This plan follows the order guidelines recommend: rule out emergencies, keep moving, build strength, then consider injections before surgery. Work through it over 6 to 12 weeks and keep your doctor informed.
Step 1: Rule out emergencies
Saddle numbness, bladder or bowel problems, or weakness in both legs: emergency department now. See when surgery is needed.
Step 2: Keep moving (days 1 to 14)
Short walks several times a day. Avoid long bed rest and long sitting.
Step 3: Calm the nerve
Sciatica exercises daily; stop any that push pain further down the leg.
Step 4: Build strength (weeks 2 to 12)
A physiotherapy programme for core and hips.
Step 5: Pain relief
NSAIDs if safe for you, heat, and pacing. Avoid relying on gabapentin-type drugs for sciatica (NICE).
Step 6: If pain persists after 6 to 12 weeks, ask about injections
| Option | What to know |
|---|---|
| Epidural | Short-term relief for severe leg pain |
| PRP | Your own blood; small trials |
| Stem cells | Early studies; could help some people avoid or delay surgery |
Step 7: Before you agree to surgery
Get your MRI reviewed. A doctor can tell you whether a non-surgical option could still fit, or whether surgery is the right next step.
