The good news is that serious sciatica is very rare!

As we saw in the last blog, sciatica can be very painful, but please be reassured that most episodes of sciatica will settle down well with good treatment and management. Rarely though, sciatica can be a sign of something more serious, and require different investigations and treatment.

Here’s what you need to look out for…

 If the nerves in the lower back that control the bladder and rectum, (and provide sensation to the genitals and anal area) are getting pinched, this needs medical attention urgently.

A sign that these nerves are affected could be that you can’t push your wee out very well, or at all. You may not feel sensation whilst wiping yourself after going to the toilet. If these symptoms develop suddenly with low back pain and sciatica you should seek attention that day, A&E if necessary. The reason for this is that these nerves don’t regenerate very well . If this condition is left for too long the numbness and bladder/bowel problems may become permanent.


Any practitioner that assesses your sciatica should always ask about your bladder, bowel and genital sensation.


 If you have a history of cancer, and this is a new episode of back pain/sciatica, this should always be monitored carefully. Very rarely tumours of the lumbar spine can cause pain and sciatica. These are nearly always secondary tumours (i.e., they will have spread from an existing or previous cancer). Back pain/sciatica associated with tumours tends to get worse and worse. You can’t find any comfortable position and might be feeling unwell and losing weight. Night pain might be preventing more than a couple of hours sleep.


Any practitioner that assesses you should always ask about your general health and whether you have a history of cancer. If you have a history of cancer and develop back pain/sciatica you should always make sure the person assessing you is aware of this.



Most sciatica is from mechanical causes, even if it is very severe, (see our previous blog), but it’s worth being aware of these signs to look out for, which might indicate that your sciatica is from a more serious cause.


If you have any concerns, or would like to book an appointment at the clinic please contact us.


exercises plympton osteopathic clinic plymouth mike bruce

Blog Author – Mike Bruce BSc. (Hons.), BSc.(Ost.)

After graduating with a first class degree from Nottingham University in Biology, Mike went on to study osteopathy at the British School of Osteopathy in London.

Mike works privately in Plympton and on an NHS Back Pain Clinic in Devonport. He has a special interest in Nerve Root Pain, Sciatica and Ergonomics.