Diagnosis and treatment of sciatica
Sciatica is a clinical diagnosis based on symptoms of radiating pain in one leg with or without associated neurological deficits on examination
- Most patients improve over time with conservative treatment including exercise, manual therapy, and pain management
- Imaging is not required to confirm the diagnosis and is only requested if pain persists for more than 12 weeks or the patient develops progressive neurological deficits
- Urgently refer patients with signs of urinary retention or decreased anal sphincter tone, which suggest cauda equina syndrome
- Surgery is an option if symptoms do not improve after 6-8 weeks of conservative treatment. It may speed up recovery but the effect is similar to conservative care at one year
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