What is sciatica?
Sciatica describes pain radiating from the lower back or buttock down the back or side of the leg, often below the knee, along the path of the sciatic nerve. It is usually caused by a herniated disc or, particularly in older people, narrowing of the spine pressing on one of the nerve roots that form the nerve. Tingling, numbness or weakness in the leg or foot may accompany the pain. It most commonly affects adults between 30 and 55, and most episodes settle within six to twelve weeks.
Diagnosis is clinical in the first instance, based on the pattern of leg pain and examination of strength, sensation and reflexes. MRI is reserved for persistent or severe cases where injections or surgery are being considered, or when there are warning signs needing urgent assessment.
Common symptoms
- Pain radiating from the buttock down the leg, often below the knee
- Burning, shooting or electric-shock quality pain
- Tingling or pins and needles in the leg or foot
- Numb patches in the leg or foot
- Weakness, such as a dragging foot
- Pain worse with sitting, coughing or sneezing
How long will you wait?
Routine NHS referral for persistent sciatica, through triage, MRI and on to injections or surgery, commonly takes several months, with around a third of patients on the national waiting list waiting over 18 weeks.
Privately, you can typically see a spinal specialist within 3–7 days, have an MRI within days, and receive an injection or surgery, if needed, usually within 2–4 weeks.
NHS England median referral-to-treatment wait: 12.4 weeks, with 2.5 million people waiting over 18 weeks (May 2026). Individual waits vary by trust and urgency.
Treatment options
- Staying active and pain relief. Gentle movement, short-term pain relief and reassurance are the foundation, as most sciatica settles without intervention.
- Physiotherapy. Guided exercise restores movement and confidence and helps prevent recurrence.
- Nerve root injection. An image-guided steroid injection around the compressed nerve can relieve severe leg pain while natural healing continues.
- Microdiscectomy. Keyhole removal of the disc fragment pressing on the nerve is highly effective for persistent disabling leg pain or progressive weakness.
What does private treatment cost?
As a guide, a private nerve root injection typically costs around £1,500–£2,500, while self-pay microdiscectomy typically costs around £8,000–£12,000.
Does health insurance cover sciatica?
New episodes of sciatica are normally covered by private medical insurance, including MRI, physiotherapy, injections and surgery where needed. Back problems that pre-date the policy are among the most commonly applied pre-existing exclusions, so check your certificate carefully. Where back pain becomes long-term, insurers cover acute flare-ups and defined interventions rather than indefinite ongoing pain management, which may be treated as a chronic condition.
Frequently asked questions
How long does sciatica take to go away?
Most episodes improve substantially within six to twelve weeks as the disc problem causing them settles naturally, and staying gently active speeds this along. A minority of cases persist beyond three months, and that is the point at which MRI and interventions such as nerve root injections or surgery are usually discussed, particularly if leg pain remains disabling.
When is sciatica an emergency?
Seek emergency care the same day if you develop numbness around the genitals or back passage, difficulty controlling your bladder or bowels, numbness when wiping, or worsening weakness in both legs. These can indicate cauda equina syndrome, a rare compression of the nerves at the base of the spine that needs urgent surgery to prevent permanent damage.
Does sciatica surgery work?
For the right patient, yes. Microdiscectomy relieves leg pain quickly and reliably in the great majority of people whose sciatica comes from a confirmed disc herniation and has not settled with time and conservative care. It is less effective for back pain itself, which is why surgeons select patients whose dominant symptom is leg pain matching the MRI findings.