Sciatica Treatment in Dubai
Who you'll see
Dr Sherief Elsayed
Consultant Spinal Surgeon, FRCS (Tr & Orth), UK-trained
Medically reviewed by Dr Sherief Elsayed, UK-trained Consultant Spinal Surgeon, FRCS (Tr & Orth). Last reviewed 15 October 2026.
Sciatica is pain that travels down the leg from an irritated nerve root in the lower back. This page explains what sciatica is and is not, its causes, how it is diagnosed, and the sciatica nerve treatment options in order, from self-care to surgery, with what the research shows. Dr Elsayed treats sciatica and performs both the injections and the operations used for it.
At a glance
- Most sciatica settles without an operation. In a trial of 183 people with sciatica, 87% reported improvement after 12 weeks, whether they rested in bed or not (Vroomen et al., 1999).
- NICE advises against gabapentinoids (such as pregabalin and gabapentin), other antiepileptics, oral steroids and benzodiazepines for sciatica, and against opioids for sciatica lasting 3 months or more (NICE NG59, recommendations 1.2.16 and 1.2.17).
- Surgery for a disc prolapse relieves leg pain faster than continued non-surgical care, but on average the results were similar by 1 year and still similar at 5 years (Peul et al., 2007; Lequin et al., 2013).
- Leg weakness that is getting worse needs a prompt specialist opinion. Numbness between the legs, or new bladder or bowel problems, need emergency care: call 998.
What is sciatica?
The sciatic nerve is formed from nerve roots that leave the lower spine, and runs through the buttock and down the leg. Sciatica is pain caused when one of those roots is compressed or inflamed, usually inside the spine. Doctors call this lumbar radicular pain; when the nerve is also not working properly (numbness, weakness or reduced reflexes), it is called radiculopathy.
Typical symptoms
- Pain spreading from the buttock down the leg, often below the knee and sometimes into the foot, usually on one side.
- Leg pain that is usually worse than any back pain.
- A burning, shooting or electric quality, often worse with sitting, coughing or sneezing.
- Pins and needles or numbness in a strip of the leg or foot; the pattern points to the nerve root involved.
- In some people, weakness, such as difficulty lifting the front of the foot or rising onto tiptoe.
What is not sciatica
Leg pain has other causes, and telling them apart changes the treatment.
- Referred pain from the back. Discs, facet joints and muscles in the lower back can cause a deep ache in the buttock or thigh that rarely goes below the knee, without numbness in a nerve pattern; see back pain treatment in Dubai.
- The hip. Hip arthritis typically causes groin pain, stiffness and difficulty putting on socks; see the difference between sciatica and hip arthritis.
- Piriformis syndrome. Buttock pain thought to come from the sciatic nerve being irritated by a muscle deep in the buttock. With no agreed test, it is usually considered once spinal causes have been excluded; see piriformis syndrome.
- Other causes. Burning or numbness in both feet suggests damage to the nerves in the legs (peripheral neuropathy), for example from diabetes. Calf pain on walking that eases when you stand still can come from poor circulation.
What causes sciatica?
- Disc prolapse. The most common cause. The soft centre of a disc pushes out through its tougher outer wall and presses on, or inflames, a nerve root, most often at the two lowest levels. It is also called a herniated or slipped disc; see herniated disc.
- Narrowing where the nerve leaves the spine. With age, bony overgrowth, a thickened ligament and a bulging disc can narrow the side channel (lateral recess stenosis) or the exit opening (foraminal stenosis) that a nerve root passes through; see spinal stenosis treatment in Dubai. Narrowing of the central canal more often causes heaviness in both legs on walking (neurogenic claudication).
- Spondylolisthesis. One vertebra slips forward on the one below, which can narrow the exit opening and pinch a nerve root.
- Rarer causes. A cyst from a facet joint, infection, a tumour or a fracture. NICE asks doctors to think about other diagnoses, especially when symptoms are new or changing (NICE NG59, recommendation 1.1.1).
How long does sciatica last?
For most people, sciatica improves over weeks to a few months.
- In a Dutch trial of 283 people with severe sciatica lasting 6 to 12 weeks, 95% in both groups reported recovery at 1 year, whether they had early surgery or continued non-surgical care with surgery only if needed (Peul et al., 2007).
- A disc prolapse can shrink by itself. In a systematic review, shrinkage on repeat scans was seen in 96% of sequestered discs (where a fragment has broken free), 70% of extrusions, 41% of protrusions and 13% of bulges (Chiu et al., 2015).
- Not everyone recovers fully. Five years after the Dutch trial, 21% reported an unsatisfactory recovery, with no significant difference between the treatment groups (Lequin et al., 2013).
How sciatica is diagnosed
History and examination
Sciatica is diagnosed mainly from your history and examination. You will be asked where the pain travels, about numbness and weakness, and about bladder and bowel function and warning signs such as fever, weight loss or a history of cancer. The examination includes:
- Straight leg raise. You lie on your back while your straightened leg is lifted. Reproducing your usual leg pain suggests an irritated nerve root. In people being assessed for surgery, the test was positive in 92% of those with a disc prolapse but also in most of those without one, so on its own it does not prove a prolapse (van der Windt et al., 2010).
- Strength, reflexes and sensation, to identify which nerve root is involved and whether it is losing function. Each test alone is not very accurate, so they are interpreted together (van der Windt et al., 2010).
- The hip and circulation, to rule out conditions that mimic sciatica.
Do you need an MRI scan?
Not always, and not straight away. NICE advises against routine imaging outside specialist care, and says specialists should consider it only if the result is likely to change management (NICE NG59, recommendations 1.1.4 and 1.1.6). Disc changes are common without pain: in a review of 3,110 people with no symptoms, disc bulges were found in 30% of 20-year-olds and 84% of 80-year-olds (Brinjikji et al., 2015). A scan must match your symptoms and examination to be meaningful.
An MRI is useful when:
- there are signs of cauda equina syndrome (an emergency scan is needed);
- leg weakness is significant or getting worse;
- infection, a tumour or a fracture is suspected;
- pain has not settled after several weeks and an injection or surgery is being considered.
X-rays show the bones and their alignment but not discs or nerves. Nerve conduction studies are occasionally used when the picture is unclear.
Sciatica treatment: the options in order
Most people start with the simplest steps and move on only if the pain is not settling. The pace depends on the severity, the duration and whether there is weakness.
1. Staying active and self-management
NICE advises information about sciatica and encouragement to continue normal activities, including work where possible (NICE NG59, recommendations 1.2.1 and 1.2.15). Bed rest does not speed recovery (Vroomen et al., 1999). Keep moving within comfort, with short, frequent walks, and break up long periods of sitting, including long drives.
2. Physiotherapy and exercise
NICE advises considering a group exercise programme, and manual therapy such as manipulation or massage only as part of a package that includes exercise (NICE NG59, recommendations 1.2.2 and 1.2.7). In a review of 5 trials, structured exercise eased leg pain slightly more than advice to stay active in the short term, with no difference in the longer term (Fernandez et al., 2015). A physiotherapist can tailor and progress the exercises as the nerve settles.
3. Medicines
NICE reviewed medicines for sciatica in 2020:
- Anti-inflammatories (NSAIDs), such as ibuprofen or naproxen. The evidence of benefit is limited and there are known risks. If used, NICE advises the lowest effective dose for the shortest time, taking account of stomach, kidney and heart risks (NICE NG59, recommendations 1.2.20 and 1.2.21).
- Gabapentinoids and other antiepileptics (such as pregabalin and gabapentin), oral steroids (such as prednisolone) and benzodiazepines (such as diazepam, sometimes given as a muscle relaxant). NICE advises against all of these for sciatica: there is no overall evidence of benefit and there is evidence of harm (NICE NG59, recommendation 1.2.16). In a placebo-controlled trial of 209 people, pregabalin did not reduce leg pain at 8 weeks or 1 year and caused more side effects, particularly dizziness (Mathieson et al., 2017); a review of 9 trials agreed (Enke et al., 2018). In a trial of 269 people, a 15-day course of prednisone modestly improved function but not pain, and side effects were about twice as common as with placebo (49% versus 24%) (Goldberg et al., 2015).
- Opioids, such as tramadol or codeine. NICE advises against them for sciatica lasting 3 months or more (NICE NG59, recommendation 1.2.17), and has called for more research on their use in more recent sciatica.
If you already take one of these medicines, do not stop it suddenly on your own. NICE advises discussing the risks of continuing and the problems coming off can cause, so that any change is planned with you (NICE NG59, recommendations 1.2.18 and 1.2.19).
4. Epidural steroid injection
For acute (under 3 months) and severe sciatica, NICE advises considering an epidural injection of local anaesthetic and steroid (NICE NG59, recommendation 1.3.5). It places medicine around the irritated nerve root to calm the inflammation. It does not remove the disc; the aim is to ease pain while the nerve recovers and you keep moving. A nerve root block, which targets a single nerve, can also help confirm which level is responsible before surgery.
Dr Elsayed performs these injections at American Hospital Dubai. Who benefits, the risks and the evidence are on the epidural steroid injection page.
5. Surgery: discectomy and decompression
Surgery removes what is pressing on the nerve: the displaced disc fragment (discectomy), or bone and thickened ligament narrowing the nerve’s channel (decompression). Some slips (spondylolisthesis) may also need the vertebrae to be fused.
Dr Elsayed performs discectomy and decompression for sciatica, by microdiscectomy (using a microscope through a small incision) or by endoscopic discectomy, through either the transforaminal or the interlaminar route, depending on where the disc fragment lies. He operates at American Hospital Dubai (Oud Metha and Dubai Science Park) and Emirates Hospital Jumeirah. The operation, recovery, return to work and the risks are explained on the herniated disc page.
When is surgery considered? NICE advises considering decompression for sciatica when non-surgical treatment has not improved pain or function and the scan findings are consistent with the symptoms. It also says weight, smoking or psychological distress should not influence referral for a surgical opinion (NICE NG59, recommendations 1.3.7 and 1.3.8). Most people choose surgery because the leg pain is too severe or has lasted too long, not because waiting is dangerous; the exceptions are significant or worsening weakness and cauda equina syndrome.
What the trials show
- Faster relief. In the Dutch Sciatica Trial, 283 people with severe sciatica for 6 to 12 weeks were assigned to early microdiscectomy or to continued non-surgical care, with surgery if needed. Leg pain eased faster after early surgery, but disability over the first year did not differ significantly, and recovery at 1 year was similar. In the non-surgical group, 39% had surgery during that year (Peul et al., 2007).
- Similar long-term results. At 5 years there were still no significant differences, and 46% of the non-surgical group had eventually had surgery (Lequin et al., 2013).
- SPORT. In a US trial of 501 people, both groups improved substantially; differences favoured surgery but were small and not statistically significant, partly because many people switched treatment (Weinstein et al., 2006). At 8 years, in a non-randomised comparison, those who had surgery reported greater improvement, with little worsening in either group after year 4 (Lurie et al., 2014).
- Longer-lasting sciatica. In a Canadian trial of people with sciatica for 4 to 12 months, average leg pain at 6 months was 2.8 out of 10 after microdiscectomy and 5.2 with non-surgical care (Bailey et al., 2020).
Comparing the options
| Option | What the evidence shows |
|---|---|
| Staying active | Bed rest does not speed recovery |
| Exercise and physiotherapy | A small extra benefit in the short term over advice alone |
| Anti-inflammatories (NSAIDs) | Limited benefit; known side effects |
| Pregabalin, gabapentin, oral steroids, benzodiazepines | No overall benefit; more side effects |
| Opioids | Not for long-term use; risk of dependence |
| Epidural steroid injection | Can ease leg pain while the nerve settles; benefit varies between people |
| Surgery | Faster relief; similar average results at 1 and 5 years |
When to see a sciatica specialist sooner
Seek a prompt specialist opinion if you have:
- leg weakness that is significant or getting worse;
- a foot drop: weakness lifting the front of the foot, so that the toes catch or the foot slaps down as you walk;
- numbness that is spreading;
- pain that cannot be controlled, or that is not easing after about 6 weeks;
- fever, unexplained weight loss, a history of cancer, or sciatica after a significant injury.
Weakness is a reason to be assessed quickly, not automatically a reason to operate. Among 150 people with moderate or severe weakness in the Dutch trial, strength recovered faster after early surgery, but by 1 year 81% and 80% had fully recovered; severe weakness at the start predicted lasting weakness (Overdevest et al., 2014). Severe or worsening weakness, including a new foot drop, should be assessed by a spinal surgeon within 24 hours. Please mention new weakness when you book.
If you are not sure which kind of doctor to see first, the guide on which specialist to see for a spine problem explains the options.
Symptoms that need urgent care
Call 998 (UAE ambulance) or go to the nearest emergency department straight away if you develop:
- numbness between the legs, or around the genitals or back passage;
- new difficulty passing urine, loss of bladder or bowel control, or new loss of sexual function;
- sciatica in both legs, or leg weakness that is getting worse quickly.
These can be signs of cauda equina syndrome, in which the bundle of nerve roots at the bottom of the spinal canal is compressed. It needs an emergency MRI scan and, if confirmed, usually urgent surgery.
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Your consultation with Dr Sherief Elsayed
Dr Sherief Elsayed is a UK-trained Consultant Spinal Surgeon, FRCS (Tr & Orth). He treats sciatica at every stage: he advises on self-management and physiotherapy, performs epidurals and nerve root blocks, and carries out discectomy and decompression when surgery is needed, so the options can be weighed at one consultation. He will take a full history, examine your back, legs and hips, and review your MRI or arrange one if it is likely to change the plan.
He sees patients at OrthoPro Clinic, Dubai Science Park, and at UPANDRUNNING on Al Wasl Road; injections are performed at American Hospital Dubai. To book, call OrthoPro Clinic on 04 835 9000, send a WhatsApp message to 052 105 2798, or use the contact page. Please bring any scans, reports and a list of your medicines. Fees depend on the procedure and your insurance. Most major insurance accepted. Please check with reception.
Frequently asked questions
Most episodes improve over weeks to a few months; in one trial, 87% of people reported improvement by 12 weeks. A minority have symptoms that last longer.
No. Bed rest does not speed recovery. Keep moving within comfort and break up long periods of sitting.
Not always. It is needed for warning signs or significant weakness, or when an injection or surgery is being considered.
Trials have not shown a benefit, and side effects such as dizziness are more common than with a placebo, so NICE advises against them for sciatica. If you already take one, do not stop it suddenly; plan any change with your doctor.
No. An epidural does not remove the disc; it aims to ease the pain while natural recovery happens.
Surgery is considered when pain or function has not improved with non-surgical care and the MRI matches your symptoms, or sooner for severe or worsening weakness. Cauda equina syndrome needs emergency treatment.
Yes, for some people. A disc can prolapse again, including after surgery, and in one large trial at least 23% of people had symptoms that came and went over 5 years, whichever treatment they had.