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Pain that runs from the lower back into one leg, because a nerve root is being squeezed where it leaves the spine. Sciatica is a symptom, not a diagnosis — the useful question is what is pressing on the nerve.
The sciatic nerve is the largest in the body. It is formed from nerve roots in the lower spine, runs through the buttock and down the back of the thigh, then divides below the knee to supply the calf and foot.
When one of those roots is compressed or irritated where it leaves the spine, the pain is felt along the nerve’s path rather than at the spot causing it. That is why sciatic nerve pain is felt in the leg while the problem sits in the back.
Sciatica is a description, not a cause. Treating it properly means finding which structure is pressing on the nerve root, and at which level. Two people with identical leg pain can need entirely different treatment.
Seen from behind, the nerve roots leave the lower spine, join to form the sciatic nerve on each side, and pass through the buttock into the thigh. The pain follows that path, which is why it is felt in the leg rather than at the point of compression.
What the picture cannot show is which root is involved. The level is worked out from where the pain, numbness and weakness fall, then confirmed against the scan.
Call us on +65 8849 0677. We will see you the same day and arrange imaging if it is needed.
For the first two, go to an emergency department if we are closed. Cauda equina syndrome is treated in hours, not days.
Call +65 8849 0677Most sciatica comes from one of three things, and they behave differently.
| Slipped disc | Spinal stenosis | Spondylolisthesis | |
|---|---|---|---|
| Typical age | 30 to 50 | Usually over 60 | Any age; teenagers in sport, or older adults with wear |
| How it starts | Often suddenly, sometimes after lifting or twisting | Gradually, over months or years | Gradually, sometimes after a period of heavy loading |
| What eases it | Lying down; standing is often better than sitting | Sitting or leaning forward, and pushing a trolley | Rest; symptoms often vary from day to day |
| What provokes it | Sitting, bending, coughing, sneezing | Walking and standing upright | Standing and arching backwards |
| Legs affected | Usually one | Often both | One or both |
Buttock pain that mimics sciatica can also come from the piriformis muscle or the sacroiliac joint rather than a nerve root — a distinction worth making before treatment starts.
Where it hurts tells us which root is involved. Pain down the back of the calf into the sole points to a different level from pain along the outer calf into the big toe. That mapping, checked against the scan, is what makes treatment specific.
Most sciatica improves within about six weeks with non-surgical care: staying as active as the pain allows, short-term pain relief, physiotherapy, and avoiding the positions that provoke it. Bed rest beyond a day or two makes recovery slower rather than faster.
Where pain persists, an injection around the nerve root can settle inflammation and make rehabilitation possible. Surgery is considered when leg pain has not settled after a proper trial of non-surgical treatment, when weakness is progressing, or for cauda equina symptoms — usually decompression to take the pressure off the root.
Physiotherapy is part of this, and we work with physiotherapists rather than employing one. What we do here is identify the level, treat the cause, and say which rehabilitation is worth your time.
Dr Mathew Tung lists sciatica among the conditions he treats, with an emphasis on non-invasive options first and keyhole techniques where surgery is needed.
Dr Lim Heng Hing treats slipped discs and stenosis, the two commonest causes, using endoscopic and robotic techniques.
No. It describes pain along the sciatic nerve. The diagnosis is what is compressing the nerve root — most often a disc, narrowing of the canal, or a slipped vertebra.
Keep moving within what the pain allows. A day or two of relative rest is reasonable in a bad flare, but prolonged bed rest slows recovery.
Most people do not. Surgery is considered when leg pain has not settled after a proper trial of non-surgical care, when weakness is getting worse, or for cauda equina symptoms, which are urgent.
Because the pain is felt along the nerve rather than at the point of compression. Leg pain worse than back pain is typical of a squeezed nerve root.
It can. A disc can herniate again and wear continues at neighbouring levels, which is why the rehabilitation and load advice matters as much as settling the current episode.
No. Bring any MRI or X-ray images and reports, and a note of what treatment you have already had.
Slipped disc · Spinal stenosis · Spondylolisthesis · Lower back pain · Sacroiliac joint dysfunction · Sciatica of the neck
Bring your scans if you have them, and be ready to describe exactly where the pain runs. That path is half the diagnosis.
