Sciatica is pain that travels from the lower back down through the buttock and along the leg, often past the knee. It is usually caused by a disc prolapse pressing on a nerve root. It can be severe — and it usually gets better on its own.
What is actually happening
A disc bulges and presses on a nerve. The nerve becomes inflamed, and that inflammation, as much as the pressure itself, causes the pain. Over weeks, the body reabsorbs the herniated material and the inflammation settles. This is why most sciatica improves without any operation.
What helps in the first six weeks
- Keep moving. Prolonged bed rest makes sciatica worse, not better. Gentle walking within your pain limits is one of the most effective things you can do.
- Structured physiotherapy. Not random exercises — a programme aimed at nerve mobility and core control.
- Sensible pain relief, so you can stay active. Pain control is a means to movement, not an end in itself.
- A targeted spinal injection if the pain is severe. This delivers anti-inflammatory medication directly to the inflamed nerve root and can break the cycle without surgery.
What does not help
- Weeks of bed rest — this weakens the very muscles that support your spine
- Passive treatments alone, with no active rehabilitation
- Repeated MRI scans in the absence of new symptoms
- Rushing to surgery for pain that has been present for two weeks
When you must see a spine surgeon
Get assessed urgently if you develop:
- Weakness in the leg or foot — especially a foot that drags or slaps when you walk
- Numbness around the groin, buttocks or inner thighs
- Any difficulty passing or controlling urine
- Sciatica in both legs at once
Otherwise, see a spine specialist if severe pain persists beyond six to eight weeks despite genuine non-surgical treatment, or if the pain is preventing you from working or sleeping.
If surgery is needed
For a disc prolapse causing persistent sciatica, an endoscopic discectomy removes the fragment through an 8 mm incision. Most patients notice the leg pain has gone when they wake up, walk the same day, and go home within 24 hours.
Concerned about back or neck pain? Dr. M.D.S. Sasidharan offers endoscopic, minimally invasive and non-fusion spine care at Iswarya Hospital, OMR, Chennai. Book a consultation to find out whether you can avoid surgery altogether.
Frequently Asked Questions
How long does sciatica take to heal?
Most cases improve substantially within six to twelve weeks. The herniated disc material is gradually reabsorbed by the body and the nerve inflammation settles. Persistent, disabling pain beyond this period, or any weakness, should be assessed by a spine specialist.
Is walking good for sciatica?
Yes. Gentle walking within your pain limits is one of the best things you can do. Prolonged bed rest actually worsens sciatica by deconditioning the muscles that support the spine. Stay as active as your pain reasonably allows.
When does sciatica need surgery?
Surgery is considered when severe pain persists beyond six to eight weeks despite proper non-surgical treatment, or immediately if there is progressive leg weakness, numbness in the groin area, or loss of bladder or bowel control.