Sciatica: Causes, Diagnosis & Treatment London

Sciatic pain is one of the most common back and spine conditions. Caused by compression of the sciatic nerve, it can lead to tingling, numbness, and shooting pains down one side of your lower body, usually affecting the legs, bottom, and lower back. Sciatic pain often indicates an underlying medical condition, such as a slipped disc or an untreated back injury.

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What is Sciatica?

Sciatica is a painful condition caused by irritation and/or compression of the sciatic nerve. It can cause pain, tingling, numbness and weakness in your bottom, legs, and feet.

The sciatic nerve runs from the bottom of your spine down the back of your thigh, branching out just above the knee joint and ending at your feet. Sciatic can even cause referred groin pain. This entire area can be affected by sciatica, with pain often exacerbated by movement (especially sudden jolts like sneezing or coughing).

Most cases of sciatica are relatively mild and last less than six weeks. These can be treated at home or with minimally invasive back and spine treatments. However, severe cases may require surgery to address the underlying cause.

Back pain by itself doesn’t usually indicate sciatica. You’ll normally have pain in the surrounding areas (such as the buttocks and thighs) as well as in your lower back.

Our sciatica and spine consultants

Signs and symptoms of sciatica

The most common symptoms of sciatica include:

  • Tingling, numbness, or weakness in your leg, foot, lower back, or bottom.
  • Pain when walking quickly.
  • Loss of sensation in your legs.
  • Difficulty bending over.

Sciatica usually only affects one side of the body. Patients may report a dull ache, an electric shock-type feeling, or a burning sensation. Symptoms may worsen after you’ve been sitting down for a long time, or with sudden movements.

In severe cases of sciatica, you may also experience sciatica on both sides of the body, extreme leg weakness, numbness around your genitals, difficulty emptying your bladder, or bladder or bowel incontinence.

In these instances, you must seek emergency care, as you may have an underlying condition or injury that requires urgent treatment.

What causes sciatica?

Sciatica stems from a range of medical conditions. It’s unlikely to develop on its own with no underlying cause. Here, you’ll find out all the possible causes of sciatica.

Most common causes of sciatica

The most common cause of sciatica is a slipped disc in your spine (also known as a herniated or prolapsed disc). This happens when the tissue between the bones in your spine is dislodged and puts pressure on your sciatic nerve.

Slipped discs can happen for a number of reasons, including:

  • Getting older.
  • Doing vigorous exercise.
  • Poor posture when lifting heavy objects.
  • Operating machinery.
  • Living a sedentary lifestyle.
  • Pregnancy.

If you have a recent back or pelvic injury, this could also be responsible for your sciatic pain.

Less common causes of sciatica

In rare cases, sciatica is caused by a more serious medical condition. These include:

  • Spinal stenosis — Your spinal canal becomes narrower, especially in the lower back, which can put pressure on the sciatic nerve.
  • Spondylolisthesis — A bone in your spine slips out of place and compresses the sciatic nerve. This differs from a slipped disc, which affects the tissue between vertebrae.
  • Piriformis syndrome — The piriformis muscle (found below the gluteus maximus) spasms, causing pain in the sciatic area.
  • Degenerative disc disease – The tissue between your vertebrae starts to break down as you get older.
  • Spinal tumour — Tumours that form close to the sciatic nerve or in the lumbar area may cause sciatica.

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How is sciatica diagnosed?

Sciatica is diagnosed with a physical exam and a medical questionnaire to assess your symptoms. At HSSH, we also use specialist diagnostic imaging and scans to determine the true cause of your back pain and find the most appropriate treatment plan.

Sciatica treatment

Home treatments

In mild cases, you can ease and treat sciatica yourself at home. Treatments include:


Physiotherapy and manual therapies like massage are often recommended if home treatments haven’t worked. 

Physiotherapy involves exercising muscles and joints to specifically target the areas affected by sciatica. A trained physiotherapist will help you determine which exercises you should perform to reduce pain and other symptoms of sciatica.

Massage and other manual therapies may help relieve muscle tension, reduce stress, and improve circulation, promoting healing and providing temporary pain relief.

Your GP can refer you to an NHS physiotherapist, but waiting times are notoriously long. At Harley Street Specialist Hospital, you’ll be referred to a physio within our team of specialists, giving you rapid continuous care.


Epidural steroid injections can help relieve the pain caused by sciatica. Combined with a local anaesthetic, these injections reduce inflammation around your spinal cord and numb the area for rapid pain relief.

Painkilling injections for sciatica are designed to help you get back to your normal daily routine without pain. Gentle movement and specific exercises will ease your condition in the long term, and could help prevent future flare-ups.

Radiofrequency ablation

Radiofrequency ablation is a procedure that stops your nerves sending pain signals to the brain. It involves using a local anaesthetic to numb your lower back, then using a needle to apply radiofrequency waves that seal off the nerve endings in your lumbar region, so they’re unable to deliver pain signals.

Radiofrequency ablation isn’t a cure for sciatica, but it can relieve pain without the need for strong painkillers.

Decompression surgery

Decompression surgery reduces compression on the sciatic nerve. It may be recommended if other sciatica treatments haven’t helped.

When your doctor knows what’s causing your sciatica, they can perform decompression surgery to address the trigger and reduce pressure on the sciatic nerve.

Decompression surgery is performed under general anaesthetic. Types of decompression surgery for sciatica include laminectomy, discectomy, and spinal fusion.

Why choose Harley Street Specialist Hospital for private pain management treatment?

At Harley Street Specialist Hospital, you can expect:

We welcome patients with private medical insurance or those wishing to pay for their own treatment.

Orthopaedic treatments

Don’t let painful bone and joint complaints stop you from living your life to the full.

Consult with one of our expert orthopaedic consultants and see how they can help reduce pain, improve movement and mobilise your joints, so you feel better.

With our consultants, clinical team, facilities and diagnostic equipment, we offer a wide range of treatments, so you won’t need to go anywhere else.
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