Sciatica

Sciatica is a condition where the patient experiences pain that radiates along the sciatic nerve. The sciatic nerve is the longest nerve in the body, running from the lower back, through the buttocks, and down each leg. Sciatica usually occurs when the sciatic nerve is compressed or irritated.
Compression is often caused by lumbar disc herniation, foraminal stenosis, or degenerative spine changes at L4-S1.

Causes of sciatica include conditions like herniated discs, spinal stenosis, and degenerative disc disease. It’s also common to see sciatica occur with the presence of conditions like spondylolisthesis and piriformis syndrome.

How do you relieve sciatica?

Sciatica is often treated non-surgically. There are ways to help with the pain, including rest, heat and cold therapy, and various over-the-counter medications. Gentle stretching can also help relieve pressure on the nerve, while physical therapy can help strengthen the muscles supporting the back to improve flexibility. Exercise-based therapy is typically more effective than prolonged rest

For more severe cases of sciatica and to help those suffering from sciatica pain, other methods of relief may be employed to help with pain. Epidural steroid injections could be recommended by a treating clinician to help reduce inflammation and alleviate pain. In more severe cases, prescription medications such as muscle relaxants or stronger pain relievers may be prescribed. Short courses of oral corticosteroids or neuropathic agents such as gabapentin may also be considered in selected cases.

Although sciatica may never go away, in a lot of cases, it can be improved and eventually resolved with time and appropriate treatment. Most cases resolve within weeks to months, though recurrence is common if contributing mechanical issues are not addressed.

Walking can be a good way to relieve pain associated with sciatica in a lot of cases. Walking promotes blood flow and circulation while delivering nutrients and oxygen to the affected areas. Additionally, patients maintain joint mobility by doing low-impact activities like walking. Patients should avoid walking to the point of pain exacerbation and may benefit from interval walking with rest.

How long do bouts of sciatica last?

How long sciatica lasts depends on the patient and several factors, including the underlying cause, severity of the condition, and the effectiveness of the treatment.

For example, with acute sciatica, episodes can last from a few days to several weeks. During this time patients may experience intense pain, numbness, or weakness along the path of the sciatic nerve. Acute sciatica is usually associated with inflammation and irritation of the nerve.

If the symptoms last for a period of four to 12 weeks, it’s considered subacute sciatica. During this phase, some improvement may be observed, but the symptoms could still be present to some extent. When sciatica lasts for more than 12 weeks, it’s considered chronic. Chronic sciatica could involve recurrent flare-ups, and the symptoms can be more persistent. Long-term management strategies, including lifestyle changes, physical therapy, and ongoing self-care, may be necessary to address chronic sciatica. Chronic cases may warrant imaging to rule out structural causes amenable to surgical intervention.

What kind of doctor should I see for sciatic pain?

There are a number of clinicians who are able to help with sciatic pain. For instance, your primary care physician, or PCP, is usually the first point of contact and can evaluate symptoms and provide initial treatment.

If a specialist is needed, your PCP may refer you to an orthopedic surgeon, a neurologist or a rheumatologist. 

• An orthopedic surgeon may be suggested for more serious cases affecting the spine and nerves.
• Neurologists address the nervous system and could be consulted if sciatic pain is related to nerve issues.
• Rheumatologists specialize in autoimmune and inflammatory conditions that can affect the joints and soft tissues. Although sciatica is usually related to nerve compression, some inflammatory conditions may contribute to symptoms.
• Physical therapists, pain management specialists and chiropractors may also be employed to help with sciatic pain.
• Neurosurgeons are often consulted when imaging reveals disc herniation, spinal stenosis, or other compressive pathology requiring surgical consideration.

What is the most successful treatment for sciatica?

The fastest and most successful way to get treatment for sciatica is to consult with your PCP or a healthcare professional to ensure an accurate diagnosis of the underlying condition that’s causing the sciatica.

From there, medications may be prescribed, including non-prescription pain relievers such as ibuprofen or naproxen, which can help reduce inflammation and alleviate pain. In more severe cases, prescription medications, including muscle relaxants or stronger pain relievers, could be prescribed.

Physical therapy is also a successful way to treat sciatica. A physical therapist can design a customized exercise program to strengthen the muscles supporting your spine, improve flexibility, and alleviate pressure on the sciatic nerve.

If conservative management fails after 6–8 weeks and MRI shows nerve root compression, surgical options such as microdiscectomy may be considered.

Does sciatica count as a disability?

Qualifying for disability benefits (e.g., through Social Security) often requires documentation of chronic, treatment-resistant symptoms and functional limitations.

If sciatica significantly impairs a person’s ability to perform  job function, and if reasonable accommodations cannot be made to enable them to work, it may be considered a disability under applicable disability laws. In the U.S., the Americans with Disabilities Act (ADA) prohibits discrimination against individuals with disabilities in employment and other areas.

Article Updated 4-4-2025