Lower back and sciatica

Sciatica: pain down the back of the leg explained

Written by Lance Peterson, GOsC-registered osteopath · Last reviewed October 2026

What sciatica is, why leg pain from the lower back happens, general self-care, and the symptoms that need urgent medical attention.

Sciatica is the name given to pain that travels from the lower back or buttock down the leg, following the path of the sciatic nerve. It is often felt on one side. It describes a set of symptoms rather than a diagnosis, and there are several possible reasons for it.

When to get urgent help

Call 999 or go to A&E straight away if you have back pain together with any of these. They can be signs of a rare but serious condition such as cauda equina syndrome. Do not drive yourself.

Numbness or tingling around your genitals, buttocks or inner thighs (the saddle area)
Difficulty passing urine, loss of bladder or bowel control, or being unable to feel when you are passing urine or stool
Pain, tingling, weakness or numbness in both legs, or sciatica on both sides, or weakness in a leg that is getting worse
New changes to sexual sensation or function alongside back or leg pain
Chest pain, or back pain that started after a serious accident such as a car crash

What it can feel like

Pain in the buttock or back of the thigh that may travel below the knee, sometimes to the foot
Tingling, pins and needles or numbness in the leg or foot
Pain that is worse with sitting, coughing, sneezing or bending forward
Sometimes a feeling of weakness in the leg, usually on one side

Common contributors

Irritation or pressure on a nerve root in the lower back, for example from a disc bulge
Narrowing of the space around the nerves in the spine (spinal stenosis)
Tight or sensitive muscles in the buttock and hip that can produce similar pain
Long periods of sitting, which can aggravate sensitive nerves
Often no single cause is found, and symptoms can still settle over time

General self-care

These are general comfort measures many people find reasonable. They are not a treatment plan, and what suits one person may not suit another.

Stay as active as you comfortably can. Gentle walking is generally better than staying in bed
Find positions that ease your leg symptoms and use them to take short breaks from sitting
Heat or cold packs can be comfortable for some people. Protect your skin and do not use them for long periods
Follow packet instructions for any over-the-counter pain relief and speak to a pharmacist or GP if it is not helping, as nerve pain often responds differently to ordinary painkillers
Avoid heavy lifting and deep twisting while symptoms are very sensitive

When to see your GP

See your GP promptly, or call NHS 111, if you have any of the following:

Feeling hot, cold, shivery or generally unwell, or severe pain that starts suddenly or quickly gets worse
Unexplained weight loss, or a lump, swelling or change in the shape of your back
Pain that is worse at night or does not ease with rest, or is worse when you cough, sneeze or open your bowels
A history of cancer and new, persistent back pain

Consider seeing your GP if:

Your sciatica has not improved after a few weeks of home treatment
The pain is getting worse
The pain stops you doing your normal activities

How osteopathy may help

Osteopaths regularly see people with sciatica and leg pain that comes from the lower back. After taking a full history and examining you, treatment typically combines hands-on techniques (such as soft-tissue work, joint mobilisation and, where suitable, manipulation) with advice and exercises you can do yourself. For some people this may help ease pain and stiffness and make movement more comfortable.

NICE guidance for low back pain says manual therapy (spinal manipulation, mobilisation or soft-tissue techniques) can be considered, but only as part of a treatment package that includes exercise. A 2026 Cochrane review found that spinal manipulation may give a small improvement in chronic low back pain compared with sham treatment and similar results to other conservative treatments, but the certainty of that evidence is low to very low.

If you have any of the urgent signs listed above, you need emergency medical care first.

Results vary from person to person, some people feel a little sore for a day or two afterwards, and osteopathic care is not right for everyone. It sits alongside, not instead of, medical care, and staying active and doing your exercises remain central.

If you would like your symptoms assessed, you are welcome to book an appointment. Osteopathic care is not right for everyone, and if something needs medical attention first, I will tell you.

Book an appointment

Common questions

How long does sciatica last?

The NHS says sciatica usually improves within a few weeks to a few months, though it can last longer and can come back, especially if you have had it before.

Is walking good for sciatica?

The NHS advises carrying on with normal activities as much as you can and not sitting or lying down for long periods. Moving may hurt, but it is not harmful and may help you recover faster.

Will paracetamol help sciatica?

The NHS says paracetamol is unlikely to help sciatica, and it is unclear how much anti-inflammatories such as ibuprofen help. Speak to a pharmacist or GP if your pain is not settling, as nerve pain often needs a different approach.

Free 5-minute exercise sheet

A simple, printable sheet of gentle exercises and stretches, about five minutes a day, based on NHS physiotherapy leaflets. It is general information, not a personal treatment plan, and it is not suitable if you have any of the urgent signs listed above.

Download the exercise sheet (PDF)

Sources and further reading

Links open in a new tab. Sources were checked in October 2026.

Related guides

This page is general information to help you understand common aches and pains. It is not medical advice and cannot diagnose your problem. If you are worried about your symptoms, please speak to your GP or call NHS 111.