Sciatica produces pain that starts in the lower back or buttock and travels down the back of one leg, sometimes reaching the foot. The hallmark is that the pain follows a specific path along the sciatic nerve, the longest nerve in the body, which runs from the lower spine through the hip and down each leg. Most people also experience some combination of numbness, tingling, or weakness alongside the pain.
What Sciatica Pain Feels Like
The pain can be sharp, burning, or electric. Some people describe it as a jolt that shoots from the lower back through the buttock and down the leg. Others feel a constant ache that gets worse with certain movements. It almost always affects only one side of the body.
Sciatica follows a predictable path along the back of the thigh and calf, sometimes reaching the foot and toes. You might feel intense pain in one part of your leg while another part feels numb. The combination of pain in your thigh with tingling in your calf, for instance, is common and can be disorienting.
An acute episode typically lasts one to two weeks and resolves on its own within a few weeks. When episodes keep recurring or pain persists for months, it’s considered chronic sciatica.
Numbness, Tingling, and Weakness
Beyond pain, sciatica often causes sensory changes. Tingling or numbness can appear anywhere along the nerve’s path, from the buttock to the toes. These sensations reflect the nerve being compressed or irritated at its root in the lower spine, usually by a herniated disc, bone spur, or narrowing of the spinal canal.
Muscle weakness is a more concerning sign. When the nerve compression is significant, the muscles it controls don’t get proper signals. This can make your leg feel heavy or unstable, and in severe cases it leads to foot drop, a condition where you can’t lift the front of your foot. People with foot drop often compensate by raising their thigh higher than normal when walking, almost like climbing stairs, and the foot may slap the floor with each step. Sudden weakness in a leg warrants prompt medical attention.
What Makes Symptoms Worse
Sitting is one of the most reliable triggers. It tightens the muscles that support your spine, especially the hamstrings and hip flexors, which increases pressure on the irritated nerve. Prolonged standing, bending, and twisting can also flare symptoms. Even small movements like sneezing, coughing, or bending to tie a shoe can send a jolt of pain down your leg.
Lifting with poor form is one of the fastest ways to irritate the sciatic nerve. Sleeping on your stomach strains the lower back and can worsen overnight discomfort. Slouching, whether at a desk or on a couch, rounds the lower back and adds pressure to the discs and nerves in the lumbar spine.
Positions and Habits That Help
Gentle movement tends to be more helpful than rest. Walking, swimming, and stretching the hips and hamstrings can relieve nerve pressure and improve mobility. If you sit for work, standing up and stretching every 30 minutes makes a noticeable difference.
When you do sit, choose a firm chair that supports your lower back rather than a deep, soft couch. Keep your shoulders back, your head aligned over your spine, and your feet flat on the ground. A small lumbar pillow or a rolled-up towel behind the lower back helps maintain its natural curve. For sleep, lying on your side with a pillow between your knees or on your back with a pillow under your knees takes pressure off the nerve.
Sciatica vs. Piriformis Syndrome
Not all pain running down the leg is true sciatica. Piriformis syndrome mimics it closely but has a different origin. In piriformis syndrome, a small muscle deep in the buttock tightens or spasms around the sciatic nerve, compressing it outside the spine. True sciatica starts inside the spine, where a structural problem like a herniated disc presses on nerve roots.
The differences are practical. Piriformis pain starts deep in the buttock or hip and rarely extends below the knee. True sciatica typically begins in the lower back and can travel all the way to the foot. Piriformis syndrome flares mainly with hip rotation, like climbing stairs, sitting for long stretches, or getting out of a car. It also produces localized tenderness when pressing on the piriformis muscle in the buttock. True sciatica is more likely to come with numbness, reflex changes, and weakness along the full length of the leg.
How It’s Diagnosed
A common clinical test is the straight leg raise. You lie on your back while a clinician lifts your affected leg. If this reproduces your radiating leg pain, it strongly suggests nerve root compression. Research shows this test picks up about 84% of confirmed cases. Imaging like an MRI is used when symptoms are severe, persistent, or accompanied by neurological changes like weakness or numbness that doesn’t improve.
Emergency Symptoms to Watch For
A rare but serious complication called cauda equina syndrome occurs when a large disc herniation or other mass compresses the bundle of nerves at the base of the spine. This is a medical emergency. The key warning signs are:
- Bladder changes: inability to urinate or not feeling the urge to go, even when the bladder is full
- Bowel incontinence: loss of control over bowel movements
- Saddle numbness: loss of sensation in the groin, inner thighs, buttocks, or genital area
- Rapidly worsening weakness: sudden loss of strength in one or both legs
- Sexual dysfunction: new onset of numbness or loss of function
Treatment within 48 hours of onset significantly improves outcomes for bladder, bowel, and leg function. If you experience any combination of these symptoms alongside sciatica, seek emergency care immediately.