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The sciatica service at The Royal Orthopaedic Hospital offers treatment to people with sciatica. Our multidisciplinary service is delivered by a team of experts including spinal surgeons and specialist orthopaedic physiotherapy practitioners. The sciatica service offers:
- An appointment to see a physiotherapy practitioner within a month of referral
- Access to an MRI within a week (depending on urgency)
- Direct access to spinal injections
- Fast-track service for microdiscectomy or decompression.
What is Sciatica?
Sciatica is where the sciatic nerve, which runs from your lower back to your feet, is irritated or compressed. It usually gets better in 4 to 6 weeks but can last longer.
Sciatica happens when something presses or rubs on the sciatic nerve. Causes include:
- a slipped disc (the most common cause) – when a soft cushion of tissue between the bones in your spine pushes out
- spinal stenosis – narrowing of the part of your spine where nerves pass through
- spondylolisthesis – when one of the bones in your spine slips out of position
- a back injury
Check if you have sciatica
If you have sciatica, your bottom, the back of your leg and your foot and toes may feel:
- painful – the pain may be stabbing, burning or shooting
- tingling – like pins and needles
Your symptoms may be worse when moving, sneezing or coughing. You may also have back pain, but it's not usually as bad as the pain in your bottom, leg or foot. You probably do not have sciatica if you only have back pain.
When to access the Sciatica Service
Generally, if your symptoms are persistent and disabling after several weeks, your GP can refer you to the sciatica service. We will discuss your symptoms and what treatment options are best for you.
The common treatments we offer include:
- Advice and reassurance, particularly if your symptoms are improving (in most cases they do)
- X-rays and scans as needed
- Injections, such as epidurals
- Referral to a surgeon to discuss whether an operation will help.
How to ease the pain yourself
carry on with your normal activities as much as possible
regular exercises for sciatica
start gentle exercise as soon as you can – anything that gets you moving can help
hold heat packs to the painful areas – you can buy these from pharmacies
ask your pharmacist about painkillers (paracetamol is unlikely to help and it's not clear how much NSAIDs help with sciatica)
put a small, firm cushion between your knees when sleeping on your side, or several firm pillows underneath your knees when lying on your back
do not sit or lie down for long periods – even if moving hurts, it's not harmful and can help you get better faster
do not use hot water bottles to ease the pain – you could scald yourself if your skin is numb