What can the NHS do for sciatica?
The NHS is known worldwide for its publicly funded, high-quality healthcare service. But while there are skilled professionals in the NHS who can diagnose and treat sciatica – and most people (83%) report a good care experience in the NHS – the NHS faces challenges that continue to grow .
These challenges include problems with booking appointments, problems with contacting a GP and lowered chances of seeing a preferred doctor . Symptoms of sciatica can be severe and debilitating – sometimes, sciatica can be so bad you can’t walk. This is why many people are choosing private healthcare providers like Harley Street Specialist Hospital.
What can the NHS do for sciatica? Here, we’ll discuss which diagnosis and treatment options are available for sciatica on the NHS and what options you have if you’re struggling to access these services.
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What can the NHS do for sciatica?
Sciatica occurs when your sciatic nerve becomes compressed and inflamed, causing pain, tingling and weakness in your buttocks and legs. This usually happens on one side, but it can sometimes affect both sides at the same time – this is known as bilateral sciatica.
If you’re struggling with sciatica, the NHS can help with lower back pain and sciatica by providing treatment to improve your symptoms. Many people visit their GP first for advice and pain relief for back and spine conditions like sciatica.
You can book an appointment with your GP if you need pain relief. Usually, you can be seen within a week of requesting an appointment, although in some areas it can be challenging to get an appointment with the GP .
Usually, non-steroidal anti-inflammatory drugs (NSAIDs) are the first method of pain relief offered. This includes ibuprofen which can be bought over the counter, and stronger NSAIDs like naproxen that require a medical review and prescription. There is also a wide range of other medications that your GP may prescribe for symptoms of sciatica (like shooting pain in your leg), including muscle relaxants, opioid analgesics, benzodiazepines, corticosteroids, antidepressants, and anticonvulsants .
You may wonder why antidepressants such as Amitriptyline and anticonvulsants are prescribed for sciatica. Research shows that antidepressants and anticonvulsants are effective in treating pain caused by nerve damage or injury, such as sciatica [2,3].
The NHS can usually offer advice for self-management of sciatica. This advice may come in the form of a leaflet, direction to an NHS website or a discussion with a GP or physiotherapist.
Advice may be offered on the use of heat and ice therapy, activity pacing, time off work and tips to help you sleep better with sciatica. You may also be provided with home stretches and exercises along with information regarding how long sciatica might last.
Many NHS hospitals and clinics offer physiotherapy throughout the country. Physiotherapists assess, diagnose and treat sciatica. They can provide personalised advice, exercise programs, group exercise classes, manual therapy and massage for sciatica.
However, physiotherapy can be hard to get on the NHS. Waiting lists for NHS physiotherapy are up to 22 weeks in some areas of the UK , and treatment sessions are often limited in duration, frequency and number.
Increasing numbers of people are turning to private physiotherapists to get faster treatment. Harley Street Specialist Hospital has a team of highly qualified physiotherapists with extensive experience in treating sciatica. Our physiotherapists also offer specialist treatments like acupuncture for sciatica and massage for sciatica pain relief. If you’re facing a long waiting list on the NHS, we can get you started on the road to recovery.
Often, diagnostic imaging is needed to diagnose the cause of your sciatica. This is available on the NHS, but you need a referral from a doctor to access it and may have to wait.
An accurate diagnosis is essential for treatment that works. Harley Street Specialist Hospital has a fully-equipped diagnostic imaging suite and a team of experts who can advise on what type of imaging you need.
The NHS offers pain management services for people struggling with chronic pain (pain persisting or recurring for over 3 months) . Pain management teams are typically made up of doctors, psychologists, physiotherapists and other chronic pain specialists.
Treatments offered for sciatica in pain management clinics include medication, injections (such as steroid injections), exercise, manual therapy and psychological therapy. However, NHS waiting lists for pain management clinics can be long. People on long waiting lists for chronic pain (5 weeks – 6 months) tend to experience a significant decline in health-related quality of life and psychological well-being .
If you’re stuck on a long waiting list for NHS treatment, Harley Street Specialist Hospital can help. Our dedicated pain management unit offers walk-in assessments for people who need to be seen today. We can often offer assessment and treatment on the same day.
Surgery for sciatica is available on the NHS. Surgery is performed by specialist spinal surgeons or neurosurgeons if other treatment methods have been unsuccessful and you meet the criteria for surgery.
There is a high demand for sciatica surgery on the NHS, so it can be difficult to access . Often, you will need to see a physiotherapist or another specialist before being considered for a surgery assessment.
If you’d prefer not to wait, Harley Street Specialist Hospital has a team of expert spinal surgeons and neurosurgeons. We can provide rapid access to the treatment that can cure sciatica permanently.
NHS exercises for sciatica
The NHS recommends exercises for sciatica, which vary depending on the underlying reason for your symptoms. These exercises may provide sciatica relief and may also help to prevent future recurrence of symptoms if done regularly.
Before attempting these exercises you need a diagnosis, and it’s a good idea to consult a physiotherapist to ensure you have the correct exercise technique. Here are a few of the most common conditions that cause sciatica and some NHS exercises that can help.
A herniated disc (also known as a slipped disc) is the most common cause of sciatica . You have soft cushions of tissue (discs) between the bones of your spine, and if one of these moves out of place (herniates), it can push on your sciatic nerve and cause sciatica. If you’ve been diagnosed with a herniated disc, here are some NHS exercises you can try for your sciatica.
The piriformis is a muscle in your buttock area. If this muscle becomes injured or goes into spasm, it can put pressure on the nearby sciatica nerve and cause sciatica. Here are some NHS exercises for sciatica caused by piriformis syndrome:
Spinal stenosis is the narrowing of the spinal canal, the space your spinal nerves pass through before branching out to other areas of your body. This narrowing often comes with age because it is usually caused by osteoarthritis. Osteoarthritis damages the cartilage between your spinal bones, causing inflammation and abnormal bone growth.
Spinal stenosis is the number one reason for spinal surgery in people over 65 years old . If your spinal canal narrows and puts pressure on your sciatic nerve, it can cause sciatica. Here are some NHS exercises for sciatica caused by spinal stenosis:
Degenerative disc disease
Degenerative disc disease is a type of arthritis that typically affects older people. It describes the wear and tear of discs between your spinal bones.
As these discs break down, they can cause pain, stiffness and inflammation in your lower back that can irritate the sciatic nerve. Here are some NHS exercises for sciatica caused by degenerative disc disease:
How do you calm an inflamed sciatic nerve?
As well as the NHS exercises above, there are several things you can do to get relief from sciatica pain at home. These include:
- Painkillers – Non-steroidal anti-inflammatories (NSAIDs) and paracetamol are often the first line of treatment for sciatica pain. These are available over the counter and can provide immediate relief for sciatica pain. If these medications aren’t sufficient to ease your pain, contact your GP who can prescribe alternative pain relief.
- Heat and ice – Both heat and ice can help to relieve pain from sciatica. Heat relaxes tight muscles, and ice numbs the painful area and reduces inflammation. Use the method that feels best for your symptoms, or alternate heat and ice if they both help. Use each for no longer than 20 minutes at a time.
- Gentle exercise – The NHS recommends gentle exercise for sciatica. However, the type of exercise is less important than how it affects your sciatica symptoms. Your exercise of choice should be comfortable (or minimally painful), and you should be able to do it several times per week . Exercise like walking, gentle stretching and swimming can be good for sciatica.
- Regular posture change – You may find that sitting in one position for too long worsens your sciatic pain. Sitting puts pressure on your lower back and sciatic nerve, while standing and moving takes the pressure off. If you’re sitting in an office chair or on the sofa for hours, it’s not surprising if your sciatica is worse when you stand up. Try to change position every 20 minutes and get up as often as possible.
How long does an irritated sciatic nerve take to heal?
Usually, sciatica heals within a few weeks without requiring any treatment – but sometimes sciatica can persist and become chronic. If your sciatic pain is severe, getting worse or not settling on its own within a week or two, it’s time to get a medical assessment.
For NHS treatment, contact your GP or local physiotherapy department. For fast access to private treatment, book an appointment at Harley Street Specialist Hospital.
What are the red flags for sciatica?
Whether you’re seeking care privately or on the NHS, it’s vital to seek medical advice as soon as possible if you experience any of these symptoms:
- Sudden changes to bladder or bowel function
- Numbness or altered sensation around your buttocks or genitals
- Pain, numbness or weakness in both legs at the same time
These symptoms may indicate a rare condition called Cauda Equina Syndrome, where all your spinal nerves become suddenly compressed. Symptoms can come on suddenly, for no apparent reason, and rapidly get worse. This is a medical emergency and requires immediate treatment .
What if I need treatment faster than the NHS can provide it?
Although the NHS offers some great resources for sciatica, there is a high demand to access them. This means waiting lists can be long, and you may find your pain worsening while you wait to be assessed.
If you want rapid assessment and treatment for sciatica, book an appointment with Harley Street Specialist Hospital. We can often diagnose your symptoms and provide treatment on the same day.