Sciatica: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Sciatica?
A primary care doctor can often begin the evaluation of sciatica, which is nerve pain in the leg. For pain that keeps going, you may see a physiatrist, a rehabilitation doctor, or a pain specialist. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is sciatica?
Sciatica is pain, weakness, numbness, or tingling in the leg. It happens when the sciatic nerve is injured or under pressure. This is the largest nerve in the body. Sciatica is a symptom of a medical problem, not a condition by itself. It is usually felt on only one side of the body.
Symptoms
Sciatica pain can vary a lot. Common signs include:
- A mild tingling, a dull ache, or a burning feeling.
- Sharp, knife-like, or electric pain that may feel like a bad leg cramp.
- Pain that gets worse when you sneeze, cough, or laugh.
- Numbness or weakness in the leg.
- A foot that gets caught on the ground when you walk.
In some cases, the pain is bad enough that a person cannot move. Cramp-like pain can last for weeks before it goes away.
Causes and who gets it
Common causes of sciatica include:
- A slipped or herniated disk, which is a cushion between the back bones that pushes out.
- Spinal stenosis, a narrowing of the spinal canal that puts pressure on the nerve.
- Piriformis syndrome, a pain problem of a narrow muscle in the buttocks.
- A pelvic injury or fracture.
- Spondylolisthesis or tumors.
In many cases, no cause can be found. You are most likely to get sciatica between the ages of 30 and 75. In people under age 40, the cause is typically a herniated disk. Older adults typically get sciatica from bone spurs and arthritis.
How doctors diagnose it
Diagnosis begins with your story. Your doctor will ask how your pain started, where it travels, and what it feels like. A physical exam may help find the irritated nerve root. Your doctor may ask you to squat and rise, or walk on your heels and toes. An X-ray or an MRI scan may confirm which nerve roots are affected. Tests are often not needed unless the pain is severe or long-lasting.
Treatment
Often, sciatica gets better on its own. About 80 to 90% of people with sciatica get better over time without surgery. Your doctor will also look for the cause of the nerve pressure and treat it. Non-surgical care is best in many cases. It may include:
- Over-the-counter pain relievers such as ibuprofen or acetaminophen.
- Heat or ice on the painful area.
- Staying active, since bed rest is not recommended.
- Back exercises, and physical therapy to learn an exercise program.
- Shots (injections) of medicine to reduce swelling around the nerve, if other steps do not help.
Surgery is usually the last resort. You might need surgery if you still have disabling leg pain after 3 or more months of non-surgical treatment. It is common for sciatica to come back.
When to see a doctor
Contact your doctor right away if you have:
- Unexplained fever with back pain.
- Back pain after a severe blow or fall.
- Redness or swelling on the back or spine.
- Weakness or numbness in the buttocks, thigh, leg, or pelvis.
- Burning when you urinate or blood in your urine.
- Severe pain when you cannot get comfortable.
- Loss of control of urine or stool.
Also call if this episode of back pain has lasted longer than 4 weeks.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either can check your symptoms, guide first treatment steps, and refer you to a specialist if the pain does not improve.
Common questions
Does sciatica go away on its own?
Often it does. About 80 to 90% of people get better over time without surgery. It is common for sciatica to return.
What causes sciatica?
Sciatica is caused by injury to or pressure on the sciatic nerve. A herniated disk and spinal stenosis are common reasons. In many cases no cause can be found.
Should I rest in bed if I have sciatica?
No, bed rest is not recommended. Try to keep moving, and find comfortable positions.
When is surgery needed for sciatica?
Surgery is usually the last resort. You might need it if you still have disabling leg pain after 3 or more months of non-surgical treatment.
Is sciatica a disease on its own?
No, sciatica is a symptom of a medical problem. Doctors treat the underlying cause of the nerve pressure.
Sources
- MedlinePlus - Sciatica
- MedlinePlus Medical Encyclopedia - Sciatica
- American Academy of Orthopaedic Surgeons - OrthoInfo - Sciatica
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
