Sciatica is a common condition that affects approximately 40% of people at some time in their lives . For many people, it clears up after a few weeks with regular exercise and home pain management. But for others, it can get progressively worse until your sciatica is so bad you can’t walk.
If your sciatica is stopping you getting up and about during the day, here’s what you need to do.
What is sciatica and why is it painful?
The sciatic nerve runs from your lower back down to your knee, where it branches off into several narrower nerves.
If the sciatic nerve is trapped — for example, as the result of a herniated disc — this can cause sharp pains to radiate down your leg.
If these pains start to move back up towards the hip and lower back, this is often a sign of sciatica improvement. But if they move further towards your ankle and toes, your sciatica symptoms may be getting worse.
Steroid injections can alleviate sciatica pain within a few days, helping you get back on your feet relatively quickly. However, these injections aren’t usually given as a first-line solution on the NHS for sciatica relief, so let’s look at self-help treatments for severe sciatica pain.
Why walking helps with sciatica
Walking is good for sciatica, so if you can manage it, try to go for a short, gentle walk to help relieve symptoms of sciatica . One study found that regular walking decreased the risk of being hospitalised with sciatica by 33% . Unlike more strenuous activity, walking doesn’t put too much strain on the lower back.
However, not everyone can walk when they have a sciatica flare-up. For some, walking up stairs or moving too quickly can worsen your symptoms. For others, even a flat, gentle flat walk irritates the nerve and causes too much pain.
What to do when your sciatica is so bad you can’t walk
Getting back on your feet isn’t easy when you have extreme sciatica. First, try resting for a few days to see if your flare-up settles down. Use a hot or cold compress to ease your symptoms, or ask a friend, partner, or massage therapist to try some sciatica massage techniques that can ease symptoms.
But medium- or long-term bed rest isn’t recommended for sciatica. So when you can, try these tips when walking to stop sciatica coming back and ease into a more comfortable movement routine.
1. Check your posture
Poor posture is often a contributing factor to sciatica flare-ups, as walking or standing in certain positions can put strain on your sciatic nerve. The longer you walk or stand with bad posture, the more difficult it is to correct.
When standing or walking, make sure your ears are directly above your shoulders, and your head is directly above your spine. Try to stay conscious of this positioning as you move.
Shorten your stride to avoid putting too much stress on your lower legs, especially if you have severe sciatica .
If you are someone who also suffers from lower back pain when standing, improving your posture can also help improve your back condition.
2. Engage your abdominal muscles as you walk
Poor posture may be down to weak core muscles. Strengthening your core as you walk can help promote good posture and reduce sciatica pain . Try pulling your stomach muscles in towards your spine as you inhale. Focus on your breath to keep the momentum going as you walk.
If you’re struggling to get up and about enough to engage your core muscles on a walk, try these home core strengthening exercises:
3. Slow down
Keep your pace slow and steady when you start walking with sciatica. Walk slowly enough that you can hold a conversation without getting out of breath.
Walking slowly and with intent enables you to:
- Concentrate on your breathing as you walk.
- Maintain a short, comfortable stride.
- Engage your core muscles as you walk.
If you’re walking with someone else, ask them to match your pace rather than hurrying to keep up.
4. Find a distraction
Try to distract yourself from sciatica pain by having a conversation, focusing on your breathing, or taking in the sights around you. This isn’t always easy, but it may help you stay mobile for a little longer. Take regular breaks to help you manage the pain.
5. Don’t carry heavy backpacks
Carrying heavy objects can make sciatica worse . So don’t carry heavy backpacks or other objects when walking.
6. Wear supportive footwear
Make sure your walking shoes have enough arch and heel support, and are the right size for your feet. They should have plenty of cushioning so they can act as shock absorbers when your feet hit the ground.
If you need to, use walking poles to support you when walking with sciatica.
7. Call 111
If your sciatica pain is too unbearable to walk, move, or find a comfortable position, call 111 for advice. They’ll be able to assess your symptoms and direct you to the best place for treatment.
Your GP may recommend some ways to get immediate relief from your sciatica pain. If these don’t work, seek private treatment for sciatica. Our pain management unit employs the UK’s largest pool of consultants to treat ongoing pain conditions like sciatica, so our specialists can help you get back on your feet.
Is it better to sit or lay down with sciatica?
There’s not much evidence to determine whether sitting or lying down is better for alleviating sciatica pain. So find a comfortable resting position and stay here for a short while. Taking short breaks is a good idea if you have sciatica, but try to avoid prolonged bed rest if you can.
Try not to stay in one position for too long, as this can make your joints and muscles stiffen up, aggravating your sciatica . Find out more about how to sleep with sciatica.
When should you go to A&E with sciatica?
If your pain is localised to just one side of the body (i.e. one leg and hip), sciatica rarely needs urgent treatment, even if you find it too painful to walk. With some rest, gentle movement, and support from a pain management consultant or private physiotherapist, you may be able to reduce your symptoms without urgent care.
However, certain symptoms may indicate a more serious problem. These include:
- Shooting pains in both legs (bilateral sciatica).
- Numbness around your genitals.
- Problems urinating.
- Inability to control your bladder or bowels.
If you have any of these symptoms with sciatica, go to A&E or call 999 for urgent help, as this can indicate a more serious underlying problem such as cauda equina syndrome.
Can you be hospitalised with sciatica?
If your sciatica is extremely painful — or you have symptoms of a more serious underlying condition, like those above — you might be hospitalised with sciatica. Hospital treatments might include:
- NHS cortisone injections (steroids that can reduce inflammation around a slipped disc).
- Radiofrequency ablation (a procedure to stop your nerves sending pain signals to the brain).
- Decompression surgery (an operation to relieve pressure on your spinal discs).
However, your GP will usually recommend that you exhaust all other sciatica pain relief options before referring you for hospital treatment. In addition, NHS waiting lists can be extensive, so you may be waiting a while for treatment. Learn more about what a hospital will do for sciatic pain.
That’s why many patients turn to private sciatica treatment. At Harley Street Specialist Hospital, you may be able to get an assessment, diagnosis, and treatment on the same day.
Book an appointment with our pain management team now to find a long-term solution to your sciatica pain.