – medications commonly used to treat nerve-related pain. These drugs work differently to standard painkillers and can help reduce burning, shooting, tingling, and electric shock-like sensations associated with sciatica.
Whilst these medications do not directly fix the underlying disc problem, they can play an important role in improving quality of life whilst the body heals naturally. By reducing pain and improving sleep quality, they can help patients remain active, continue working, perform basic daily activities, and engage more effectively with rehabilitation exercises.
As with all medications, there are potential side effects and not every medication is suitable for every individual. For this reason, treatment should always be tailored to the patient's medical history, current medications, and symptom severity.
Acupuncture
At Elite Joint Solutions, we offer a unique combined approach by integrating physiotherapy, chiropractic treatment (where clinically indicated), and massage therapy within the same treatment session and under one roof.
The aim of this combined approach is to address the multiple factors that can contribute to sciatica symptoms. Treatment can help:
Reduce muscle spasm and tension around the lower back and pelvis
Improve joint mobility within the lumbar spine and surrounding structures
Improve flexibility and mobility of the neural tissue
Reduce mechanical irritation around the affected nerve root
Improve movement patterns and core stability
Help patients return to normal daily activities more comfortably
By improving mobility and reducing tension within the surrounding tissues, it is thought that pressure and irritation around the affected nerve can be reduced, helping to calm the sensitised neural tissue and promote recovery.
In our experience, patients often require a course of treatment rather than a single session. As a rough guide, many patients begin to notice meaningful improvements after approximately 6–8 treatment sessions delivered over an 8-week period, although this can vary depending on the severity and duration of symptoms.
If there has been little or no improvement after approximately 3 months of appropriate conservative treatment, further investigation may be warranted. At this stage, an MRI scan is often recommended to assess the underlying cause of the symptoms in greater detail and determine whether additional interventions may be beneficial.
These may include:
Nerve root block injections
Epidural steroid injections
Specialist spinal consultation
Surgical assessment where appropriate
The vast majority of patients with sciatica recover without surgery; however, imaging can be invaluable in guiding treatment decisions when symptoms are persistent, severe, or associated with neurological deficits.
When Is an MRI Needed?
If your sciatica is persistent or worsening, it may be appropriate to consider alternative interventions such as:
Nerve root block injections
Spinal injections
Surgical opinion
Before considering these options, it is common practice to arrange an MRI scan. This allows specialists and surgeons to identify the exact location and severity of the disc problem and helps guide further treatment decisions.
Important:
If you develop significant leg weakness, loss of bladder or bowel control, numbness around the saddle region (genitals or buttocks), or rapidly worsening symptoms, you should seek urgent medical attention as these can be signs of a more serious condition known as Cauda Equina Syndrome. This is a medical emergency and requires immediate assessment.
Contact Us
If you would like to discuss your sciatica symptoms in more detail or explore treatment options, please contact us:
Mobile : 07495368853
References
Weber H. Lumbar disc herniation: a controlled, prospective study with ten years of observation. Spine. 1983;8(2):131-140.
Stafford MA, Peng P, Hill DA. Sciatica: a review of history, epidemiology, pathogenesis, and the role of epidural steroid injection in management. British Journal of Anaesthesia. 2007;99(4):461-473.
Konstantinou K, Dunn KM. Sciatica: review of epidemiological studies and prevalence estimates. Spine. 2008;33(22):2464-2472.
Valat JP, Genevay S, Marty M, Rozenberg S, Koes B. Sciatica. The Lancet. 2010;372(9630):1638-1648.
Koes BW, van Tulder MW, Peul WC. Diagnosis and treatment of sciatica. BMJ. 2007;334:1313-1317.
McKenzie R, May S. The Lumbar Spine: Mechanical Diagnosis and Therapy. Spinal Publications.
Werneke M, Hart DL. Centralization phenomenon as a prognostic factor for chronic low back pain and sciatica. Spine. 2001.
May S, Donelson R. Evidence-informed management of chronic low back pain with the McKenzie Method. The Spine Journal. 2008.
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