Sciatica: Introduction FeedbackA general introduction to Sciatica.Source: Clinical Knowledge Summaries, 16 Nov 2009
Sciatica is the term for symptoms of pain, tingling, and numbness which arise from nerve root compression or irritation in the lumbosacral spine.
Compression can be caused by several factors including:
A slipped disc — about 90% of cases.
Symptoms of sciatica typically extend to below the knee — from the buttocks, across the back of the thigh, to the outer calf, and often to the foot and toes.
Known risk factors for the onset of sciatic pain include:
Age — incident peaks at 45-65 years of age.
Height — risk is increased in taller people.
Smoking status — risk is increased in long term smokers.
Strenuous physical activity (e.g. frequent lifting and driving) — risk is increased if the whole body is exposed to vibration.
Permanent nerve damage.
Loss of employment.
Prognosis is worse for women and people who initially have greater disability or pain.
Checking for ‘red flags’ indicative of serious conditions such as spinal fracture, cancer, or infection; if any red flags are present, admission or referral should be arranged with appropriate urgency.
Providing information and advice to foster a positive attitude and realistic expectations e.g. explaining that sciatica settles within 6–12 weeks in most people).
Giving self care advice (e.g. bed rest should not be prolonged for longer than necessary, care should be taken when lifting and twisting, and a cold pack or local heat may relieve pain and muscle spasm).
Providing adequate analgesia (paracetamol or ibuprofen first-line) for symptom relief. Additional and/or stronger analgesics can be considered if necessary.
If pain does not respond to additional or stronger analgesics the following options should be considered:
A trial of amitriptyline (off-label use) or gabapentin (or pregabalin).
Referral for physiotherapy.
Referral for assessment for epidural injection of corticosteroids.
If the paraspinal muscles are in spasm, a short course of a benzodiazepine (e.g. diazepam) should be considered.
The decision on if and when to follow up should be made using clinical judgement. If a follow up is indicated, the person's diagnosis should be reviewed and their response to treatment should be assessed.
If there is progressive, persistent, or severe neurological deficit, referral for neurosurgical or orthopaedic assessment (preferably to be seen within 1 week) should be made.
If pain or disability continues for more than 1 or 2 weeks, early referral for physiotherapy (or other physical therapy) and assessment for an epidural injection of corticosteroid should be considered.
If, after 6–8 weeks, sciatica is still disabling and distressing and symptoms fail to respond to treatment, referral to a specialist low back pain and sciatica services should be made depending on local arrangements (preferably to be seen within 2 weeks).
If pain or disability continues despite appropriate drug and physical therapy, and if surgery is inappropriate or ineffective, referral to a multidisciplinary back pain service or a chronic pain clinic should be considered.
Sciatica: Guidance FeedbackThe most relevant search results for Sciatica from producers of guidance information.
Information for the public
Sciatica: Information for the public FeedbackThe most relevant search results for Sciatica, from Department of Health accredited producers of patient information.
- NHS Choices, 26 August 2014
- NHS Choices, 21 February 2013
- NHS Choices, 01 August 2014
- NHS Choices, 24 October 2013
- NHS Choices, 12 June 2014
- Patient UK
- NHS Choices, 10 April 2014
- NHS Choices, 15 November 2012
Sciatica: Medicines FeedbackAppropriate medicines information for Sciatica supplied by Datapharm, a leading source of trusted, credible information about medicines.
Sciatica - Medicines Information
- Anadin Ibuprofen (a brand of Ibuprofen)
- Anadin Paracetamol (a brand of Paracetamol)
- Brufen (a brand of Ibuprofen)
- Calprofen (a brand of Ibuprofen)
- Cuprofen (a brand of Ibuprofen)
- DHC Continus (a brand of Dihydrocodeine Tartrate)
- Diclofenac potassium
- Diclofenac sodium
- Dicloflex (a brand of Diclofenac Sodium)
- Diclomax (a brand of Diclofenac Sodium)
- Dihydrocodeine Tartrate
- Dihydrocodeine Tartrate/Paracetamol
- Dromadol (a brand of Tramadol Hydrochloride)
- Econac (a brand of Diclofenac Sodium)
- Emflex (a brand of Acemetacin)
- Eucalyptus/Terpineol/Methyl salicylate/Menthol/Camphor
- Froben (a brand of Flurbiprofen)
- Generic Sciargo tablets
- Hedex Ibuprofen (a brand of Ibuprofen)
- Hydroxyethyl salicylate/Methyl nicotinate (a generic version of Ralgex Heat Spray)
- Hydroxyethyl salicylate/Methyl nicotinate/Capsicum oleoresin (a generic version of Ralgex Cream)
- Indolar (a brand of Indometacin)
- Ketocid (a brand of Ketoprofen)
- Ketovail (a brand of Ketoprofen)
- Larapam (a brand of Tramadol Hydrochloride)
- Motifene (a brand of Diclofenac Sodium)
- Neurontin (a brand of Gabapentin)
- Orudis (a brand of Ketoprofen)
- Oruvail (a brand of Ketoprofen)
- Pain Relief balm
- Panadol (a brand of Paracetamol)
- Paracetamol/Tramadol hydrochloride
- Pardelprin (a brand of Indometacin)
- Ralgex cream
- Ralgex Heat spray
- Remedeine (a brand of Dihydrocodeine Tartrate , a brand of Paracetamol)
- Surgam (a brand of Tiaprofenic Acid)
- Tiaprofenic Acid
- Tramacet (a brand of Paracetamol , a brand of Tramadol Hydrochloride)
- Tramadol hydrochloride
- Tylex (a brand of Codeine , a brand of Paracetamol)
- Voltarol Rapid (a brand of Diclofenac Potassium)
- Zamadol (a brand of Tramadol Hydrochloride)
- Results are currently sorted by relevance (Sort results by: date)
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...Twitter Facebook Email More... Sciatica (lumbar radiculopathy) Sciatica (lumbar radiculopathy) D012585Sciatica...2009-11-16Last revised in November 2009 Sciatica (lumbar radiculopathy) - Summary Sciatica...
Clinical Knowledge Summaries, 16 November 2009
The clinical effectiveness and cost-effectiveness of management strategies for sciatica: systematic review and economic model
...costeffectiveness of management strategies for sciatica: systematic review and economic model...costeffectiveness of management strategies for sciatica: systematic review and economic model...effectiveness of management strategies for sciatica: systematic review and economic model...
NIHR Journals Library - Health Technology Assessment, 12 February 2013
...Traction for low-back pain with or without sciatica Inge Wegner 1,* , Indah S Widyahening...Traction for low-back pain with or without sciatica. Cochrane Database of Systematic Reviews...with low-back pain with and without sciatica Traction compared with placebo, sham...
Cochrane Database of Systematic Reviews, 19 August 2013 - Publisher: John Wiley & Sons, Ltd
Epidural corticosteroid injections in the management of sciatica: a systematic review and meta-analysis
...corticosteroid injections in the management of sciatica: a systematic review and meta-analysis...compared with placebo, in patients with sciatica. Not all the findings were included...injections, compared with placebo, for sciatica. Searching PsycINFO, MEDLINE...
Database of Abstracts of Reviews of Effects, 16 November 2012
...Drugs for relief of pain in patients with sciatica: systematic review and meta-analysis...commonly prescribed for the management of sciatica in primary care was unclear. Despite...care for the management of patients with sciatica. Searching The following databases...
Database of Abstracts of Reviews of Effects, 21 February 2012
...active for acute low-back pain and sciatica Kristin Thuve Dahm 1,* , Kjetil...active for acute low-back pain and sciatica. Cochrane Database of Systematic Reviews...compared to advice to stay active for sciatica Background Top of page Summary...
Cochrane Database of Systematic Reviews, 16 June 2010 - Publisher: John Wiley & Sons, Ltd
...toxin injections for low-back pain and sciatica Zeeshan Waseem 1,* , Chris Boulias...toxin injections for low-back pain and sciatica. Cochrane Database of Systematic Reviews...female with non-specific LBP and/or sciatica were included. LBP was defined as...
Cochrane Database of Systematic Reviews, 19 January 2011 - Publisher: John Wiley & Sons, Ltd
... NIHR Conservative treatment of sciatica: a systematic review Vroomen P C...To evaluate conservative treatments of sciatica. Searching MEDLINE from 1966 to...the review Studies of patients with sciatica and/or nerve root compression as a...
Database of Abstracts of Reviews of Effects, 30 June 2002
Efficacy of epidural steroids in low back pain and sciatica: a critical appraisal by a French Task Force of randomized trials
...epidural steroids in low back pain and sciatica: a critical appraisal by a French Task...treatment of common low back pain and sciatica. Searching The authors searched...lumbosciatica', 'low back pain and sciatica', and 'epidural steroids'. The authors...
Database of Abstracts of Reviews of Effects, 28 February 2001
Diagnostic value of history and physical examination in patients suspected of sciatica due to disc herniation: a systematic review
...examination in patients suspected of sciatica due to disc herniation: a systematic...history and examination in the diagnosis of sciatica due to disc herniation. Searching...prolapse', 'hernia nuclei pulposi' or 'sciatica', and the thesaurus terms 'intervertebral...
Database of Abstracts of Reviews of Effects, 28 February 2003
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