Sciatica is the term for symptoms of pain, tingling, and numbness which arise from nerve root compression or irritation in the lumbo-sacral spine.

Symptoms of sciatica typically extend to below the knee — from the buttocks, across the back of the thigh, to the outer calf, and often to the foot and toes.

Nerve root compression is typically caused by:

• A herniated intervertebral disc — in about 90% of cases.

• Spondylolisthesis.
• Spinal stenosis.

Risk factors which may increase the risk of developing sciatica include:

◦ Strenuous physical activity, for example heavy lifting or jogging.

◦ Whole body vibration, for example with driving.

Complications of sciatica include:

◦ Permanent nerve damage.

◦ Psychosocial problems.

◦ Loss of employment.

Management of sciatica involves:

◦ Checking for red flag symptoms and signs which may indicate a serious underlying cause such as cauda equina syndrome, spinal fracture, cancer, or infection. If present, admission or urgent referral should be arranged depending on clinical judgement.

◦ Providing adequate analgesia (paracetamol or ibuprofen first-line) for symptom relief. Additional and/or stronger analgesics can be considered if necessary.

◦ Providing information about its expected time course, self-help measures, and advice about staying active, resuming normal activities, and returning to work as soon as possible.