Most episodes of sciatic leg pain naturally improve with time.

If it does not do so within a reasonable period of time, or if the symptoms are unacceptable, it is reasonable to consider treatment. What constitutes a reasonable period of time, and what are unacceptably severe symptoms, are of course subjective matters and will vary from one person to another.

When natural improvement occurs, it will usually be evident within the first six weeks and the patient should be showing good signs of recovery by three months. Not everybody can wait this length of time for symptoms to settle. If this is the case, or if symptoms have failed to show the expected improvement, nerve root block and/or microdiscectomy may well be appropriate.

If there is associated foot drop or other leg muscle weakness, again most patients will find natural improvement as the pain settles. However, if the weakness extends up to 12 weeks, patients at this stage are usually much better off with surgery to try and reverse the weakness, as the results of further watchful waiting or late surgery are much poorer.

There are other causes for leg pain, such as spinal stenosis. Please see spinal stenosis for further information.