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Conditions
Sciatica
Pain radiating along the sciatic nerve - from the lower back through the hip and down one leg. Can range from a mild ache to sharp, debilitating pain.
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Symptoms
CommonsymptomsofSciatica
An AHPRA-registered doctor assesses these symptoms online - no in-person visit required.
Pain radiating from lower back down one leg
Numbness or tingling in the leg or foot
Weakness in the affected leg
Sharp, burning or shooting pain
Pain worse when sitting or standing for long periods
Difficulty standing up or walking
Pain that worsens with coughing or sneezing
Our Scope
Howwecanhelp
InstantMed handles many common conditions entirely online. Here's what fits our service.
What we can help with
- Medical certificates for sciatica-related absences
- Initial assessment and management advice
- Guidance on when imaging is appropriate
- Physiotherapy and specialist referral recommendations
What needs in-person care
- Physical examination (some sciatica needs this)
- Spinal injections or surgical assessment
- Emergency cauda equina assessment
Depending on your situation, an AHPRA-registered doctor may be able to issue a medical certificate or arrange a repeat prescription after reviewing your request online.
Clinical Guidance
Whentoseeadoctor
These indicators suggest you should seek professional medical advice promptly.
Signs you need a doctor
- 1Pain lasting more than a few weeks
- 2Pain not responding to self-care
- 3Progressive weakness or numbness
- 4Pain significantly affecting daily activities
- 5You need a medical certificate for work
Seek emergency care if
- Loss of bladder or bowel control (cauda equina - emergency)
- Numbness in the groin or inner thighs
- Sudden severe weakness in both legs
- Sciatica after a significant injury
Call 000 or go to your nearest emergency department
Clinical Insight
Adoctor'sperspectiveonSciatica
InstantMed Clinical Team
AHPRA-registered medical team · Reviewed 2026-03
Sciatica describes a pattern of pain caused by irritation of the sciatic nerve - typically from a disc herniation compressing a nerve root in the lower spine. The diagnosis is clinical: pain radiating below the knee in a specific nerve distribution is the hallmark. What I assess remotely is whether the pattern is consistent with simple sciatica (pain only, no weakness, no bladder issues) or whether red flags suggest something requiring urgent investigation. The most critical red flag is cauda equina syndrome - compression of the nerve bundle at the base of the spine causing bilateral leg symptoms, saddle numbness, and bladder dysfunction. This is a surgical emergency. In the vast majority of cases, sciatica resolves with conservative management: staying active, pain relief, and time. The evidence does not support early MRI unless symptoms are worsening or not improving after 6 weeks.
Treatment
TreatingSciatica
Sciatica from disc herniation is usually managed conservatively. The eTG recommends NSAIDs as the most effective oral analgesics for radicular pain. Paracetamol has weaker evidence for nerve-related pain but is used as adjunct. Neuropathic agents (pregabalin, gabapentin) are used for persistent radicular symptoms when NSAIDs are insufficient, though evidence for sciatica specifically is mixed. Oral corticosteroids provide short-term relief in acute severe cases. Surgery (microdiscectomy) is reserved for progressive neurological deficit or failure of 6-12 weeks of conservative management.
Naproxen
Naprosyn, Inza
Class:NSAID
Typical dose:500mg twice daily with food; review after 2 weeks
PBS:PBS listed; $25.00 general / $7.70 concession (PBS, 2026)
- NSAIDs are first-line for sciatica per eTG -- more effective than paracetamol for radicular pain
- Anti-inflammatory mechanism targets the nerve root irritation component of disc herniation
- Take with food; avoid in cardiovascular disease, renal impairment, and peptic ulcer
- Reassess within 2 weeks; short-course preferred
Paracetamol
Panadol, Panamax
Class:Analgesic
Typical dose:500-1000mg every 4-6 hours; maximum 4g per 24 hours
PBS:Available OTC without prescription
- Adjunct to NSAIDs; weaker evidence for neuropathic pain components compared to NSAIDs
- Use when NSAIDs are contraindicated or for around-the-clock mild pain control
- Safe for most adults; well tolerated
Pregabalin
Lyrica, Pregabalin Sandoz
Class:Alpha-2-delta ligand / neuropathic analgesic
Typical dose:75mg twice daily, increasing to 150mg twice daily after 1 week if tolerated; maximum 300mg twice daily
PBS:PBS listed for neuropathic pain; $25.00 general / $7.70 concession (PBS, 2026)
- Used when NSAIDs provide insufficient relief for the neuropathic (burning, shooting) component of sciatica
- Evidence for sciatica specifically is mixed; eTG recommends a time-limited trial with reassessment at 4-6 weeks
- Common side effects: dizziness, sedation, weight gain -- start at low dose and titrate
- A telehealth consult can assess suitability and initiate a trial with clear review plan
Source: Therapeutic Guidelines -- Musculoskeletal and Oral, 2023; Cochrane Review: Drug therapy for sciatica (2020); Australian Commission on Safety and Quality in Health Care: Low Back Pain Clinical Care Standard. This information is educational only and does not replace clinical assessment.
Specialist referral: Urgent referral to a neurosurgeon or spinal surgeon if cauda equina syndrome is suspected (bilateral leg weakness, bladder or bowel incontinence, saddle anaesthesia). Elective referral to a spinal specialist if: progressive neurological deficit, severe pain unresponsive to 6-8 weeks of conservative management, or MRI confirms significant disc herniation amenable to surgical decompression. Physiotherapy referral as first-line for rehabilitation.
Sciatica in Australia
Sciatica affects 5-10% of people with low back pain - approximately 1-3% of the Australian population
It is most common between ages 30-50, particularly in occupations involving heavy lifting or prolonged sitting
80-90% of sciatica cases resolve without surgery within 6-12 weeks
Disc herniation is the most common cause, but spinal stenosis becomes more common after age 50
Recovery
Whattoexpect
Typical recovery timeline and return-to-work guidance for most patients.
Typical recovery
Most sciatica improves significantly within 4-6 weeks. 80-90% of cases resolve within 3 months without surgery. The leg pain typically improves before the back pain. Some residual numbness or tingling may take longer to resolve.
Return to work
For desk work: 1-2 weeks with ergonomic adjustments (frequent position changes, standing desk if available). For physical work: 4-8 weeks depending on severity. Avoid heavy lifting until symptoms resolve. A graduated return is safer than going straight back to full duties.
When to reassess
Seek urgent assessment if you develop bladder or bowel control problems, numbness in the groin area, progressive weakness in the leg, or if symptoms are not improving after 6 weeks. These may indicate a need for imaging or surgical referral.
Self-Care
ManagingSciaticaathome
Evidence-based tips to support your recovery alongside medical treatment.
Keep moving - short, frequent walks are one of the best things you can do. Avoid prolonged bed rest
Alternate between sitting, standing, and walking throughout the day - no single position for more than 30 minutes
Apply heat or ice to the lower back (whichever feels better) for 15-20 minutes at a time
Sleep on your side with a pillow between your knees to reduce spinal pressure
Anti-inflammatory medication (ibuprofen) may be more effective than paracetamol alone for nerve-related pain
Gentle stretches targeting the piriformis muscle and hamstrings can relieve pressure on the sciatic nerve
FAQ
CommonquestionsaboutSciatica
Answers to the most common questions from patients.
Yes. Sciatica can be severely debilitating, particularly for physical work or jobs requiring prolonged sitting. Our doctors can assess your situation and provide a certificate if appropriate.
Not usually in the first 6 weeks unless there are red flag symptoms (weakness, numbness, bladder/bowel changes). Most sciatica improves with conservative management. Imaging is considered if symptoms persist beyond 6-8 weeks or are worsening.
Most episodes of sciatica improve significantly within 4-6 weeks with conservative management. About 80-90% of people recover without surgery. Some people experience recurrent episodes.
Staying gently active is better than bed rest. Short walks, gentle stretching, and avoiding aggravating positions (prolonged sitting) help recovery. Complete bed rest can actually slow healing.
Ready to get help with Sciatica?
Australian-registered doctors review your request when available.
Full refund if the doctor declines.