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Sciatique

عرق النسا

Pain that radiates along the path of the sciatic nerve, from the lower back through the hip and down one leg, most often caused by a herniated disc pressing on the nerve. Distinct from general back pain in both its symptom pattern and typical treatment approach.

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Réponse rapide

Sciatica is pain that travels along the sciatic nerve — from the lower back through the buttock and down the back of the leg. It is a symptom of irritation or compression of the nerve, most often from a slipped (herniated) disc.

Typical signs are shooting or burning pain down one leg, sometimes with tingling, numbness or weakness. It usually affects one side and is often worse when sitting, coughing or sneezing.

Most sciatica improves within weeks with staying active, pain relief and time. Seek medical care if pain is severe, lasts more than a few weeks, or comes with weakness. Loss of bladder or bowel control or numbness between the legs is an emergency.

Symptômes

  • Pain from the lower back or buttock down the leg

    Often sharp, shooting or burning.

  • Pain usually on one side

  • Tingling, pins and needles or numbness in the leg or foot

  • Weakness in the leg or foot

  • Pain worse with sitting, coughing, sneezing or straining

  • Difficulty standing up or walking

  • Lower back pain

    May or may not be present.

Guides des symptômes

Causes et facteurs de risque

Causes

  • Slipped (herniated) disc — A disc pressing on a nerve root is the most common cause.
  • Spinal narrowing (spinal stenosis) — Narrowing of the canal or nerve exit spaces.
  • Degenerative changes and bone spurs
  • Piriformis syndrome — Muscle tightness in the buttock irritating the nerve.
  • Spondylolisthesis — A vertebra slipping forward over another.
  • Less common causes — Injury, infection or tumours.

Facteurs de risque

  • Age 30–50, when disc problems are more common
  • Overweight or obesity
  • Prolonged sitting
  • Physically demanding work involving lifting or twisting
  • Smoking
  • Diabetes — Increases the risk of nerve damage.

Comment le diagnostic est-il posé ?

Sciatica is usually diagnosed from symptoms and a physical examination; imaging is used when needed.

  1. History and examination

    Pain pattern, strength, sensation, reflexes and leg-raising tests.

  2. MRI

    Used if symptoms are severe, persistent, or if surgery or injections are being considered, or if red flags are present.

  3. X-ray or CT

    In selected cases, for bony problems.

  4. Nerve studies

    Occasionally, to assess nerve function.

Traitement

Most sciatica gets better on its own over weeks. Treatment focuses on relieving pain and keeping you moving; more intensive options are considered if it persists.

  • Staying active

    Gentle activity and walking are recommended over prolonged bed rest.

  • Pain relief

    Simple painkillers and, for nerve pain, other medicines prescribed by a doctor; heat or cold packs may help.

  • Physiotherapy

    Exercises to strengthen and stretch, and advice on posture and movement.

  • Injections

    Steroid injections near the nerve root may be considered for persistent severe pain.

  • Surgery

    Considered when there is significant weakness, loss of nerve function, or severe pain that doesn't respond to other treatment.

Avoid heavy lifting and long periods of sitting while symptoms are severe, but try to keep gently moving.

Quand consulter un médecin ?

Prévoyez une évaluation médicale si

  • Pain lasting more than about 4–6 weeks
  • Pain that is severe or getting worse
  • Leg weakness, foot drop or tripping
  • Numbness or tingling that spreads
  • You have diabetes, cancer history or a weakened immune system

Consultez en urgence si

  • Loss of control of the bladder or bowel, or difficulty passing urine
  • Numbness around the genitals, buttocks or inner thighs (saddle numbness)
  • Weakness in both legs, or rapidly worsening weakness
  • Back pain with fever, unexplained weight loss, or after a significant injury

Prévention

  • Stay active and exercise regularly

    Including core-strengthening and stretching.

  • Use good posture and lifting technique

    Bend your knees, keep loads close to your body.

  • Maintain a healthy weight

  • Avoid prolonged sitting

    Take breaks and move regularly.

  • Don't smoke

Questions fréquentes

What is sciatica?

Pain along the path of the sciatic nerve, from the lower back down the leg, caused by irritation or compression of the nerve.

What causes sciatica?

Most often a slipped disc pressing on a nerve root; also spinal narrowing and other spinal changes.

How long does sciatica last?

Many people improve within about six weeks, though it can take longer.

Should I rest or stay active?

Gentle activity is usually better than prolonged bed rest. Avoid activities that sharply worsen the pain.

Do I need an MRI?

Not usually at first. It is considered for severe or persistent symptoms, neurological deficits, or before injections or surgery.

When is sciatica an emergency?

With loss of bladder or bowel control, saddle numbness, or rapidly worsening weakness in the legs.

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Sources médicales

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