# Sciatica

- Web page: https://kainezitherapy.com/en/conditions/back/sciatica/
- Body area: [Back and lower back](https://kainezitherapy.com/en/conditions/back.md)
- Recommended treatment:
  - [Kinesitherapy for nerve pain (neuralgia)](https://kainezitherapy.com/en/services/kinesitherapy/kinesitherapy-for-neuralgia.md): €40.00, 60 min
  - [Kinesitherapy for a herniated disc](https://kainezitherapy.com/en/services/kinesitherapy/kinesitherapy-for-disc-herniation.md): €40.00, 60 min
  - [Electrotherapy](https://kainezitherapy.com/en/services/physiotherapy/electrotherapy.md): €25.00, 15 min
- Address: 10 Popovo Street, Lozenets, Sofia, 1409
- Opening hours: Mon - Fri | 9:00 - 19:00
- Phone: +359 886 750 462
- WhatsApp: +359 886 750 462
- Viber: +359 886 750 462
- Book online: https://superdoc.bg/lekar/kaloyan-zarkov
- Booking page: https://kainezitherapy.com/en/appointments/

Sciatica is pain along the sciatic nerve, from the lower back through the buttock and down the leg, often with numbness.

## At a glance

- **How it feels** Pain from the lower back down the leg, often with numbness
- **How long treatment takes** Usually about 5 sessions, 2–3 a week
- **Surgery** Not needed for most people

Sciatica is pain along the sciatic nerve, from the lower back down the leg. Sciatica symptoms and treatment depend on where the nerve is irritated: most often by a herniated disc in the lower back, less often by a tight muscle in the buttock. People also call it a trapped nerve or nerve root irritation (radiculopathy). It usually affects one leg.

## Symptoms

- Pain that starts in the lower back or buttock and runs down the back or outer side of the leg.
- Burning, shooting pain or a feeling like an electric shock down the leg.
- Numbness or pins and needles in the lower leg, foot or toes.
- Pain that gets worse when you sit, cough or bend forward.
- Sometimes weakness in the leg or foot.

The leg pain is often stronger than the pain in the lower back. It can be constant or come in attacks. Many people can’t sit for long, but cope better with standing and walking.

## Why it happens

The sciatic nerve is the thickest nerve in the body. It starts in the lower back and runs down to the foot. It hurts when something presses on it or irritates it somewhere along the way. The most common causes are:

- a herniated disc or disc bulge (protrusion) in the lower back;
- narrowing of the spinal canal in older people (stenosis);
- a tight piriformis muscle in the buttock (piriformis syndrome);
- wear of the vertebrae and the small joints of the spine;
- less often, pregnancy, an injury or another illness.

In younger people the most common cause is a herniated disc, and after the age of 60 it is more often stenosis. With stenosis, the pain comes on when you walk and goes away when you sit down or lean forward.

## How we treat it

Kaloyan first looks for where the nerve is irritated. Bring your scans and test results if you have them; if you don’t, he will decide whether you need them. He asks when the pain started and in which positions it eases, checks the strength, reflexes and sensation in your leg, and tests how freely the nerve moves. If the problem is in the nerve and the muscles around it, the main treatment is [kinesitherapy for nerve pain (neuralgia)](https://kainezitherapy.com/en/services/kinesitherapy/kinesitherapy-for-neuralgia/), which means exercise and manual therapy. It combines nerve gliding (gentle movements that help the nerve slide freely), manual therapy and exercises.

If the nerve is pressed by a tight muscle in the buttock, the work focuses more on that muscle: a manual technique and gentle stretching. When a confirmed herniated disc is behind the sciatica, Kaloyan follows the programme for [kinesitherapy for a herniated disc](https://kainezitherapy.com/en/services/kinesitherapy/kinesitherapy-for-disc-herniation/). On days when the pain is strong, he adds [electrotherapy](https://kainezitherapy.com/en/services/physiotherapy/electrotherapy/) to reduce the pain. The course is usually about 5 sessions, 2–3 a week. Many people feel less pain after just the first 2 sessions; the rest are for maintenance and strengthening. As you improve, the pain retreats upwards, from the foot towards the lower back, and the numbness eases more slowly than the pain. If there is no progress after a few weeks, Kaloyan will refer you to a neurologist.

## What you can do yourself

- Don’t sit for long. If you have to sit, get up for a moment every half hour.
- Find a position that eases the leg, for example lying on your back with your knees bent.
- Go for gentle walks, as far as the pain allows.
- Sleep on your side with your knees bent and a pillow between them.
- Don’t stretch the leg hard if it makes the pain in it worse. Kaloyan will show you the movements that suit you.

## When to see a doctor first

These signs are rare, but they mean that the nerve is badly compressed or that the cause is something else:

- Numbness in the groin or around the anus.
- Problems with urinating or with bowel movements. You need an urgent examination by a neurologist and imaging (MRI, CT scan or X-ray).
- Weakness that is getting worse, for example your foot starts to drag.
- Pain in both legs at the same time.
- Pain after a fall or a blow, a fever or unexplained weight loss.

Performed by

## Kaloyan Zarkov, kinesitherapist

- Kinesitherapy degree, NSA “Vassil Levski”
- 10+ years of practice

[About us](https://kainezitherapy.com/en/about/)

## Frequently asked questions

### What are the symptoms of sciatica, and how is it treated?

The main symptom is pain from the lower back down the leg, often with numbness. It is treated with kinesitherapy, usually about 5 sessions. If the pain is strong, a doctor may also prescribe medication.

### How long does sciatica last?

With treatment, in many people the pain eases after the first 2 sessions. Numbness sometimes stays longer.

### What is the difference between sciatica and radiculopathy?

Radiculopathy means an irritated nerve root in the spine. Sciatica is the leg pain it causes, so people often use the two words for the same thing.

### Should I use heat or cold for sciatica?

In the first few days of strong pain, cold often helps; later, heat. If anything makes the pain worse, stop.

### Can I have a massage for sciatica?

Yes, but massage isn’t the main treatment. It helps if the nerve is irritated by a tight muscle in the buttock; with a herniated disc, exercise is the core of treatment.

### Do I need an MRI for sciatica?

Not always. You need an MRI if there is weakness in the leg, if the pain doesn’t ease after a few weeks, or if a doctor is considering surgery.

## Other conditions in “Back and lower back”

[All about back and lower back](https://kainezitherapy.com/en/conditions/back/)

- [Lower back pain](https://kainezitherapy.com/en/conditions/back/low-back-pain/)
- [Herniated disc](https://kainezitherapy.com/en/conditions/back/disc-herniation/)
- [Scoliosis](https://kainezitherapy.com/en/conditions/back/scoliosis/)
- [Pain between the shoulder blades](https://kainezitherapy.com/en/conditions/back/upper-back-pain/)

## Want to improve your health?

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