Sciatica
Sciatica is pain that travels along the sciatic nerve, from the lower back through the buttock and down a leg, usually from a herniated disc pressing on the nerve. It can bring sharp pain, tingling, numbness, or weakness in the leg. Most sciatica improves within a few weeks with activity and simple care, though some cases need more treatment.
What is sciatica?
Sciatica is not a condition on its own but a description of pain caused by irritation or pressure on the sciatic nerve, the large nerve that runs from the lower back through the buttock and down each leg. When something presses on this nerve where it leaves the spine, pain and other symptoms travel along its path, usually down one leg. The most common cause is a herniated (slipped) disc, though other changes in the spine can do it too. Because sciatica is a symptom, treating it means finding what is pressing on the nerve.
What does sciatica feel like?
The classic sign of sciatica is pain that radiates from the lower back or buttock down the back of one leg, often described as sharp, burning, or electric. Other common symptoms include:
- Tingling or a pins-and-needles feeling in the leg or foot
- Numbness along the path of the nerve
- Weakness in the leg or foot
- Pain that worsens with sitting, standing up, bending, coughing, or sneezing
Sciatica usually affects just one side. The pain can range from a mild ache to severe, and it often eases when lying down or walking gently.
What causes sciatica?
Sciatica happens when something compresses or irritates the sciatic nerve, most often where the nerve roots exit the lower spine. Common causes include:
- A herniated or bulging disc pressing on a nerve root, the most frequent cause
- Spinal stenosis, a narrowing of the spinal canal that crowds the nerves
- A bone spur from arthritis in the spine
- Less often, muscle tightness (such as the piriformis muscle), or pressure from the growing uterus during pregnancy
Risk factors include age-related spine changes, heavy lifting or twisting, prolonged sitting, and carrying extra weight. Identifying the cause guides the right treatment.
When should I worry about sciatica?
Most sciatica is not dangerous and improves over a few weeks, but certain symptoms signal a problem that needs urgent care. Seek emergency care right away for the red flags below; otherwise, see a provider if pain lasts more than a few weeks, keeps worsening, or comes with leg weakness.
Go to the ER right away if you have
New loss of bladder or bowel control
- Numbness in the groin or inner thighs (the saddle area)
- Sudden, severe weakness in one or both legs
- Sciatica after a major fall or accident
These can signal nerve pressure that needs immediate treatment. Short of these, sciatica that lingers, recurs, or limits your daily life is worth a non-urgent visit to get the right plan.
How is sciatica diagnosed?
A provider can usually recognize sciatica from your symptoms and a physical exam, including tests like raising your straightened leg to see whether it reproduces the pain, which points to nerve involvement. Imaging is not needed for typical sciatica that is improving. An MRI or CT is used when symptoms are severe, are not getting better after several weeks, or when there are warning signs, to pinpoint what is pressing on the nerve before considering injections or surgery.
How is sciatica treated?
Most sciatica gets better without surgery, and treatment usually starts simple and steps up only if needed. Here is how the options compare:
| Approach | What it involves | When it is used |
|---|---|---|
| Self-care | Staying active, heat or cold, and over-the-counter pain relievers | First step for most; many cases improve within weeks |
| Physical therapy | Targeted stretches, strengthening, nerve-gliding exercises, and posture work | Core treatment, especially if pain lasts beyond a couple of weeks |
| Medications, injections | Prescription anti-inflammatory or nerve-pain medicine, or an epidural steroid injection | For more severe or persistent pain not eased by self-care and therapy |
| Surgery | A procedure to relieve pressure on the nerve, such as a microdiscectomy | Reserved for severe, lasting cases or red-flag nerve problems |
For the large majority of people, staying active and working with physical therapy resolves sciatica over a few weeks. Injections or surgery are reserved for pain that is severe, persistent, or accompanied by nerve problems, and a spine specialist guides those decisions.
How long does sciatica last?
Most sciatica improves within a few weeks, and many people are substantially better within four to six weeks with activity and conservative care. Some cases take longer or come and go, especially if the underlying disc or spine issue persists. Sticking with a physical therapy program, staying active, and addressing posture and core strength help both recovery and preventing the next flare. Pain that is not improving after about six weeks is worth re-evaluating.
Can sciatica be prevented?
You cannot prevent every case, but you can lower the risk and the chance of recurrence. Keeping the core and back muscles strong supports the spine, while regular movement and good posture reduce pressure on the discs and nerves. Lifting with your legs rather than your back, avoiding long stretches of sitting, keeping a healthy weight, and setting up a supportive workspace all help protect the lower back over time.
Who treats sciatica?
Sciatica is treated by several types of providers, and most people do not need surgery or even a specialist to start. A primary care or orthopedic provider can diagnose sciatica, rule out warning signs, and begin treatment, often with a referral to physical therapy, which is the cornerstone of recovery for most people. Physical therapists design the stretching, strengthening, and movement programs that relieve nerve pressure, restore function, and reduce the chance of recurrence.
When sciatica is severe, does not improve after several weeks, or involves nerve problems like weakness, a spine specialist (within orthopedics or neurosurgery) has the focused expertise to evaluate the spine, interpret imaging, and offer options from targeted epidural injections to surgery in the cases that need it. A procedure such as a microdiscectomy can relieve pressure on the nerve when conservative care has not worked.
At Duly Health and Care, orthopedics, spine care, and physical therapy work together across the Chicago suburbs, so evaluation, therapy, injections, and any surgery connect into one coordinated plan rather than separate, disconnected stops. That continuity matters for sciatica, where most people recover with the right exercises and time, and only a minority need a procedure. If you are unsure where to begin, a primary care or orthopedic provider is a reliable starting point for sciatica that is not an emergency, and they can bring in spine and physical therapy expertise as your symptoms require.
Frequently asked questions
How long does sciatica usually last?
Most sciatica improves within a few weeks, with many people much better in four to six weeks of staying active and doing physical therapy. Some cases linger or recur, particularly when a disc or spine change keeps pressing on the nerve. If your sciatica is not improving after about six weeks, keeps coming back, or is getting worse, it is worth having re-evaluated for additional options.
What helps sciatica pain the fastest?
For quicker relief, gentle movement usually beats bed rest, along with heat or cold, over-the-counter anti-inflammatories used as directed, and avoiding positions that worsen the pain, often prolonged sitting. Specific stretches and nerve-gliding exercises, ideally guided by a physical therapist, can ease symptoms and speed recovery. If pain is severe or not improving, a provider can discuss prescription options or an injection.
Should I rest or stay active with sciatica?
Stay active, within comfort. Long bed rest tends to make sciatica worse by stiffening the back and weakening supporting muscles, while gentle activity and a gradual return to normal movement help the nerve settle. That does not mean pushing through severe pain or heavy lifting; it means continuing to move with appropriate exercises. A physical therapist can guide how much to do and which movements to favor or avoid.
Can sciatica go away on its own?
Often yes. The majority of sciatica resolves on its own over a few weeks as the irritation around the nerve calms down, especially with activity and conservative care, which is why treatment usually starts simple. Cases that do not improve, keep returning, or come with leg weakness or red-flag symptoms need evaluation and sometimes a procedure, but most people get better without one.
Where can I get sciatica treated in Chicagoland?
Duly Health and Care offers orthopedic, spine, and physical therapy care for sciatica across the Chicago suburbs, with a coordinated plan from evaluation through therapy, and injections or surgery only when they are needed. You can book an orthopedic visit online to start, and be referred to spine care if your symptoms call for it. For red-flag symptoms like loss of bladder or bowel control, go to the nearest ER.
Care at Duly Health and Care
Sciatica can be painful and frustrating, but for most people it improves with the right care, and few need surgery. Duly Health and Care combines orthopedics, spine expertise, and physical therapy across the Chicago suburbs to find what is pressing on the nerve, relieve the pain, and rebuild the strength and habits that keep it from returning, turning to injections or a procedure only when they will help. Whether your sciatica is new or recurring, the team helps you move comfortably again.
Medically reviewed by Kelly Perillo, PA‑C — Last reviewed July 2026
