What is sciatica, and how long does it last?

Sciatica is a specific pattern of nerve pain rather than a general label for back ache. The pain travels along the path of the sciatic nerve: out of the low back, through the buttock, down the back or side of the leg, sometimes into the foot. NHS guidance puts it plainly: the symptoms usually affect your bottom and the back of one leg, often including your foot and toes, and the leg pain is usually worse than any back pain that comes with it. If your pain stays in the back, that is not the usual picture - NHS advice notes that you probably do not have sciatica if you only have back pain.

The distinction matters because the two problems run on different clocks and answer to different treatments. Here is how to tell them apart, what sciatica actually is, and how long it honestly lasts.

What the nerve is actually doing

The sciatic nerve is not one cable but a bundle of nerve roots that leave the spine through gaps between the vertebrae in the low back, join up behind the pelvis, and run down each leg, reaching the feet and toes.

Sciatica happens when the sciatic nerve is irritated or compressed. NHS guidance lists the causes it sees most often: a slipped disc, where a soft cushion of tissue between the bones in the spine pushes out and is the most common cause and more likely with age; spinal stenosis, a narrowing of the part of the spine where nerves pass through; spondylolisthesis, where one of the bones in the spine slips out of position; and a back injury. The nerve is irritated along its length, and the pain is felt in the leg the nerve supplies rather than only where the problem sits. Nerve root irritation can produce symptoms in the leg rather than the back.

The quality of the pain tells the story. NHS guidance describes sciatica as a sharp, burning pain down the back of the leg, often with tingling, numbness or weakness in the same area. Ordinary back ache, by contrast, throbs or aches and stays put.

The straight-leg clue people often notice first

A classic pattern helps separate nerve pain from ordinary back ache. NHS advice is that sciatica pain may be worse when you move, sneeze or cough, and it may come on suddenly or start slowly. Symptoms of that sort, worse on coughing or sitting, are what a case history is trying to tease out.

Getting out of a car, or bending to put on socks, can become the hardest moment of the day. That pattern, pain shooting down the leg on sitting and easing on walking, points at the nerve root; other patterns point elsewhere.

How long it lasts: the honest numbers

NHS guidance is that sciatica usually gets better in a few weeks to a few months, but it can sometimes last longer, and it can return if you have had it before. That is the realistic frame rather than a fixed countdown.

• Sciatica usually improves over a few weeks to a few months. NHS guidance gives that range rather than exact dates.
• It can sometimes last longer than a few months.
• It can come back. NHS advice notes there is a chance it could happen again if you have had it before.

NICE guidance says manual therapy (spinal manipulation, mobilisation or soft tissue techniques such as massage) may be considered for low back pain with or without sciatica, but only as part of a treatment package that includes exercise. That qualification matters: manual therapy for this problem is not a standalone fix. For exercise, NHS guidance says to carry on with your normal activities as much as possible, try regular exercises for sciatica and start gentle exercise as soon as you can. NHS also advises not sitting or lying down for long periods, because even if moving hurts it is not harmful and can help you get better faster. Physical activity within your tolerance is the credible core, not complete rest.

What hands-on care actually does

Care for sciatica within the NICE framework means manual therapy as part of an exercise-inclusive package, not as a standalone treatment. NICE recommends it only alongside exercise, and the aim is to support the recovery NHS guidance says is expected anyway, while encouraging you to stay active rather than letting fear of pain freeze you. It does not "push the disc back in," and no hands-on technique does that.

On medication, be aware that NICE advises against gabapentinoids, other antiepileptics, oral corticosteroids and benzodiazepines for managing sciatica, because there is no overall evidence of benefit and there is evidence of harm. NICE also says: do not offer opioids for managing chronic sciatica, and to be aware of the limited evidence of benefit and the possible harms of NSAIDs in sciatica. NHS advice adds that paracetamol is unlikely to help and it is not clear how much NSAIDs such as ibuprofen help with sciatica, and suggests asking a pharmacist about painkillers. The plan, broadly, is to keep moving a little more each week, in the direction the nerve tolerates, and to get assessed if things are not improving.

When sciatica stops being a waiting matter

Some signs mean the situation has changed and you should be seen urgently. NHS guidance is explicit about going to A&E or calling 999 if you have sciatica and you:

• have sciatica on both sides.
• have severe or worsening weakness or numbness in both legs.
• have numbness around or under your genitals, or around your bottom (anus).
• find it hard to start peeing, cannot pee, or cannot control when you pee - and this is not normal for you.
• do not notice when you need to poo, or cannot control when you poo - and this is not normal for you.

These can be symptoms of a serious back problem that needs to be treated in hospital as soon as possible, and hours can matter. NHS also says: do not drive yourself to A&E - ask someone to drive you or call 999 and ask for an ambulance, and bring any medicines you take with you. For non-emergency back pain, NHS advises asking for an urgent GP appointment or getting help from 111 if you feel hot, cold, shivery or generally unwell, or if your pain is severe and starts suddenly or is getting worse quickly. Everyone with leg pain should know the emergency signs, which is why we keep a full note on when back pain is an emergency.

The short version

First step

Note where the pain is felt and what makes it worse - movement, coughing, sneezing - and see a GP if home treatments have not helped after a few weeks or the pain is stopping you doing normal activities.

What it is

NHS describes it as the sciatic nerve being irritated or compressed, most often by a slipped disc; symptoms usually affect the bottom and back of one leg, sometimes the foot.

Honest limits

NHS gives a range of a few weeks to a few months rather than exact dates; it can last longer and can come back. NICE supports manual therapy only within an exercise-inclusive package, and advises against gabapentinoids, oral corticosteroids, benzodiazepines and opioids for chronic sciatica. Emergency signs belong in hospital, not here.

If you are unsure whether your leg pain is sciatica, that is the sort of question an assessment can help with. Related reading: is a slipped disc a real thing? and which back pain exercises does evidence support.