Sciatica Pain? Why Your Nerve Is Flaring & Medically Approved Next Steps

Sciatica is not a condition itself — it's a symptom. When people say they have sciatica, they're usually describing pain that travels from the lower back down through the buttock and into the leg. That pain follows the path of the sciatic nerve, the longest and widest nerve in the body.

If you're dealing with sciatica, you're not alone. It's a common cause of lower back and leg pain, especially in adults between ages 30 and 60. The good news? Most cases improve with conservative treatment. But understanding why your sciatic nerve is flaring up — and what to do next — is key.

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What Is Sciatica?

The sciatic nerve starts in your lower spine (lumbar spine), travels through your pelvis and buttocks, and runs down each leg. When this nerve becomes irritated, inflamed, or compressed, it can cause:

• Sharp, shooting pain down one leg
• Burning or tingling sensations
• Numbness in the leg or foot
• Muscle weakness
• Pain that worsens with sitting, coughing, or sneezing

Sciatica usually affects one side of the body.

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Why Is Your Sciatic Nerve Flaring Up?

Sciatica happens when something presses on or irritates the nerve roots in the lower spine. The most common medically recognized causes include:

1. Herniated (Slipped) Disc

This is the leading cause of sciatica. The discs between your spinal bones act as cushions. If a disc bulges or ruptures, it can press on nearby nerve roots — including the sciatic nerve.

2. Degenerative Disc Disease

As we age, spinal discs naturally lose water and flexibility. This can narrow the space where nerves exit the spine, causing irritation.

3. Spinal Stenosis

This condition involves narrowing of the spinal canal, which can compress nerves. It's more common in adults over 60.

4. Spondylolisthesis

This occurs when one vertebra slips forward over another, potentially pinching a nerve.

5. Piriformis Syndrome

The piriformis muscle in the buttock can sometimes irritate the sciatic nerve if it tightens or spasms.

6. Injury or Trauma

Falls, car accidents, or sports injuries can inflame or compress the nerve.

7. Pregnancy

Hormonal changes and weight distribution shifts can temporarily trigger sciatica.

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What Sciatica Pain Typically Feels Like

Sciatica pain can range from mild to severe. Many people describe it as:

• Electric shock–like pain
• Burning or searing discomfort
• Deep ache in the buttock
• Pain radiating below the knee

Unlike simple muscle strain, sciatica pain typically travels down the leg.

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When Sciatica Is More Serious

Most cases improve within a few weeks. However, certain symptoms require urgent medical attention.

Seek immediate medical care if you experience:

• Loss of bladder or bowel control
• Severe or rapidly worsening leg weakness
• Numbness in the groin or inner thighs (saddle anesthesia)
• Severe pain after a major injury

These could signal cauda equina syndrome, a rare but serious emergency.

If you're unsure what your symptoms mean, use Ubie's free AI-powered Acute Low Back Pain symptom checker to get personalized insights and understand your next steps.

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Medically Approved Next Steps for Sciatica

The majority of sciatica cases improve without surgery. Evidence-based treatment focuses on relieving inflammation, improving mobility, and reducing nerve pressure.

1. Stay Active (But Smartly)

Bed rest is no longer recommended for sciatica. Prolonged inactivity can actually worsen stiffness and delay healing.

Instead:

• Continue light activities as tolerated
• Take short walks
• Avoid heavy lifting and twisting

Movement promotes blood flow and helps the nerve recover.

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2. Physical Therapy

Structured physical therapy is one of the most effective treatments for sciatica.

A physical therapist may guide you through:

• Core-strengthening exercises
• Stretching for hamstrings and piriformis muscle
• Posture correction
• Nerve-gliding exercises

These approaches reduce pressure on the sciatic nerve and improve long-term outcomes.

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3. Over-the-Counter Pain Relief

For short-term symptom control:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen
• Acetaminophen for pain relief

These can help reduce inflammation and make movement easier. Always follow dosing instructions and speak to a healthcare provider if you have kidney, stomach, or heart conditions.

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4. Heat and Ice

• Ice packs can reduce inflammation in the first 48 hours
• Heat can relax tight muscles afterward

Use for 15–20 minutes at a time.

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5. Prescription Medications (If Needed)

If pain is severe, a doctor may prescribe:

• Short-term muscle relaxants
• Oral steroids
• Neuropathic pain medications

These are typically used for limited periods under supervision.

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6. Steroid Injections

If pain persists beyond several weeks and interferes with daily life, a physician may recommend an epidural steroid injection. This can reduce inflammation around the nerve root.

Relief may last weeks to months, but it's not a permanent cure.

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7. Surgery (For Specific Cases)

Surgery is generally reserved for:

• Persistent pain beyond 6–12 weeks despite treatment
• Progressive neurological deficits
• Severe structural issues seen on imaging

Procedures like discectomy or laminectomy aim to relieve nerve compression.

The majority of people with sciatica do not need surgery.

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How Long Does Sciatica Last?

Acute sciatica often improves within:

• 4–6 weeks with conservative care

Chronic sciatica may last longer and require structured treatment.

Recovery depends on the underlying cause, overall health, and adherence to treatment.

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Can Sciatica Come Back?

Yes. Recurrence is possible, especially if underlying risk factors aren't addressed.

Common risk factors include:

• Prolonged sitting
• Poor posture
• Weak core muscles
• Obesity
• Smoking
• Physically demanding work

Prevention strategies include:

• Regular exercise
• Core strengthening
• Maintaining a healthy weight
• Proper lifting techniques
• Avoiding long periods of sitting

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Should You Get Imaging?

Not always.

Most medical guidelines recommend waiting before getting MRI or CT scans unless:

• Red flag symptoms are present
• Pain persists beyond several weeks
• There are neurological deficits

Early imaging does not usually change treatment in uncomplicated sciatica.

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Practical Steps You Can Take Today

If you're currently experiencing sciatica pain:

• Stay gently active
• Avoid bed rest
• Use NSAIDs if safe for you
• Try targeted stretches
• Apply heat or ice
• Monitor for worsening symptoms

If symptoms are new or confusing, Ubie's Acute Low Back Pain symptom checker can help you understand whether your symptoms align with sciatica and provide guidance on what to do next.

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When to Speak to a Doctor

You should speak to a doctor if:

• Pain lasts longer than a few weeks
• Pain is severe and limits daily activities
• You notice numbness or weakness
• Symptoms are worsening
• You have a history of cancer, infection, or significant trauma

Always seek urgent care for:

• Loss of bladder or bowel control
• Progressive leg weakness
• Severe neurological symptoms

While most cases of sciatica are not life-threatening, certain rare complications can be serious. It's important not to ignore warning signs.

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The Bottom Line on Sciatica

Sciatica happens when your sciatic nerve becomes irritated — most commonly due to a herniated disc or age-related spinal changes. The pain can be intense, but in the majority of cases, it improves with conservative treatment.

The key is staying active, addressing inflammation, and strengthening supportive muscles. Surgery is rarely needed but may be appropriate in specific situations.

If you're unsure about your symptoms or worried about something more serious, don't guess. Consider starting with a free online symptom check, and always speak to a doctor about persistent, severe, or potentially life-threatening symptoms.

Sciatica can be painful — but with the right steps, most people recover and return to normal activity.