Could your sciatica be a sign of something serious? It’s possible.  As an Edinburgh osteopath for nearly 30 years, I’ve seen literally thousands of sciatica sufferers. I specialise in lower back pain and sciatica, so you’re in good hands here.  First, let’s just cover what sciatica is.  Then we can determine when it might be a symptom worth seeing your doctor about.

What is sciatica?

As I’ve said many times, sciatica is a description.  It’s not a diagnosis.  Sciatica simply means pain and/or pins and needles in the distribution of your sciatic nerve.  It doesn’t tell you why you have those symptoms.  It would be like going to the doctor saying I have a pain in my head and the doctor telling you “You have a headache”.  “Really!!??” you might be tempted to say.

What causes sciatica?

If you’d like to know the possible causes of sciatica, you can find more information on that here.

Sciatica – a sign of something serious. Why?

Pain is essentially a warning system.  It’s non-specific.  It’s your body’s way of telling you something is wrong.  There are a number of possible causes of sciatica.  The vast majority of cases of sciatica are due to problems with your muscular and/or skeletal system.  But about 0.1% of cases of sciatica are a sign of something serious.

Sciatica – a sign of something serious.  But what?

So, if you’ve read this far, you really do want to know what sciatica could represent…  Remember, the chance is slim.  The list of questjons below is really for people with lower back pain.  But it’s still relevant for you if you have sciatica.  If you answer “no” to all of the below, I wouldn’t normally recommend you see a doctor about it.

Danger questions related to sciatica

  • Compared with during your waking day, is your background pain worse when trying to sleep?  (Not the sharper pain you get when you’re turning over, just the constant type of ache).
  • Have you lost any great amount of weight without meaning to over the last year?
  • Have you been diagnosed with Cancer at any time?
  • Had lower back surgery in the last 2 years?
  • Do you have any weakness (rather than pain) in any of the following?

When standing, lifting either big toe up

When standing, pushing up onto the toes of one foot (compared with the other, or compared with what you would expect is your normal)


  • Do you have any numbness (lack of sensation) or pins and needles in your pelvic floor area (up between your upper thighs, the area you would sit on if on a saddle)?
  • Have you had any recent change in sexual function?  Loss of feeling, erection or ability to orgasm?
  • Do you have any difficulty urinating or defecating (using the toilet)?  e.g. trouble starting or stopping, or not aware of your bladder filling
  • Have you suffered any significant trauma recently, which in any way could impact on your lower back?
  • Been on a prolonged course of oral corticosteroids in the past or now?
  • Have you had a persistent high temperature recently?

So what can sciatica be a sign of exactly?

So, what are we talking about here?  Yes, all the nasties are on the list.  Cancer and vascular disease are the most likely pathologies to be related to sciatica.  But there are neurological diseases and others too.  BUT, remember, they’re really not common.

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