Anyone who has experienced sciatica will know how excruciating the pain can be and the profound effect it can have on daily life.
A burning or stabbing sensation which radiates down one or both legs, or an electric shooting pain which can start in the lower back, hips or buttock and pulse downwards as far as the heels, it is endured by around three million people in the UK – wrecking sleep, making it impossible to work and preventing normal movement.
Such pain occurs when the roots of the sciatic nerve – the body’s largest nerve which runs from the base of the spine through the buttocks and down each leg – become inflamed or compressed. And while it is already a relatively common complaint, affecting one in four people at one point in their lifetime, anecdotally, experts suggest it may be becoming more prevalent and is affecting even younger adults.
Singer Adele, for example, who is 37, has been open about her ‘really bad’ sciatica – which stemmed from a slipped disc after sneezing in bed when she was 15 – which has caused her to spend half her life in pain and to ‘waddle’ on stage during her Las Vegas shows.
There are no official figures to back up the recent rise, partly because sciatica is the term used to describe a set of symptoms, rather than being a diagnosis in itself, and because it can develop as a result of other primary problems such as slipped or compressed discs (the ‘cushions’ between each vertebra), arthritis or osteoporosis.
But NHS England’s most recent Health Survey for England in 2024 found 26 per cent of adults report being in chronic pain of any kind, of whom more than half were struggling with back pain.
Sciatic pain is likely to be a significant part of that burden, experts say. And as the Health Foundation estimates that 1.9 million more adults could be living in chronic pain by 2040 – with back pain and other musculoskeletal problems the biggest part of that – it is clear that this is an issue which will affect increasing numbers of people.
It’s partly linked to the rising tide of obesity. Around one third of adults in the UK are now obese, up from 15 per cent in the early 1990s. Excess weight can, over time, contribute to the development of the conditions that lead to sciatica as well as putting additional pressure on joints and contributing to nerve compression, making it more likely that a sneeze or sudden twist could trigger it. It can also make sciatica worse if you do develop it.
Singer Adele, 37, has been open about her ‘really bad’ sciatica – which stemmed from a slipped disc after sneezing in bed when she was 15
In addition, more sedentary lifestyles post-Covid, and more jobs which are desk-based or involve working from home, are triggering a rise even in younger adults, experts say.
Consultant neurosurgeon Alireza Shoakazemi, honorary reader in medical education at Queen Mary University of London, says: ‘From what I’m seeing in my clinics, and from what’s known in the general population and backed by global studies, the number of people with sciatica is increasing.
‘In the UK these figures are rather hidden because sciatica can be caused by so many other problems and it’s considered a symptom, not a diagnosis.
‘An ageing population is part of it, but what I’ve observed is a trend for younger adults to develop it earlier. There are lots of reasons for that, but emerging evidence suggests more sedentary behaviour is a big factor – prolonged sitting, office working, and even things like conducting meetings in video calls rather than in person, may all be contributing.’
Last week, when The Mail on Sunday’s resident GP Dr Ellie Cannon asked readers to get in touch about their experiences of sciatica, we were flooded with responses. Some said they ‘couldn’t walk more than a step’ without excruciating pain.
One wrote: ‘I wouldn’t wish severe sciatica on my worst enemy. Waking every day to the constant, debilitating pain was really depressing. It does ruin your life.’
However, most insisted they had developed sciatica without being overweight or obese. Intriguingly, some questioned whether stress or bereavement might have triggered their physical pain, while others blamed more sedentary lifestyles during Covid.
In addition, several readers suggested that the modern habit of keeping a wallet or mobile phone in a rear pocket could be to blame.
Cat Merrick, a yoga teacher, is in extreme pain caused by a bulging disc which is pinching the root of the sciatic nerve
As one reader wrote: ‘Having large wallets stuffed in back pockets causes you to sit unevenly, placing additional pressure on the lower back and nerves.’
So how much of this is true – and what else might be triggering the suggested rise in sciatic pain?
John Sutcliffe, lead clinician at the London Spine Clinic, explains that there are several categories of patients who develop sciatica: those who develop general wear and tear of the joints as they age, those who are living more sedentary lives without the core strength they need to support their spine and lower back, and the super-fit, who may also end up with earlier wear and tear.
‘Ergonomics is a big issue, too – we saw a lot of people during lockdown who had been working from the sofa or bedrooms with poor postures and developed sciatic pain as a result,’ Mr Sutcliffe says. ‘That remains an issue as more people are working from home.
‘If you’re obese you may be more prone to it if you do something as simple as sneeze or twist or turn in bed, and sedentary lifestyles are contributing too. The counter to that is that lots of people also took up running or cycling in lockdown, and they weren’t fit or prepared enough, and that caused problems too.’
Stress can also be a trigger. Mr Sutcliffe adds: ‘We see lots of people who are fine on holiday, but their pain returns in the office.
‘When you’re stressed, the muscles tighten up, and if your core muscles aren’t strong then that pressure transfers to your spinal discs which can bulge out, compressing the nerve and causing pain.’
The theory about wallets or large modern smartphones wedged in back pockets triggering sciatic pain may also have some truth to it, Mr Sutcliffe suggests. The issue has been described in case reports in medical literature and referred to as ‘wallet neuritis’ – or fat wallet syndrome.
‘I’ve never come across this specifically, but anything that causes asymmetry can lead to pain – I’ve been known to stop people who are carrying rucksacks on one shoulder,’ he says. ‘And of the patients we see with back problems, about 15 per cent will have one leg slightly longer than the other.’
Treating sciatic pain can be tricky, and most people are initially advised to stay active, continue normal daily activities as much as possible and to use over-the-counter painkillers such as ibuprofen or paracetamol and heat or cold packs for pain relief.
Most people can resolve their sciatica within a few months by keeping up gentle movement.
‘Rest is the worst thing you can do,’ says Dr Dan Baumgardt, a GP and senior lecturer in pain at the University of Bristol. ‘Gentle stretching and getting out of bed is the main thing, otherwise the problem will only get worse.’
There are studies that suggest walking, gentle yoga and swimming are particularly good for easing sciatic pain, as long as you do it consistently and regularly.
If symptoms persist, physiotherapy will help with posture, strengthening the core muscles and keeping you mobile – although there are long waits for NHS treatment and most people will find their symptoms resolve before they can be seen. Other neuromodulator drugs, such as amitriptyline and gabapentin, can be prescribed if normal painkillers are not effective.
Adele, whose flare-ups came when she was stressed or sitting with bad posture, found that strengthening her core has helped.
In an interview, the singer said: ‘Where I got my tummy strong, down at the bottom, which I never had before, my back doesn’t play up as much. It means I can do more, I can run around with my kid more.’
Dr Esther Fox, a physiotherapist, says any consistent, low-impact exercise would make a difference to sciatica pain
Dr Esther Fox, a physiotherapist, has found that doing pilates several times a week has successfully staved off her sciatica over the past 20 years.
The 47-year-old, who runs the Mount Kelly Physiotherapy Centre in Tavistock, Devon, says any consistent, low-impact exercise would make a difference. ‘Honestly, there were times when I thought I would need a hip replacement,’ says Dr Fox, who is also a pilates instructor. ‘I’d be frightened to move because you know that shooting pain is coming. But I now no longer need to use any painkillers and only notice it coming back if I don’t do pilates for a few days.
‘Some people will need surgery, but for most it gets better by itself, and losing weight and being more active will help.’
One reader, from Redditch, Worcestershire, wrote to the MoS to say he got rid of his sciatica by losing weight and exercising.
The 64-year-old had piled on the pounds after giving up smoking, and was told by a physiotherapist that his sciatica was ‘a direct consequence’ of his weight. After changing his diet and three weeks of daily walking, his pain had gone. And two years on, he has not needed to see a doctor since.
He wrote: ‘When my treatment was complete, the physiotherapist told me that if all her patients took up daily walks, she would lose a lot of work.’
But for some patients with more extreme sciatic pain, steroid injections – designed to reduce inflammation – may be required. About 6 per cent of patients may require surgery, known as a discectomy, to remove the part of a bulging disc which is compressing a nerve.
The bad news is that, once someone has experienced sciatica, they are likely to have another episode. However, it is possible to reduce that risk.
‘Losing weight will potentially help, as will staying active – but find that sweet spot and don’t push it too hard,’ Dr Baumgardt says.
‘If poor posture or working from home or at a desk is the cause, speak to your occupational health team. Avoid prolonged sitting, and quit smoking – it can affect the integrity of blood supply and disc health too.’
Mr Shoakazemi advises his patients to set an alarm on their phones as a reminder to stand and move around every 30-40 minutes, and to keep computer monitors at eye level to promote good posture.
Mr Sutcliffe adds that those at risk should make sure to sit correctly in a chair.
‘Push your bum right to the back so your back is against the backrest and you’re sitting nice and upright – having an arm rest helps,’ he says. He also recommends core strengthening exercises, such as planks and bridges.
‘A few minutes a day can reduce the risk of having a significant problem that causes sciatica,’ he adds. ‘I can’t stress that enough.’