Probability of Developing Sciatica

Sciatica, pain that radiates along the sciatic nerve from the lower back through the hip and down the leg, affects approximately 40% of people at some point during their lifetime. The annual incidence is about 1-5% of the population. It is the most common form of radiculopathy and a leading cause of work disability.

The most common cause is a herniated lumbar disc (about 90% of cases), which compresses the nerve root. Other causes include spinal stenosis, spondylolisthesis, piriformis syndrome, and rarely, tumors or infections. Risk factors include age (peak incidence 40-50 years), obesity, sedentary lifestyle, occupations involving heavy lifting or prolonged sitting, and diabetes.

Most cases of sciatica resolve within 4-6 weeks with conservative treatment. About 80-90% of patients improve without surgery. First-line treatments include physical therapy (the most evidence-based approach), NSAIDs, activity modification, and short courses of oral corticosteroids. Epidural steroid injections may provide temporary relief for severe cases. Surgery (microdiscectomy) is considered when conservative treatment fails after 6-12 weeks or when there are progressive neurological deficits.