Quick Answer
Sciatica causes leg pain radiating from the lower back — from disc herniation or spinal stenosis. Most cases improve with conservative treatment.
Medically reviewed by Dr. Jitendra Prasad Yadav • NMC 8029 • Kathmandu Neurology Clinic & Cognitive Center
Sciatica is pain radiating from the lower back down the leg — caused by compression or irritation of the sciatic nerve or its nerve roots (lumbar radiculopathy). The most common causes are lumbar disc herniation and lumbar spinal stenosis. Pain typically follows a dermatomal pattern (L4–S1 distribution) and may be accompanied by numbness, tingling or weakness.
Symptoms
Sharp, burning or electric pain radiating from lower back to buttock, thigh, calf or foot (usually one leg), numbness/tingling in the leg, weakness in specific muscles (foot drop, inability to stand on toes/heels), pain worsened by sitting, coughing or straining.
Causes
Lumbar disc herniation (most common — nucleus pulposus compresses nerve root), lumbar spinal stenosis (narrowing of spinal canal — common in older adults, worse with walking/standing), degenerative disc disease, spondylolisthesis, piriformis syndrome (rare).
Diagnosis and treatment
MRI confirms nerve root compression. Most cases (90%) improve with conservative treatment: physical therapy, activity modification, NSAIDs, epidural steroid injections. Surgery (microdiscectomy, decompression) for persistent pain, progressive weakness or cauda equina syndrome (emergency — bilateral leg weakness, bladder/bowel dysfunction). Red flags: cauda equina, cancer history, infection, trauma.
When to seek professional evaluation
Sciatica with leg weakness or bladder/bowel symptoms needs urgent evaluation — because cauda equina syndrome is a surgical emergency.
This guide is educational and does not replace individual medical advice.
Frequently asked questions
Answers reviewed by Dr. Jitendra Prasad Yadav • MBBS, MD (Internal Medicine), FICN (Neurology), FCNV, FIHM • NMC 8029
Supplements only help when a deficiency is present; underlying cause-directed care is needed.
If the underlying cause is corrected early (e.g., improving glucose control, treating vitamin deficiency), improvement may occur. Long-standing neuropathy is often not fully reversible.
Migraine is a neurological condition; headache is one feature. Associated symptoms and functional impact are important for diagnosis.
Aura refers to visual, sensory, or speech symptoms that precede the headache in some people. Both types are migraine; the presence of aura may influence management discussion.
More: All FAQs → · Ask Dr. Jitendra →
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References & Review
Reviewed by Dr. Jitendra Prasad Yadav • Last reviewed: 2026-11-10
- International Classification of Headache Disorders, 3rd edition (ICHD-3).
- Harrison's Principles of Internal Medicine — Neurology sections.
- American Academy of Neurology guidelines for selected conditions (where applicable).
Content is educational and aligns with standard medical references; individual evaluation may vary. External links provide context and do not imply endorsement.