Sciatica and Lower Back Pain: Causes, Relief and When to Worry

A sharp, electric pain that starts in the lower back and runs through the buttock and down the back of the leg. Maybe it feels like a burning or tingling in the calf or foot. If this sounds familiar, you may have sciatica. Back pain in general is one of the most common health complaints worldwide, and in Pakistan, long hours of sitting, heavy lifting, poor mattresses and sitting on the floor all add to it.

What is sciatica?

Sciatica is not a disease by itself. It is the name for pain along the path of the sciatic nerve, the longest nerve in the body, which runs from the lower back through the hips and down each leg. Pain happens when something presses on or irritates this nerve, usually in the lower spine.

Common causes of back pain and sciatica

• Slipped (herniated) disc: a disc between the spine bones bulges and presses on a nerve. This is the most common cause of sciatica.
• Muscle strain and spasm: from lifting, a sudden twist, or weak core muscles.
• Spinal narrowing (stenosis) and age-related wear in older adults.
• Piriformis syndrome: a tight muscle in the buttock irritates the nerve.
• Pregnancy, because of the extra weight and changes in posture.
• Obesity, smoking, long sitting hours, and low vitamin D, which can all contribute to back pain.
• Osteoporosis in older adults, which can cause small spine fractures.

Symptoms of sciatica

• Pain from the lower back or buttock down one leg, usually only on one side
• Burning, shooting or electric pain, worse on coughing, sneezing or sitting
• Numbness, pins and needles, or weakness in the leg or foot
• Pain that eases when you walk or lie down

Red flags: go to hospital the same day

• Loss of control of urine or stool, or trouble passing urine
• Numbness around the groin or inner thighs
• Weakness in both legs, or a foot that drops
• Back pain after a fall or accident
• Back pain with fever, unexplained weight loss, or a history of cancer
• Severe pain at night that does not ease at all with rest

What to do in the first few days

• Keep moving gently. Bed rest for more than a day or two makes it worse. Short walks and normal light activity help the back recover faster.
• Heat or cold: a cold pack in the first day or two, then a warm pack or hot water bottle, can ease spasm.
• Change position often. Avoid sitting for more than 30 to 40 minutes at a time.
• Sleep on your side with a pillow between the knees, or on your back with a pillow under the knees, on a firm but not rock-hard mattress.
• Lift smart: bend your knees, keep the load close, and do not twist.

Medicines your doctor may suggest

Short courses of paracetamol or an anti-inflammatory painkiller, a muscle relaxant for painful spasm, or a medicine for nerve pain such as gabapentin or pregabalin may be prescribed, depending on your problem. Vitamin B12 is sometimes added when nerve symptoms are present. Muscle relaxants can make you drowsy, so avoid driving. Do not take strong painkillers or steroid injections from a clinic without knowing the exact medicine. Most people with sciatica get better within 4 to 8 weeks without surgery.

Physiotherapy and long-term protection

• A physiotherapist can teach stretching and core-strengthening exercises, and these are the best way to stop it coming back.
• Walking, swimming and gentle yoga or stretching help most people.
• Lose excess weight, especially around the belly.
• Use a chair with back support and put your feet flat on the floor. Take breaks from your desk every half hour.
• Quit smoking, which reduces blood supply to the spinal discs.
• A lumbar support belt may help for short periods during activity, but should not be worn all day because it can weaken the muscles.

When to see a doctor

• Pain that is not improving after one to two weeks
• Severe pain that stops you sleeping or doing daily tasks
• Pain below the knee with numbness or weakness
• Back pain in children or in people over 50 for the first time

Key takeaways

• Sciatica is nerve pain from the lower back to the leg, most often from a slipped disc.
• Gentle movement and heat usually help more than bed rest.
• Most cases settle in weeks, but loss of bladder or bowel control, leg weakness or injury need urgent care.
• Exercise, good posture and weight control protect your back long term.

Related medicines on Medimart

• Thiocolchicoside and cyclobenzaprine: muscle relaxants for painful spasm
• Gabapentin and pregabalin: prescribed for nerve pain
• Mecobalamin: a form of vitamin B12 used for nerve health

Browse muscle pain products, nerve pain products and supports and braces on Medimart, delivered across Pakistan. Prescription medicines are supplied only against a valid prescription and should be taken only as advised by your doctor.

This guide is for general information and does not replace advice from a doctor.