Sciatica is a common reason people develop pain that starts in the lower back or buttock and travels down one leg. In my practice, I often meet Bangladeshi patients who describe it as a sharp, burning, electric, or pulling pain that makes sitting, walking, prayer positions, travel, and sleep difficult. Sciatica is not a disease by itself. It is usually a symptom that happens when a nerve root in the lower spine becomes irritated or compressed. Common causes include a slipped or herniated disc, lumbar spinal stenosis, and other spine-related problems. [1] [2] [3]

One important point I want Bangladeshi patients to understand is that sciatica can range from mild and temporary to severe and disabling. Some people improve with time, activity modification, medicines, and physiotherapy, while others need imaging, injections, or surgery depending on the cause and severity. [1] [2] [3]

What Is Sciatica?

Sciatica refers to pain, tingling, numbness, or weakness caused by irritation of the sciatic nerve pathway. The sciatic nerve is the largest nerve in the body. It begins from nerve roots in the lower spine and travels through the buttock and down the leg. Because of this pathway, sciatica usually affects one side and may travel from the back into the hip, thigh, calf, or foot. [1] [3]

Many patients use the word “sciatica” for any leg pain, but not every leg pain is true sciatica. Muscle strain, hip disease, knee problems, vascular disease, and peripheral nerve problems can also cause pain in the leg. That is why proper assessment matters, especially when symptoms are severe or persistent.

Common Symptoms of Sciatica

Sciatica does not feel the same in every person. The symptoms depend on which nerve root is affected and how much pressure or inflammation is present.

Typical Symptoms

You may notice:

• pain starting in the lower back, buttock, or hip and going down one leg
• burning, stabbing, or electric-shock type pain
• tingling or pins-and-needles in the leg or foot
• numbness in part of the leg
• weakness when walking, climbing stairs, or lifting the foot
• pain that worsens with coughing, sneezing, bending, or prolonged sitting [1] [3]

Symptoms Patients in Dhaka Often Describe

When I evaluate patients with this problem, many tell me the pain becomes worse:

• after long traffic travel in buses, rickshaws, or cars
• after sitting for office work without back support
• after lifting heavy market bags or household items
• after sudden bending, twisting, or lifting
• after long periods of bed rest followed by sudden activity

These daily realities are very relevant in Dhaka and across Bangladesh, because repeated sitting, difficult commuting, and delayed physiotherapy access can all make recovery slower.

What Causes Sciatica?

Sciatica is usually caused by pressure on a nerve root in the lumbar spine. Several conditions can do this.

Herniated or Slipped Disc

A disc between the vertebrae may bulge or rupture and press on a nerve root. This is one of the most common causes of sciatica, especially in younger and middle-aged adults. [1] [3]

Lumbar Spinal Stenosis

As people get older, the spinal canal may become narrower because of degenerative changes. This can squeeze the nerves and produce back pain, leg pain, numbness, or weakness. [2] [3]

Degenerative Spine Changes

Age-related wear and tear in the discs, joints, and ligaments of the spine can contribute to nerve irritation and chronic symptoms. [2] [3]

Spondylolisthesis or Other Structural Problems

Sometimes one vertebra shifts relative to another or the spine develops mechanical instability, which can irritate nerve roots and cause sciatica-like symptoms. [3]

Less Common Causes

Less commonly, sciatica-like pain may be related to trauma, pelvic injury, inflammatory disease, or other nerve problems. Because of this, not every case should be self-treated for too long without proper review. [1] [2]

Who Is More Likely to Develop Sciatica?

Sciatica can affect many adults, but some factors increase the chance of developing it:

• prolonged sitting
• poor lifting technique
• repetitive bending or twisting
• physically demanding work
• weak core and back muscles
• obesity or excess body weight
• age-related spinal degeneration
• smoking
• poorly controlled diabetes and other nerve-related conditions [1] [2]

In Bangladesh, I also see sciatica in homemakers, drivers, office workers, garment-sector workers, manual laborers, and older adults who continue physically demanding activities despite pain.

How Sciatica Is Diagnosed

Diagnosis begins with a careful history and physical examination. I usually ask where the pain starts, where it travels, whether there is numbness or weakness, how long it has been present, and what activities make it worse or better.

Clinical Assessment

A good examination often includes:

• checking posture and walking
• testing leg strength
• checking sensation
• assessing reflexes
• looking for pain with nerve stretch tests
• examining the spine and hip together

This helps distinguish sciatica from hip pathology, muscle problems, or other causes of leg pain.

When Imaging Is Needed

Not every patient with sciatica needs an MRI immediately. Imaging becomes more important when: