When to see a doctor.

The red flags you must know

Go to the emergency room immediately if you experience:

• New problems with bladder or bowel control. Incontinence, inability to urinate, or loss of sensation during urination or defecation.
• Saddle numbness. Numbness or tingling in the groin, inner thighs, genitals, or buttocks—the area that would touch a saddle if you sat on a bike.
• Bilateral sciatica. Severe pain, numbness, or weakness in both legs at the same time.
• Sudden severe leg weakness. Difficulty walking, trouble lifting your foot, or your leg giving out.
• New sexual dysfunction not present before.

When you should make an appointment (not an emergency)

Book a regular visit with your primary care doctor or a physical therapist if:

• Your sciatica has lasted more than 6 weeks despite home treatment.
• The pain is getting worse over time, not better.
• You had a recent injury or fall.
• You have a history of cancer.
• You have unexplained weight loss or fever with the back pain.
• Pain is severe enough to disrupt sleep most nights.

What to expect at the appointment

Your doctor will likely begin with a physical exam—testing your reflexes, muscle strength, and how your pain responds to movement. The classic test is the straight leg raise: lying flat while your doctor lifts one leg. If this reproduces your pain, it’s often a sign of nerve root irritation.

Imaging (X-ray, MRI, or CT) isn’t usually needed for the first 4–6 weeks unless red flags are present or the pain is severe. First-line treatment typically includes physical therapy, over-the-counter pain relievers, and targeted exercises.

The bottom line

Sciatica is almost always something your body can heal on its own with the right support. But knowing when to escalate is not optional—it’s the single most important piece of knowledge to have. Save this page and share it with anyone you know who deals with back pain.